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How Do I Get a Diagnosis of Heart Failure?

Medically Reviewed by Brunilda Nazario, MD on June 08, 2021

To check if you have heart failure, your doctor will ask you about your symptoms and may order some tests, as well. Once they figure out what's going on, the two of you will work together to get the right treatment.

Physical Exam for Heart Failure

First, your doctor will want to know if you:

Your doctor will also do a physical exam. They'll look for signs of heart failure as well as other illnesses that may have weakened your heart.

During your visit, your doctor will:

They’ll also look at your appearance while you sit, do mild activity, and lie flat. People with mild or moderate heart failure may appear comfortable at rest, but when active, they often become short of breath. Those with heart failure may be uncomfortable if they lie flat for a few minutes.

Your doctor may check for fluid in your lungs with a stethoscope. People with heart failure may also have neck veins that are larger than normal, swelling of the legs or abdomen, or an enlarged liver.

Tests for Heart Failure

The doctor may suggest you get some tests to find the cause of your heart failure and see how severe it is.

Blood tests. They look at your kidney and thyroid gland health and measure your cholesterol levels. They also check if you have anemia, which happens when you don't have enough healthy red blood cells.

B-type natriuretic peptide (BNP) blood test. Brain natriuretic peptide is a substance your body makes. Your heart releases it when heart failure develops. It is turned into N-terminal pro-brain natriuretic peptide (NT-proBNP). Levels of both can be higher in people with heart failure. These tests can be used to help figure out if a patient’s shortness of breath is caused by heart failure.

Chest X-ray. This shows the size of your heart. It also lets your doctor know if there's a buildup of fluid around your heart and lungs.

Echocardiogram. This test, often called an "echo," shows your heart's movement. During this exam, your doctor places a wand on the surface of your chest. It sends ultrasound waves that show pictures of your heart's valves and chambers. Those images let your doctor look at how well your ticker is pumping.

Your doctor may combine an echocardiogram with tests called Doppler ultrasound and color Doppler to check blood flow across your heart's valves.

Ejection fraction (EF). It's a measure of how much blood is pumped out of your heart each time it beats. A normal amount is between 55% and 75%, which means that over half of the blood volume is pumped out of the heart with each beat. Heart failure may happen because of a low EF.

Electrocardiogram (EKG). This records the electrical impulses traveling through your heart. During the test, your doctor puts small, flat, sticky patches called electrodes on your chest. They're attached to a monitor that charts your heart's electrical activity on graph paper. This test can tell your heart rhythm and give a general roadmap of your heart's ability to pump blood.

Cardiac catheterization. This measures whether you have clogged heart arteries (called coronary artery disease). Your doctor may also call it coronary angiogram.

Cardiac MRI. This less-commonly used test helps your doctor figure out if you have problems with your heart muscle or the tissues that surround the heart.

CT coronary angiogram. It uses an X-ray and a contrast dye to see if you have coronary artery disease. Your doctor can view images in 3-D, which lets them see blockages in your arteries.

Myocardial biopsy. In this test, your doctor puts a small, flexible biopsy catheter into a vein in your neck or groin, and takes a small piece of your heart muscle. This test can diagnose certain types of heart muscle diseases that cause heart failure.

Stress test. Your heart gets "stressed" when you walk on a treadmill or take medications that increase its pumping. It helps your doctor find clogged heart arteries.

WebMD Medical Reference

Sources

SOURCES:

American Heart Association: "Common Tests for Heart Failure," "Symptoms & Diagnosis of Heart Failure," "Heart Failure."

UpToDate: "Natriuretic peptide measurement in heart failure."

Mayo Clinic: "Coronary angiogram: Overview."

Cleveland Clinic: "Myocardial Biopsy."

Heart Failure Society of America: "Learn More About Heart Failure."

National Heart Lung and Blood Institute: "How Is Heart Failure Diagnosed?"

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