Diagnosis, referral & management


Diagnosing heart failure

For patients with HF, early diagnosis and treatment can be essential to wellbeing.1

HF can present either acutely or as a progressive condition characterised by shortness of breath, coughing or wheezing, fatigue, fluid retention in the legs and/or abdomen, and/or reduced ability to exercise or perform physically demanding activities.2

HF is typically diagnosed through a combination of examinations.2


An assay to diagnose and stratify at-risk patients

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a cardiac biomarker that can help diagnose HF, assess risk and inform clinical decision-making. Elevated serum levels of NT-proBNP may indicate HF and levels tend to increase with disease severity.4

Managing heart failure

Even with current HF standard of care, nine out of ten patients remain symptomatic and are still at risk of hospitalisation for heart failure and cardiovascular death.5*

Prevention of HF by addressing its most common causes and screening for asymptomatic left ventricular (LV) dysfunction in high-risk individuals is the ideal scenario.
6 However, for patients diagnosed with HF, the primary goals of management are to:6

  1. Treat the underlying cause
  2. Improve clinical status, function, and quality of life
  3. Prevent hospitalisations
  4. Reduce mortality

Comprehensive heart failure management should include a combination of:6

  1. A guideline-based approach with pharmacological and/or nonpharmacological interventions, which requires careful consideration of the patient’s history and physical examination   
  2. A patient-centric approach that promotes shared decision-making  
  3. Patient education to improve treatment adherence and compliance   
  4. Monitoring and follow-up to detect possible decompensation and adjust or prescribe appropriate therapy


The risk of HF may start earlier than you might suspect in your patients with Type 2 Diabetes (T2D).7

Learn more about the risk of HF in patients with T2D

*Based on a US prospective observational study of 3,494 US outpatients with chronic HFrEF in the CHAnge the Management of Patients with Heart Failure (CHAMP-HF) registry.4


  1. Centers for Disease Control and Prevention. Heart failure. Available from: https://www.cdc.gov/heartdisease/heart_failure.htm. Accessed 6 August 2020.
  2. Ponikowski P, Voors AA, Anker SD, et al. 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. Eur Heart J. 2016;37(27):2129-2200.
  3. Rutten FH, Gallagher J. What the General Practitioner Needs to Know About Their Chronic Heart Failure Patient. Cardiac Failure Review 2016;2(2):79–84.
  4. Salah K, Stienen S, Pinto YM, et al. Prognosis and NT-proBNP in heart failure patients with preserved versus reduced ejection fraction. Heart 2019;105:1182–1189.
  5. Khariton Y, Nassif ME, Thomas L, et al. Health Status Disparities by Sex, Race/Ethnicity, and Socioeconomic Status in Outpatients With Heart Failure. JACC Heart Fail. 2018;6(6):465-473.
  6. Ferreira JP, Kraus S, Mitchell S, et al. World Heart Federation Roadmap for Heart Failure. Glob Heart. 2019;14(3):197-214.
  7. Faden G, Faganello G, De Feo S, et al. The increasing detection of asymptomatic left ventricular dysfunction in patients with type 2 diabetes mellitus without overt cardiac disease: data from the SHORTWAVE study. Diabetes Res Clin Pract. 2013;101(3):309-316.