TY - JOUR T1 - Diagnosis and management of chronic heart failure: NICE guideline update 2018 JF - British Journal of General Practice JO - Br J Gen Pract SP - 265 LP - 266 DO - 10.3399/bjgp19X702665 VL - 69 IS - 682 AU - Clare J Taylor AU - Jim Moore AU - Norma O’Flynn Y1 - 2019/05/01 UR - http://bjgp.org/content/69/682/265.abstract N2 - Heart failure (HF) is a common problem affecting almost 1 million people in the UK. Prevalence increases with age, rising to 10% in people aged ≥75 years. The diagnosis requires symptoms and evidence of a structural or functional abnormality of the heart. HF is classified according to left ventricular ejection fraction (EF). In HF with reduced ejection fraction (HFrEF) the EF is below 40%, and in HF with preserved ejection fraction (HFpEF) the EF is ≥50% but there is evidence of impaired relaxation and stiffness in the left ventricle. The type of HF is important for determining further management options. Arrhythmias and valvular heart disease are also important causes of HF.The National Institute for Health and Care Excellence (NICE) has updated its chronic heart failure guideline.1 This article highlights areas of particular importance for primary care.Patients with HF may present with one or more of the classical triad of symptoms: breathlessness, ankle swelling, or fatigue. Clinical assessment is important to determine if the patient is stable or requires admission. The history should include symptom onset, change in exercise tolerance, risk factors for cardiovascular disease, and any history of cardiovascular disease. Examination should include pulse, blood pressure, and oxygen saturations along with auscultation of the heart and lungs with assessment of fluid retention.If HF is suspected, a natriuretic peptide (NP) blood test is required to guide referral decisions. NPs are released by the myocardium in response to increased wall … ER -