This comprehensive guideline sets out clearly evidence based recommendations for best practice in the diagnosis and treatment of heart failure in adults - and of those with suspected heart failure. The guideline is one of a series commissioned by the National Institute for Clinical Excellence (NICE) which aims to ensure that standards of care throughout England and Wales are uniformly high.

In particular, this guideline sets out recommendations with the aim of improving the length and quality of life for people with heart failure, and of ensuring that the diagnosis is made promptly and correctly, and that the experience of care from the NHS is good.

There are effective diagnostic procedures and treatments available for heart failure, but care needs to be better organised, throughout the course of the condition, including end-stage care.

This single, authoritative source of information for the NHS will improve uptake of appropriate diagnostic procedures and treatments for the condition, improve co-ordination and the sharing of information between health care professionals, and reduce regional variation in the quality of care.

Clinical highlights:

* The guideline focuses on making sure all potential heart failure patients receive the correct diagnosis. This will mean resources are used more effectively for those who need them.
* The guideline sets out clearly for those in primary care the circumstances in which specialist referral is recommended.
* Echocardiography is recommended for heart failure patients, following appropriate diagnostic tests. This is both clinically useful and cost-effective.
* The guideline recommends that prescription of ACE inhibitors be considered for all heart failure patients.
* Prescription of beta-blockers is recommended for all patients, following diuretic and ACE inhibitor therapy.
* The guideline promotes co-ordination and sharing of the management plan for individual patients between different professionals and sectors of care and provides management algorithms.
* Where there is evidence for the cost-effectiveness of treatment, this is given in the guideline and these issues are also discussed in some depth in the appendices.
* In addition to an extensive reference list supporting the evidence for the recommendations of the guideline, a detailed evidence table is available on the website that complements the guidelines.

The Included and excluded literature, Evidence tables and clinical questions Appendix J and K are only available online

Development of the guideline
Introduction
Methodology
Hierarchy of evidence and grading of recommendations
The guideline
Implementation summary of recommendations
Diagnosing heart failure
Treating heart failure
Monitoring
Referral and approach to care
Supporting patients and carers
Anxiety and depression
End of life
Prevention
Audit criteria
Areas for future research
Appendices
References