Acute heart failure assessment (adult UK pathway)
A source-linked educational visual of acute adult heart failure assessment, monitoring, initial treatment and escalation based on NICE CG187.
Important safety note
This visual algorithm is an educational representation of published UK clinical guidance and is not a substitute for clinical judgement, local protocols, senior/specialist advice, or the original guideline. Verify current guidance before clinical use.
Scope and source
- Scope
- Adults with suspected or confirmed acute heart failure in UK emergency and acute-care services.
- Jurisdiction
- UK
- Primary guidance
- NICE CG187: Acute heart failure: diagnosing and managing acute heart failure in adults
- Guidance last updated
- 2021-11-17
- Clinical reference reviewed
- 2026-09-08
- Review due
- 2027-03-08
Interactive clinical algorithm
This source-backed visual algorithm is available in the interactive page experience. Open the original guidance and the node notes before clinical use.
How to read this visual
- Read across the columns for the phases of the pathway; the swimlanes are who acts — Emergency team, Investigations and imaging, Critical care and heart-failure team.
- Bold marks the dose, threshold or time limit that decides the next step; the rest of a label is context.
- Stabilise in the emergency-team band before working through the diagnosis and escalation columns.
- Follow notes for diagnostic thresholds, diuretic monitoring and specialist escalation.
Clinical notes
- Treat acute coronary syndrome, arrhythmia, hypertensive emergency and sepsis when present using their own pathways.
- Drug doses and fluid strategy need current local policy and patient-specific review.
Sources
- NICE CG187: Acute heart failure (NICE; 2021-11-17)
Open an editable reference copy
Create a personal educational copy. Verify the original guidance before clinical use.