1- Algorithm For Diagnosis of Non-Acute Heart Failure – From 2016 ESC Heart Failure Guidelines

Be sure to also review 2016 ESC Guidelines for the diagnosis
and treatment of acute and chronic heart failure – Web Addenda [Full Text PDF]. This resource has useful tables not included in the HTML or PDF copies. Examples include

The following are excerpts from the 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:

4.3 Algorithm for the diagnosis of heart failure

4.3.1 Algorithm for the diagnosis of heart failure in the

non-acute setting

An algorithm for the diagnosis of HF in the non-acute setting is

shown in Figure 4.1.

The diagnosis of HF in the acute setting is discussed in Section 12 [See my post HF in the Acute Setting].

For patients presenting with symptoms or signs for the first time, non-urgently in primary care or in a hospital outpatient clinic (Table 4.1), the probability of HF should first be evaluated based on the patient’s prior clinical history [e.g. coronary artery disease (CAD), arterial hypertension, diuretic use], presenting symptoms (e.g. orthopnoea), physical examination (e.g. bilateral oedema, in-creased jugular venous pressure, displaced apical beat) and resting ECG. If all elements are normal, HF is highly unlikely and other diagnoses need to be considered. If at least one element is abnormal,plasma NPs should be measured, if available, to identify those who need echocardiography (an echocardiogram is indicated if the NP level is above the exclusion threshold or if circulating NP levels cannot be assessed).55 – 60,75 – 78

Resources

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. [PubMed Citation] [Full Text HTML] [Full Text PDF]. Eur J Heart Fail. 2016 Aug;18(8):891-975. doi: 10.1002/ejhf.592. Epub 2016 May 20.

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart
failure – Web Addenda [Full Text PDF -you may need t register for a free ESC account to access this resource]