Even with a normal NT-proBNP, clinicians can still refer to a heart failure specialist if they think the patient has heart failure. Perhaps write a little more on why you are convinced the patient has heart failure in your referral.
Click here to find NICE advice about what else could it be?Factors that can reduce levels of serum natriuretic peptides
Factors that can increase levels of serum natriuretic peptides other than heart failure
You will find more about the causes of elevated natriuretic peptides in the resources section at the end of the diagnosis section.