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Fast diagnosis urged for heart failure

Friday January 15th, 2010

Doctors should not delay in diagnosing patients with suspected heart failure, according to proposals published yesterday.

The up-dated guidelines say doctors should send a patient immediately for ultrasound diagnosis if the patient has previously had a heart attack.

Earlier guidelines, published five years ago, advised GPs to conduct a series of tests and only to use the ultrasound test - echocardiography - if these were inconclusive.

The new guidelines, published by the National Institute for Health and Clinical Excellence, say echocardiography and specialist assessment should take place within two weeks of a GP referral.

They support a raft of new drug treatments for patients with heart failure from left ventricular systolic dysfunction.

Patients of African origin should be offered isosorbide/hydralazine if the two front-line drugs, ACE inhibitors and beta-blockers, are not successful, they add.

The guidelines are still in draft form, allowing comments to be submitted over the next eight weeks.

Dr Fergus Macbeth, of NICE, said it aimed to improve the length of life and its quality for people with heart failure.

About 900,000 Britons currently have a diagnosis and another 900,000 are thought to have heart damage likely to lead to failure.

Dr Macbeth said: "The prevalence of heart failure is expected to rise in the future as more people live longer generally, people survive longer with coronary artery disease and there are better treatments for heart failure.

"It's clearly very important that clinicians working in this area have a guideline that is based on the most up-to-date evidence of what works best."

He added: "The original guideline recommended the use of echocardiography to help confirm a diagnosis of heart failure only after other tests were inconclusive.

"However, based on a review of new evidence about the best way for primary care physicians to diagnose heart failure published since the original NICE guideline, the updated draft recommends that people with suspected heart failure and who have had a previous heart attack should be referred urgently for echocardiography and specialist assessment."

Tags: Heart Health | NHS | UK News

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