Acute heart failure: diagnosis and management

Diagnosis and assessment

If your doctor suspects you might have acute heart failure, they should ask you about your symptoms and your medical history, and examine you. They should also offer you tests – for example, a chest X‑ray, blood tests and an ECG (or 'electrocardiogram' – a test that measures the rate, rhythm and other electrical activities of the heart). See other NICE guidance for more information about tests in our guidance on chronic heart failure.

If your doctor thinks you have heart failure and you have not had it before, they should measure the level of a substance in your blood called a natriuretic peptide (also known as BNP or NT-proBNP). If the level is raised, you should have an echocardiogram, ideally within 48 hours, to help find out if there is something wrong with your heart. An echocardiogram is a test that looks at the pumping action and structure of the heart, including the heart valves. A probe is moved over the surface of the chest and picks up echoes of sound (similar to an ultrasound scan used in pregnancy), which are shown as a picture on a screen. If the serum natriuretic peptide level is not raised, heart failure is very unlikely and your symptoms will probably be due to another cause.