Mending Hearts in Northland: It's Not Rocket Science

Applying heart failure (HF) guidelines in a rural hospital clinic setting can result significant improvements patient outcomes. We describe the early days of HF service. Northland has one highest cardiovascular disease and death rates country; addition, access to primary care is suboptimal for variety reasons. In late 2019, cardiologist with an interest took over responsibility cardiology clinics mid far North. The data below relate 86 consecutive patients diagnosis reduced ejection fraction (rEF), attending either Kaitaia or Bay Of Islands hospitals between October 2019 March 2020. patients, 85% were male 71% Māori. average age was 62.2 years, ranging 25–84 years median 63 years. 38% diabetic, almost all type 2. Causative contributing factors included ischaemic 24% alcohol 41%. Methamphetamine familial/genetic causes involved 7% each. Usual guideline recommended therapy utilised followed up (EF) results are shown below.Tabled 1Year20182019202020212022Average EF%29.729.930.435.338.8 Open table new tab Four died, five relocated, there issues adherence that likely contributed delayed and/or poorer outcomes 15%. Contributors EF improvement will be described elsewhere. This real-life highlight complex burden Northland, but how relatively successful guideline-focused management strategy be.