The results of previous studies indicate that the use of natriuretic peptides is cost effective,8,9 but none of the studies encompassed the use of POC in general practice when diagnosing HF.8 Mant et al state that 'future work should include evaluation of the clinical decision rule [NT-proBNP and echocardiography] ... in clinical practice'.9 The aim of this study was to estimate the 1-year cost of the three strategies GPs may adopt to make a HF diagnosis, and the proportion of initial correct diagnoses. This evidence concerns the gene NPPB and hydrops fetalis.