Heart failure (HF) is a common, costly and treatable clinical syndrome.1 2 Over 920 000 people in England are living with the condition and 3%–4% of the National Health Service (NHS) budget is spent on HF services.3 Large clinical trials have established the clinical and cost-effectiveness of disease-modifying drugs and device therapies in improving quality of life, reducing hospitalisations and increasing survival for patients with HF with reduced ejection fraction.4 5 The same prognostic benefit was not seen in HF with preserved ejection fraction but diagnosis remains important to explain patients’ symptoms. In both types of HF, diuretics are effective in reducing fluid overload and exercise-based cardiac rehabilitation is beneficial once patients are stable.

Timely and accurate diagnosis is key to accessing appropriate, evidence-based treatment. People with HF initially experience symptoms of breathlessness, fatigue and ankle swelling which progress over…

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