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Heart Failure Health Center

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Understanding Heart Failure -- Diagnosis and Treatment

How Do I Know If I Have Heart Failure?

Doctors diagnose heart failure by taking a medical history and conducting a physical exam and tests. 

During the medical history your doctor will want to know if:

Understanding Heart Failure

Find out more about heart failure:

Basics

Symptoms

Diagnosis and Treatment

Prevention

  • You have any other health problems such as diabetes, kidney disease, angina (chest pain), high blood pressure, or other heart problems
  • You smoke
  • You drink alcohol, and if so, how much
  • You are taking medications.

During the physical, the doctor will check your blood pressure, use a stethoscope to hear sounds associated with heart failure in the heart and lungs, and look for swollen neck veins, an enlarged liver, and swollen feet.

What Tests Are Used to Diagnose Heart Failure?

Tests your doctor might order to diagnose heart failure include:

Blood tests to check for anemia, thyroid problems, and high cholesterol, conditions that can be related to heart failure. There is also a blood test for B-type natriuretic peptide (BNP), which can indicate active heart failure.

Urine tests to look for signs of kidney problems or diabetes, a cause of heart disease

Electrocardiogram (ECG or EKG) to assess the heart rate and rhythm. This test can often detect heart disease, heart attack, an enlarged heart, or abnormal heart rhythms that may cause heart failure.

Chest X-ray to see if the heart is enlarged and if the lungs are congested with fluid.

Echocardiogram, an ultrasound test, to evaluate heart muscle function, to see how well the heart is pumping, and to detect problems with the heart valves that may cause heart failure. Ejection fraction (EF) also can be measured. EF is a measure of how much blood is pumped out of the heart with each beat, and how much blood pumps through the heart with each beat. A normal EF is generally greater than 50%, which means that over half of the blood volume in the heart's main pumping chamber is pumped out with each beat.

Radionuclide ventriculography to show the pumping function of the left and right ventricles (the heart's large pumping chambers) during heart contractions. This test can also measure EF. Rarely performed by itself, this test may be part of an exercise stress test.

Cardiac MRI to distinguish scar from normal tissue and abnormalities in the heart muscle. This can also measure EF. This test is generally available only in large heart centers and is rarely used as a first step in heart disease diagnosis.

Exercise stress test, an ECG performed while either walking on a treadmill, riding a stationary bike, or using medications to simulate exercise to check for any heart function problems brought on by exercise, which may indicate coronary artery disease.

In addition, your doctor may perform a variety of more invasive tests, such as cardiac catheterization, to directly visualize the heart's chambers. This test can determine if coronary artery disease is present and can also provide a measure of EF.

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