Diagnosis and initial management of heart failure

Timely diagnosis of heart failure leads to anticipated introduction of effective treatments, improved quality of life, and better outcomes. However, for many patients, diagnosis of heart failure is still made too late for a variety of reasons, including the heterogeneity and lack of specificity of its signs and symptoms, the absence of universally accepted diagnostic criteria and limited access to specialist care. Implementing and potentially expanding the use of natriuretic peptide testing for individuals at high risk can aid identification of preclinical cardiac dysfunction amenable to treatment, delay progression of disease or refute a heart failure diagnosis in equivocal cases. In addition, greater public awareness of the signs and symptoms of heart failure and how it differs from other cardiovascular diseases may lead affected individuals to seek prompt medical attention. Improving early diagnosis and treatment relies on bringing heart failure to the fore in both the public arena and the clinic.