Introduction
Heart failure is a serious syndrome accounting for around 4% of UK general practitioner (GP) consultations in patients over 45 years.1 Diagnosis is complex with frequent co-existing symptoms; misdiagnosis may lead to inappropriate treatment and inefficient use of scarce healthcare resources.2
The National Institute for Health and Clinical Excellence (NICE) guidelines for chronic heart failure state that the 12-lead electrocardiogram (ECG) and/or natriuretic peptides tests (where available) may be used to help exclude heart failure.3 Abnormal ECGs are usually observed in heart failure cases, although in one study, around 20% of pa
