heart and blood vessel disorders
Heart Failure (HF)
Diagnosis of Heart Failure
Chest x-ray Electrocardiography (ECG) Echocardiography and sometimes other imaging tests Blood tests Doctors usually suspect heart failure on the basis of symptoms alone. The diagnosis is supported by the results of a physical examination, including a weak, often rapid pulse, reduced blood pressure, abnormal heart sounds and murmurs and fluid accumulation in the lungs both heard through a stethoscope, an enlarged heart, swollen neck veins, an enlarged liver, and swelling in the abdomen or legs. Procedures to evaluate heart function are usually done. Testing is also needed to identify the cause of heart failure. A chest x-ray can show an enlarged heart, and congested blood vessels and fluid accumulation in the lungs. Electrocardiography (ECG) is almost always done to determine whether the heart rhythm is normal, whether the walls of the ventricles are thickened, and whether the person has had a heart attack. Echocardiography and Other Ultrasound Procedures , which uses sound waves to produce an image of the heart, is one of the best procedures for evaluating heart function, including the pumping ability of the heart and the functioning of heart valves. Echocardiography can show the following: Whether the heart walls are thickened and relax normally Whether the valves are functioning normally Whether contractions are normal Whether any area of the heart is contracting abnormally Echocardiography may help determine whether heart failure is due to systolic or diastolic dysfunction by enabling doctors to estimate the thickness and stiffness of the heart walls and the ejection fraction. The ejection fraction, an important measure of heart function, is the percentage of blood pumped out by the heart with each beat. A normal left ventricle ejects about 55 to 60% of the blood in it. If the ejection fraction is low (less than 40%), systolic heart failure is confirmed. If the ejection fraction is normal or high in a person who has symptoms of heart failure, diastolic heart failure is likely. Blood tests are almost always done. Doctors frequently measure natriuretic peptides (NPs). NPs are substances that accumulate in the blood when heart failure is present but less often when other disorders that cause shortness of breath are present. Other blood tests may be done to look for disorders that may be causing heart failure. Other procedures, such as Radionuclide Imaging of the Heart , Rarely, a biopsy of heart muscle is needed, usually when doctors suspect infiltration of the heart (as occurs in Amyloidosis ) or myocarditis due to a bacterial, viral, or other infection. 