Get answers to your Heart Failure questions.
Cardiomyopathy; Congestive heart failure
Doctors can often make a preliminary diagnosis of heart failure by medical history and careful physical examination.
A thorough medical history may identify risks for heart failure that include:
The following physical signs, along with medical history, strongly suggest heart failure:
Both blood and urine tests are used to check for problems with the liver and kidneys and to detect signs of diabetes. Lab tests can measure:
An electrocardiogram (ECG) cannot diagnose heart failure, but it can indicate underlying heart problems. It is also called an EKG. The test is simple and painless to perform. It may be used to diagnose:
If a patient has a completely normal ECG they are unlikely to have heart failure.
The best diagnostic test for heart failure is echocardiography. Echocardiography is a noninvasive, entirely safe test that uses ultrasound to image the heart as it is beating. Cardiac ultrasounds provide the following information:
Doctors use information from the echocardiogram for calculating the ejection fraction (how much blood is pumped out during each heartbeat), which is important for determining the severity of heart failure. Stress echocardiography may be needed if coronary artery disease is suspected.
Doctors may recommend angiography if they suspect that blockage of the arteries is contributing to heart failure. This procedure is invasive.
X-Rays. Chest x-rays can show whether the heart is enlarged. Computed tomography (CT) and magnetic resonance imaging (MRI) may also be used to evaluate the heart valves and arteries.
Radionuclide Ventriculography. Radionuclide ventriculography is an imaging technique that uses a tiny amount of radioactive material (called a trace element). It is very sensitive in revealing heart enlargement or evidence of fluid accumulation around the heart and lungs. It is may be done at the same time as coronary artery angiography. It can help diagnose or exclude the presence of coronary artery disease and helps demonstrate how the heart works during exercise.
Magnetic Resonance Imaging. Magnetic resonance imaging (MRI) scans that use contrast dyes to improve resolution may help identify whether there is any heart muscle that can be helped by opening up the arteries feeding it. Damage appears as very bright areas on the scan.
The exercise stress test measures heart rate, blood pressure, electrocardiographic changes, and oxygen consumption while a patient is performing physically, usually walking on a treadmill. Can help determine heart failure symptoms. Doctors also use exercise tests to gauge long-term outlook and the effects of particular treatments. A stress test may be done using echocardiography or may be done as a nuclear stress test.
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