HeFSSA Practitioners Program 2014 - Case 1 - A male patient ( long distance truck driver) presents, previously well, with significant hypertension and acute pulmonary oedema. There is a background history of poorly controlled hypertension over years, recent episode of gout and a history of marital strife. This is a good case to illustrate the commonest form of AHF related to HF-PEF and hypertension. The implications of long standing uncontrolled hypertension, LVH, probable use of NSAID's for the gout and a ppt of renal dysfunction and AHF. The role of emotional stress could also be discussed. Management with diuretic, nitrate and possible NIV can be discussed. The different pathophysiology of this case as a problem of " fluid redistribution" should be discussed and the implications therefore on prescribed therapy.

HeFSSA Practitioners Program 2014 - Case 2 - A patient with known HF-REF, related to burnt out sarcoidosis, with LBBB, and a history of intermittent atrial fibrillation, presents after days of deteriorating functional class into casualty with severe SOB on exertion, but comfortable at rest. This is a good case to discuss the next commonest form of AHF - deterioration in patient with known HF-REF. The pathophysiology in this case ( in contrast to case 1) is or of fluid overload and gradual neurohormonal activation. The importance of precipitating factors will be highlighted, a brief discussion of sarcoidosis and the heart, and the approach to management with higher dose diuretics, possible inotrope use, the problem of withdrawal of background therapy will be discussed. The role of devices will be discussed here together with other options to prevent recurrent hospitalisations .

HeFSSA Practitioners Program 2014 - Case 3 - An elderly woman presents with chest pain intermittently over days, associated with SOB and fatigue and 1 episode of syncope. She has been hypertensive in the past and has refused to take statins for her Hypercholesterolemia because she says she is too old. She presents to casualty at 00H30 on a Sunday evening after returning from Australia on the Saturday. This case is to illustrate the wide differential associated with a diagnosis of AHF - and is to illustrate that the question must be asked about if this is not AHF, what else could it be- eg Pulmonary Embolus, Pneumonia etc. It also highlights the cardiac differential diagnoses including ACS, tight aortic stenosis, bilateral renal artery stenoses etc. the timing of her casualty visit is important as often these patients present when the least experienced doctors are on duty and the challenge of diagnosing the condition is significant. The role of statins in the elderly can also be discussed. This is a case of ACS related to severe CAD, but the differential should be discussed , as well as the management of ACS and AHF.

HeFSSA Practitioners Program 2014 - Case 4 - A talk on HF-PEF, it's presumed pathophysiology, associated conditions and "failed" trials of therapy. The point that these patients have a worse prognosis than just hypertensive patients without heart failure should be made.

ESC Guidelines on Chronic Heart Failure - HeFSSA Practitioners Program 2013

Clinical Case Presentation 3 - HeFSSA Practitioners Program 2013

Clinical Case Presentation 2 - HeFSSA Practitioners Program 2013

August 2, 2014 - Umdlalo Lodge, 20 Rethman Drive, Umtentweni, Kwa ZuluNatal
Hefssa Practitioner's Program 2014 - Port Shepstone

August 2, 2014 - Protea Hotel Willow Lake, 101 Henry Street, Willows, Bloemfontein
Hefssa Practitioner's Program 2014 - Bloemfontein

August 2, 2014 - Ibhayi Hotel
Hefssa Practitioner's Program 2014 - Port Elizabeth

August 16, 2014 - Arebbusch, 1 Golf Street, Olympia, Windhoek
Hefssa Practitioner's Program 2014 - Windhoek

October 16, 2014 - Durban ICC
SA Heart Congress 2014