Finding and Managing Heart Failure Earlier: Why Enhancing Primary Care Teams to Apply More Definitive Surveillance is the Solution.

Typically, heart failure (HF) is definitively diagnosed and treated with guideline-directed medical therapy late in its natural history, with reported delays, missed investigation and inpatient diagnoses associated with poor outcomes. Accordingly, better, more decisive primary care can and should play a critical role in addressing this seemingly intractable problem. However, as reflected by a paucity of evidence to inform the recommendations of expert HF guidelines, primary care teams are rarely considered as part of the solution. In this review, we explore all the potential outcomes from more proactive screening for HF in primary care when introducing artificial intelligence-mediated portable cardiac ultrasound. Based on the strengths and weaknesses of the screening components that can now be applied, we consider the spectrum of early to late forms of HF likely to be revealed and more immediately diagnosed. Within this context, we present, as an example of what can be achieved in this space, a clinical algorithm that was developed for a prospective, multicentre project to find and manage HF earlier in the primary care setting.