Diagnosing heart failure

Heart failure means that the heart does not pump blood around the body as well as it should. It is caused by damage to the heart muscle, for example because of a heart attack, congenital heart disease, cardiomyopathy, high blood pressure, or some types of chemotherapy.

Without early diagnosis and treatment, heart failure steadily gets worse. But, until the late 1990s, when a GP suspected a patient had heart failure, they did not have an easily available way to test for the condition.

A blood test to help diagnose heart failure

Heart failure can be hard to diagnose because its symptoms (breathlessness and fatigue) can be caused by other conditions, and the physical signs are often not obvious. But early and accurate diagnosis is important so that patients can start the right treatment.

In 1997, a team of doctors including BHF-funded Professor Allan Struthers and BHF Professor Phillip Poole-Wilson discovered that a simple blood test could transform early diagnosis of heart failure. The test measured levels of a chemical called B-type natriuretic peptide (BNP) in the blood. More BNP is present in people with heart failure, so a low reading rules out heart failure whereas a high reading tells us that heart failure is a possibility.  

Having access to this test has meant that GPs can make faster referrals for tests, like an echocardiogram (ultrasound of the heart), to confirm or rule out the diagnosis of heart failure, so patients get the care and medication they need as quickly as possible.

In 2010, national guidelines for doctors included the BNP test as part of the gold standard for heart failure diagnosis and by 2016, MPs were urging all GP surgeries to adopt the BNP test.

Campaigning for improved heart failure care

Despite the focus on BNP testing as an important part of heart failure care, the test is still not universally or even routinely available across the UK.

That is why in 2020 we worked with healthcare professionals to produce a report (“Heart Failure: A blueprint for change") and launched a campaign highlighting the main barriers to improving heart failure diagnosis and care in the UK. The report called for an improved awareness of heart failure as a long-term condition and suggested key areas for change to deliver high quality and consistent heart failure care across the UK, including equal access to BNP testing.

First published 1st June 2021