Heart failure has a significant impact on health and its prevalence increases with age (Cowie et al, 1997). Coronary heart disease (CHD) and hypertension are the most common causes (Cowie et al, 1999). The National Service Framework for Coronary Heart Disease identifies that people with suspected heart failure should be offered appropriate investigations to confirm the diagnosis and identify the cause (DoH, 2000). Also, those with confirmed heart failure should be offered treatment to relieve symptoms and reduce the risk of death. The National Institute for Clinical Excellence will publish guidelines this summer, which will aim to improve the management of heart failure.

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