Identifying the patient with heart failure.

Heart failure is becoming an increasing concern to healthcare worldwide, and of particular concern in the Western world where the age of the population continues to rise. Furthermore, it has now become clear that, if heart failure is identified and treated in the earliest stages of ventricular dysfunction, the possibility of recovery from or substantial delay in progression to complete heart failure is extremely good and will give the patient a considerably improved quality of life. Certain signs and symptoms found on routine examination, coupled with knowledge of patient history, can indicate early heart failure. Patients will normally present to their family practitioner, who is likely to have long term, firsthand knowledge of the patient's medical and family history. Consequently, the general practitioner has a key role in identifying individuals with early heart failure. It is essential that the general practitioner is aware of the signs and symptoms of early heart failure, can interpret them correctly and knows what follow-up tests are necessary to confirm the diagnosis. Guidelines are presented here to assist the general practitioner in this task.