Reflective accounts

Heart failure: part 1

A CPD article improved Anita Skinner’s knowledge of the pathophysiology, signs and symptoms of chronic heart failure.

A CPD article improved Anita Skinner’s knowledge of the pathophysiology, signs and symptoms of chronic heart failure


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What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article was the first of a two-part series on chronic heart failure. It examined the physiology of the heart, the causes and types of chronic heart failure, and its signs and symptoms. 

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

Chronic heart failure is a common clinical syndrome that results from impaired cardiac relaxation or contraction following a loss of myocardial cells through injury. I learned that chronic heart failure can occur in all age groups; however, it is more common in older people.

From reading the article, I learned that the prevalence of chronic heart failure is increasing, primarily as a result of improved survival rates from ischaemic heart disease and an ageing population. Chronic heart failure is not a disease in itself, but develops secondary to another disease process such as hypertension, coronary heart disease, congenital heart disease and arrhythmias.

I learned that breathlessness is considered the most debilitating symptom of chronic heart failure; however, patients may also experience fatigue, pain and peripheral oedema. As well as physical symptoms, people with chronic heart failure may also experience mental health issues such as anxiety and depression.

How did you change or improve your practice?

Reading the article has improved my understanding of the symptoms that affect the patients I care for with chronic heart failure. I am now aware that breathlessness secondary to chronic heart failure can be acute or chronic, and I will inform patients that chronic breathlessness is usually associated with exertion, which causes limitations in physical activity. 

The article also outlined various types of breathlessness, including orthopnoea, which takes place when patients are lying flat, and paroxysmal nocturnal dyspnoea, which involves the sensation of sudden breathlessness at night. In my practice, I will ensure patients experiencing breathlessness are holistically assessed to identify the underlying cause.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

Nurses can use the information about chronic heart failure provided in the article to improve their understanding of the condition and enhance patient care, in accordance with the theme of practising effectively. 

The article also outlined the signs and symptoms of chronic heart failure, as well as its potential effects on patients’ mental health. This is relevant to the theme of prioritising people, which states that nurses must assess and respond to patient’s physical and psychological needs.

Anita Skinner is manager at Red House Nursing Home, Kent


This reflective account is based on NS875 Brake R, Jones ID (2017) Chronic heart failure part 1: pathophysiology, signs and symptoms. Nursing Standard. 31, 19, 54-60. 

Write your own reflective account

You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a reflective account. To write a reflective account for Nursing Standard, use the NMC reflective accounts form. Complete the four questions about a CPD article you have read, writing about 700 words in total.

The authors of reflective accounts that are published in Nursing Standard receive a £50 book token. Details of how to submit your reflective account for publication are available here.

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