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The Suspected Heart Failure For Patients With NTproBNP greater than 2000
pathway has been updated to align with the current NICE guidance. The aim is to provide patients with suspected heart failure with an NTproBNP greater than 2000 a one-stop diagnostic and clinical assessment within 2 weeks.
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Referrals submitted which do not meet the referral criteria or don’t have the mandated results attached will be returned.
A recent ECG attached to the referral is no longer a mandatory requirement.
Attaching any recent (within the last 12 months) ECGs that are available on the primary care clinical system is still encouraged to allow comparison and aid secondary care triage.
GPs will no longer be expected to refer for Echo prior to cardiology referral in patients with a NTproBNP greater than 2000.
On receipt of a referral, the cardiology administrative team will arrange a one-stop appointment which will include:
The clinical features of heart failure are notoriously non-specific, emphasising the need for diagnostic tests such as the NTproBNP level and echocardiography
Please see the ‘Red Flags’ section for indications for immediate referral to secondary care.
BNP also raised in:
| BNP can be suppressed by:
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For all patients with suspected heart failure and a positive NTproBNP (particularly when very high) please consider starting treatment with a loop diuretic immediately. Advice can be found on the Devon Formulary guidelines here.
If referring a patient for advice only, please make this clear in your referral letter. If it is not made clear, then these patients will be invited to clinic.
Examples of when this may be appropriate include:
The following patients warrant referral to General Cardiology Clinic:
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Although not mandated, please request an HbA1C, Ferritin and Transferrin Saturation when clinically indicated. Having these results available allows the specialists to consider all therapeutic options without the delay caused by requesting additional tests. A recent ECG attached to the referral is no longer a mandatory requirement.
Referrals submitted which do not meet the referral criteria or don’t have the mandated results attached will be returned.
Referral to: Suspected Heart Failure For Patients With NTproBNP greater than 2000
Refer via e-Referral system:
Heart Failure Hub referral form no merge fields
This guideline has been signed off on behalf of NHS Devon.
Publication date: December 2015
Updated: May 2023