Heart failure
Heart failure is a clinical syndrome of breathlessness, fatigue and fluid retention caused by a heart that cannot pump or fill normally. Early diagnosis and modern medical therapy transform the outlook — but the workup needs to be focused and the medication titrated carefully.
Led by our consultant cardiology team at The Vesey, Sutton Coldfield. Same-week appointments typical. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix). No GP referral required.
What it is
Heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF) have overlapping symptoms but different management. Common drivers are ischaemic heart disease, hypertension, valvular disease, atrial fibrillation, and (increasingly) diabetes and obesity. NT-proBNP and echocardiogram are the two investigations every patient needs.
Symptoms and signs
- Breathlessness on exertion, progressing to breathlessness on lying flat (orthopnoea) or waking at night (paroxysmal nocturnal dyspnoea).
- Ankle and leg swelling, usually pitting, worse at the end of the day.
- Fatigue out of proportion to activity, reduced exercise tolerance.
- Unintended weight gain (fluid) or weight loss (cardiac cachexia in advanced disease).
- Cough, particularly at night; occasionally frothy or pink sputum.
How we investigate
NT-proBNP, echocardiogram (with global longitudinal strain where available), 12-lead ECG, full blood count, electrolytes, kidney function, HbA1c, thyroid function, iron studies, and ambulatory BP. Cardiac MRI where the echo is inconclusive or aetiology unclear. Sleep study where central or obstructive sleep apnoea is suspected.
Treatment options at The Vesey
- Four pillars of HFrEF therapy — ACE inhibitor or sacubitril/valsartan, beta-blocker, MRA (spironolactone or eplerenone), SGLT2 inhibitor — titrated carefully with regular review.
- Diuretic therapy — loop diuretic for fluid management, adjusted to daily weights.
- HFpEF management — SGLT2 inhibitor, BP control, AF management, exercise rehabilitation.
- Device therapy referral — direct consultant-to-consultant pathway for ICD or CRT where indicated.
- Coordinated long-term review — every 3 months until stable, with shared-care arrangements with your NHS GP.
What is the difference between HFrEF and HFpEF? +
HFrEF (heart failure with reduced ejection fraction) means the heart muscle is weak and pumps poorly — ejection fraction below 40%. HFpEF (preserved ejection fraction) means the heart pumps adequately but is stiff and fills poorly — ejection fraction above 50%. The distinction matters because medication choices differ significantly.
What is NT-proBNP and why is it measured? +
NT-proBNP is a hormone released by stretched or stressed heart muscle. Elevated levels strongly support a diagnosis of heart failure; a normal result makes heart failure unlikely. It is available as a same-visit blood test at The Vesey and guides whether further imaging is needed.
Can heart failure be reversed or cured? +
Some causes of heart failure are reversible — tachycardia-induced cardiomyopathy, alcohol-related cardiomyopathy, and post-viral myocarditis can improve dramatically with treatment. Many other forms stabilise with modern guideline-directed medication. Complete cure is not always possible but significant improvement in quality of life and prognosis is the norm with optimal management.
What are the four pillars of HFrEF treatment? +
Current guidelines recommend four drug classes together: an ACE inhibitor or sacubitril/valsartan (ARNi), a beta-blocker, a mineralocorticoid receptor antagonist (spironolactone or eplerenone), and an SGLT2 inhibitor. Each class reduces mortality independently and the combination is strongly synergistic.
Pricing at a glance
Initial consultant cardiology consultation £290 (includes ECG). NT-proBNP from £90. Echocardiogram from £320. Cardiac MRI from £750. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to see a specialist
Book if you have been told you have heart failure but are not on full guideline-directed therapy, if your symptoms have changed despite treatment, or if you have new breathlessness or ankle swelling that has not yet been investigated.
Cost and pathway
Initial consultant cardiology consultation £290 (includes ECG). NT-proBNP from £90. Echocardiogram from £320. Cardiac MRI from £750. Self-pay and insurance accepted.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our consultant cardiology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.87/5 on Doctify from 700+ verified reviews
View our cardiology services →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727