Diagnosis of CHF--often a trap in itself

The increasing clinical burden of congestive heart failure (CHF) is exacerbated by our limited abilities in clinically identifying the various aetiologies of the condition, such as the differentiation between systolic and diastolic heart failure. This denies appropriate therapy to a substantial proportion of patients, particularly outside specialised centres, and can even lead to the use of potentially deleterious interventions. The development of practically applicable definitions of the various types of CHF, combined with the rationalisation of diagnostic techniques, has helped both primary and secondary care physicians to target therapies appropriately to specific patient groups. This should reduce the number of misdiagnoses, thus minimising the proportion of patients 'falling through the net' of effective CHF management, and thereby improving clinical outcomes and the quality-of-life of those affected.