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Table 1 Diagnostic assessments according to guidelines Assessments to be performed routinely to establish the presence and likely cause of heart failure (Eur Soc Cardiol 2001).

From: General practitioners' reasoning when considering the diagnosis heart failure: a think-aloud study

Assessments The diagnosis of heart failure Suggests alterantive or additional diagnosis
  Necessary Supports Opposes  
Appropriate symptoms +++   +++ (if absent)  
Appropriate signs   +++ + (if absent)  
Cardiac dysfunctioning on imaging (usually echocardiography) +++   +++ (if absent)  
Response of symptoms or signs to therapy   +++ +++ (if absent)  
Electrocardiography    +++ (if normal)  
Chest X-ray   + (if pulmonary congestion or cardiomegaly) + (if normal) Pulmonary disease
Full blood count*     Anemia/secondary polycythemia
Biochemistry and urinalysis*     Renal or hepatic disease/diabetes
Plasma concentration of natriuretic peptides in untreated patients (where available)*   + (if elevated) +++ (if normal)  
  1. + = of some importance; +++ = of great importance
  2. *) Recommended assessments which are not included in the corresponding table in the Medical Products Agency version of guidelines from 1996.