Diagnosing Heart Failure – Experience and ‘Best Pathways’

Abstract

Heart failure is a clinical syndrome associated with high rates of morbidity and mortality and associated healthcare costs. The burden of heart failure is likely to increase with time, but effective treatments that improve quality of life and survival are available. Accurate and timely diagnosis is crucial to ensure patients receive appropriate treatment and avoid hospital admissions. However, diagnosing heart failure can be difficult as symptoms and signs commonly overlap with other conditions. A chest X-ray can be useful to identify evidence of heart failure or other lung pathology; however, a normal result does not rule out a diagnosis of heart failure. An electrocardiogram (ECG) is often abnormal in patients with heart failure, although up to 10% of patients may have a normal ECG. Natriuretic peptides are a useful biomarker for heart failure and a negative result can rule out the diagnosis. This can be helpful in determining who should be referred for echocardiogram. A new clinical-decision rule (CDR) could help clinicians to achieve a more timely and accurate diagnosis of heart failure.