Heart failure not only reduces life expectancy, but is associated with symptoms of breathlessness, fluid retention, and fatigue that notably impair quality of life. It is a clinical syndrome that may result from any structural or functional cardiac disorder that impairs the pumping ability of the heart.

Major changes in treatment have resulted from an improved understanding of the pathophysiology of heart failure and from the results of large clinical trials. Furthermore, with the publication of evidence based management guidelines, much needed attention has been focused on the care of the chronic phase of the syndrome. But we are still far from having “solved” heart failure. Patients with heart failure often require hospitalisation to re-establish control of the syndrome; heart failure admissions account for around 5% of emergency medical admissions in the UK, and chronic …