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.