Heart Failure: Management of Decompensation


exp date isn't null, but text field is

Back to Heart Failure: Assessment and Investigations

Back to Heart Failure: Diagnosis (new)

Back to Heart Failure: Medical management


  • Disease process
  • Fluid and weight management
  • Early warning signs (traffic lights)
  • Medication concordance
  • Cardiac rehabilitation
  • Immunisation
  • Social support

Cardiac devices

The choice of device will be decided by the cardiology team based on the following criteria:

Implantable Defibrillator (ICD) Primary Indications

  • QRS <120mms
  • Ejection fraction < 35% (equivalent to moderate/severe LVSD)

Cardiac Resynchronisation Therapy (CRT +/- D)

  • QRS >120mms
  • Ejection fraction <35% (equivalent to moderate/severe LVSD)

Referral to nurse led heart failure service

The Nurse Led Heart Failure Service provides a comprehensive care package for heart failure patients, working in partnership between primary and secondary care.

Referrals can be made by any member of the multidisciplinary team as long as the following criteria are met:

  • Patient must have documented evidence of heart failure due to left ventricular systolic dysfunction (LVSD) (either by echo, MUGA scan or angiogram).


  • Be symptomatic despite medical therapy


  • Had a recent hospital admission due to heart failure

Ultimately- patient must be willing to be part of the service.

Benefits can include

  • Education- to detect early warning signs and symptoms and to enable self management
  • Medication optimization
  • On-going support for patient and carer
  • Palliative Care Support

For more details please contact your local Heart Failure Nurse or contact the main Heart Failure Office on 01463 704628 or email nhsh.heartfailureservice@nhs.scot

Patient name and CHI number needed for referrals.

Further information

Patient information can be accessed here


Abbreviation Meaning
ACE inhibitor Angiotensin-converting-enzyme inhibitors
ARB Angiotensin receptor blockers
ECG Electrocardiogram
LVSD Left ventricular systolic dysfunction
CHSS Chest, Heart and Stroke Scotland

Last reviewed: 21 December 2017

Next review: 31 December 2019

Author(s): Cardiovascular Improvement Group

Approved By: TAM subgroup of ADTC

Reviewer Name(s): Consultant Cardiologist and Lead Heart Failure nurse

Document Id: TAM132