When should a patient with acute heart failure be referred to secondary care for further management?

Refer a patient with acute heart failure to secondary care if they have raised natriuretic peptide levels and require early specialist management, such as transthoracic Doppler 2D echocardiography within 48 hours of admission ³.

Additionally, if the person has new suspected acute heart failure with serum BNP less than 100 ng/litre or NT-proBNP less than 300 ng/litre, heart failure can be ruled out, but if suspicion remains, specialist assessment should be considered ³.

People presenting with acute heart failure should be managed in hospital with early input from a specialist heart failure team, and follow-up assessment should be undertaken within 2 weeks of discharge ³.