Because it can be difficult to diagnose heart failure correctly, NICE has given specific advice in its guideline, issued in 2010. In 2012, any patient with suspected heart failure should have the diagnosis confirmed or refuted rapidly, with onward referral for echocardiography and specialist assessment. GP access to BNP/NTproBNP testing is vital to do this effectively. The GP is key to this process – acting as the patient’s advocate for timely diagnosis, making sure drug therapy is introduced and optimised, monitoring the patient’s condition, and identifying when the plan needs to be modified. With access to good diagnosis and good treatment the prognosis of this condition has improved remarkably in the past 20 years but without such modern therapy the syndrome can still be a death sentence.