Heart Failure: Diagnosis & Tests Menu

How is heart failure diagnosed?

In order to make a diagnosis, your doctor will look at your symptoms and review your medical history, as well as perform a physical examination and perform some diagnostic tests. Symptoms that you may experience include the following:

  • Shortness of breath
  • Fatigue or weakness
  • Swelling in your legs, ankles or feet
  • Rapid or irregular heart beat
  • Reduced ability to exercise
  • Persistent cough or wheezing with white or pink blood tinged phlegm
  • Increased need to urinate at night
  • Swelling of your abdomen
  • Sudden weight gain from fluid retention
  • Lack of appetite and nausea
  • Difficulty concentrating or decreased alertness
  • Sudden, severe shortness of breath and coughing up pink foamy mucus
  • Chest pain

Testing will be performed to determine how bad your heart failure is and what the causes may be. These may include the following:

  • Blood tests, such as cholesterol levels, hemoglobin to look for high cholesterol levels or anemia
  • NT-proB-type Natriuretic Peptide (BNP) blood test- BNP is a hormone released into the blood by the lower chambers of the heart in people with heart failure and the level changes based on the severity of the disease.
  • Cardiac catheterization: a long, thin tube called a catheter is inserted into an artery in your arm or leg. The doctor uses a special X-ray machine to guide the catheter to your heart. There are two types of cardiac catheterization — left and right. If you have a left heart catheterization, your doctor may inject dye to record videos of your heart valves, coronary arteries and heart chambers (atria and ventricles). A right heart catheterization does not use dye; it lets your doctor know how well your heart is pumping blood and checks your ejection fraction.
  • Chest x-ray- shows the size of your heart as well as will show presence of any fluid build up around your heart and lungs.
  • Echocardiogram-this is an ultrasound to see how well your heart can pump and relax, as well as can check the heart valves, measure your heart and check blood flow
  • Ejection fraction- is a measurement of the blood pumped out of your heart with each beat and can be checked either by echocardiogram, MUGA scan, nuclear stress test, MRI or cardiac catheterization
  • Electrocardiogram- this test records the electrical activity of the heart by using electrodes which are connected with wires to a monitor.
  • MUGA scan- the test shows your doctor how well the lower chambers of your heart (ventricles) are pumping blood. A small amount of dye is injected into a vein and a special camera is used to create a video of your heart as it beats.
  • Stress test- this test shows how your heart reacts to stress, which is induced with either exercise or with a medication that will create the same effect on your heart.

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