This guideline covers diagnosing and managing acute heart failure or possible acute heart failure in people aged 18 and over. It aims to improve the immediate care of someone who is acutely unwell as a result of heart failure.
Heart failure may indicate acute myocardial injury in patients with COVID-19. See the recommendations on diagnosing and managing acute myocardial injury in our COVID-19 rapid guideline on managing COVID-19.
In November 2021, we withdrew the recommendations on valvular surgery and percutaneous intervention because they have been replaced by the NICE guideline on heart valve disease.
This guideline includes recommendations on:
- diagnosis, assessment and monitoring
- initial pharmacological and non-pharmacological treatment
- treatment after stabilisation
- treatment with mechanical assist devices
Who is it for?
- Healthcare professionals
- Adults who have a diagnosis of acute heart failure, or have possible acute heart failure, or are being investigated for acute heart failure
Is this guideline up to date?
We checked this guideline in December 2017. We found no new evidence that affects the recommendations in this guideline.
Guideline development process
This guideline was previously called acute heart failure: diagnosing and managing acute heart failure in adults.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.