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FOR APPs & PRIMARY CARE CLINICIANS

Heart failure — Quick reference

First steps, urgent findings, referral guidance, and handoff essentials.

First steps

Assess congestion, perfusion, symptoms, EF history, renal function, electrolytes, medications, and adherence. Distinguish the clinical phenotype.

Recognize the urgent patient

Severe dyspnea, hypoxemia, shock, ischemic symptoms, or dangerous arrhythmia requires acute care.

When to refer

Coordinate cardiology for new HF, persistent symptoms, therapy optimization, or uncertain cause; advanced disease may need an HF team.

What to send with the referral

Echo/EF trend; weights and symptoms; BP; renal/electrolyte results; drug doses and intolerance; recent admissions.

Avoid this pitfall

A preserved EF does not exclude HF. Improved EF does not automatically justify withdrawing effective therapy.

Reviewed October 11, 2026. This quick reference summarizes the linked guide; use the full guide for context and clinical references.