if suspected acute heart failure, use a single measurement of serum natriuretic peptides (B-type natriuretic peptide [BNP] or N-terminal pro-B-type natriuretic peptide [NT-proBNP]) and the following thresholds to rule out the diagnosis of heart failure:
BNP less than 100 ng/litre
NT-proBNP less than 300 ng/litre
if presenting with new suspected acute heart failure with raised natriuretic peptide levels, perform transthoracic Doppler 2D echocardiography to establish the presence or absence of cardiac abnormalities
consider performing transthoracic Doppler 2D echocardiography within 48 hours of admission to guide early specialist management
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