A clinical opinion inspired by a real case from ESC Congress, Madrid 2025 ECG is failing us when it is treated as sufficient for ruling out structural and functional heart disease. It is fast, inexpensive, widely available, and indispensable for rhythm assessment — particularly atrial fibrillation. But familiarity can quietly turn into overreliance. A real […]
ECG Is Failing Us — and Guidelines Already Know It Read More »
NT-proBNP heart failure diagnosis in primary care has long relied on biomarker-led pathways, yet remains limited—especially for patients with heart failure with preserved ejection fraction (HFpEF). However, its diagnostic value is more limited in heart failure with preserved ejection fraction (HFpEF), which represents a growing and often underdiagnosed clinical challenge. In real-world primary care, NT-proBNP
LVEF in Primary Care is becoming essential as heart failure (HF) continues to rise globally, driven by population ageing and the increasing prevalence of hypertension, diabetes, and obesity. In the UK, around 900,000 people live with heart failure, and projections suggest this number will rise by 25% over the next two decades. Early detection matters:
LVEF in Primary Care: Redefining Early Heart Failure Diagnosis Read More »
Executive Summary Device-based heart failure diagnostics are increasingly recognized as essential to complement NT-proBNP testing. Although NT-proBNP remains central to current diagnostic pathways, clinical evidence and guideline recommendations highlight clear limitations—particularly in HFpEF and complex patient populations. This article outlines why tools delivering echocardiography-like outputs are needed to improve accuracy, reduce delays, and relieve pressure
Device-Based Heart Failure Diagnostics: Why Tools Beyond NT-proBNP Are Needed Read More »
NT-proBNP thresholds in heart failure diagnosis are essential for understanding how different healthcare systems identify and manage the disease. N-terminal pro B-type natriuretic peptide (NT-proBNP) is a key biomarker used in diagnosing heart failure (HF). However, the threshold levels that trigger referral and further testing vary significantly between healthcare systems, influencing both diagnostic accuracy and
Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as a common subtype of heart failure, particularly in older adults and women over the age of 65. Despite representing more than half of heart failure cases in this demographic, HFpEF is still underdiagnosed in primary care. A major reason lies in the limitations of
The Decision to Order NT-proBNP: How ECG Findings and Clinical Factors Influence Testing Read More »
NT-proBNP in HFpEF diagnosis is increasingly recognized as a challenge, particularly among older women. Addressing these diagnostic challenges is critical because HFpEF now represents more than half of all heart failure cases in older adults, and timely recognition can substantially reduce hospital admissions. Despite its growing significance, HFpEF remains frequently underdiagnosed in primary care due
Key takeaways (TL;DR): NT-proBNP in Heart Failure is central to diagnosis, but obesity complicates interpretation. Obesity has emerged as a significant health challenge, particularly as the aging population in the UK continues to grow. With one in four adults in the UK classified as obese, this condition is becoming one of the leading contributors to
The Impact of Obesity on NT-proBNP in Heart Failure: Focus on HFpEF and Early Diagnosis Read More »
NT-proBNP and diabetes are closely linked, and this interplay can alter test interpretation in heart-failure diagnosis. N-terminal pro B-type natriuretic peptide (NT-proBNP) is a biomarker widely used to assess heart failure (HF) and other cardiovascular conditions. It is the inactive fragment released when the heart produces brain natriuretic peptide (BNP), a hormone involved in fluid
NT-proBNP and Diabetes: Risks of Misdiagnosis in Heart Failure Read More »
Misconceptions, Misuse, and Missed Diagnoses in the Primary Care Pathway. Abstract – Misuse of NT-proBNP in Primary Care and Diagnostic Delays N-terminal pro B-type natriuretic peptide (NT-proBNP) is widely used in the diagnostic pathway for heart failure (HF). While it remains a sensitive marker for excluding HF, particularly in acute settings, its application in
