1.1.3 Plan the following with people with acute heart failure in line with the NICE guideline on chronic heart failure: discharge from hospital after the acute phase and subsequent management in primary care, including ongoing monitoring and care provided by the multidisciplinary team and information and communication about their condition, its treatment and prognosis. 1.1.4 A follow-up clinical assessment should be undertaken by a member of the specialist heart failure team within 2 weeks of the person being discharged from hospital. 1.2 Diagnosis, assessment and monitoring 1.2.1 Take a history, perform a clinical examination and undertake standard investigations for example, electrocardiography, chest X-ray and blood tests in line with the NICE guideline on chronic heart failure. 1.2.2 In people presenting with new suspected acute heart failure, use a single measurement of serum natriuretic peptides (B-type natriuretic peptide [BNP] or N-terminal pro-B-type natriuretic peptide [NT-proBNP]) and the following thresholds to rule out the diagnosis of heart failure: BNP less than 100 ng/litre NT-proBNP less than 300 ng/litre. 1.2.3 In people presenting with new suspected acute heart failure with raised natriuretic peptide levels (see recommendation 1.2.2), perform transthoracic Doppler 2D echocardiography to establish the presence or absence of cardiac abnormalities. 1.2.4 In people presenting with new suspected acute heart failure, consider performing transthoracic Doppler 2D echocardiography within 48 hours of admission to guide early specialist management. 1.2.5 Do not routinely offer pulmonary artery catheterisation to people with acute heart failure. 1.3 Initial pharmacological treatment 1.3.1 For guidance on patient consent and capacity follow recommendations on consent and capacity in the NICE guideline on patient experience in adult NHS services. 1.3.2 Do not routinely offer opiates to people with acute heart failure. 1.3.3 Offer intravenous diuretic therapy to people with acute heart failure. Start treatment using either a bolus or infusion strategy. 