Exam and Testing for Heart Failure

If you have any of the symptoms of heart failure, it is important to first determine if you have heart failure. The next step will be to determine the cause of the heart failure.

Your doctor will need to take a detailed medical history and do a physical exam. Knowing if you have risk factors for developing heart failure is important. During the physical exam the doctor will check your weight, blood pressure and heart rate, listen to your heart and lungs, and examine for swelling and changes in circulation. The information from your history and exam will help determine which tests need to be done.

You will need to have blood drawn for specific laboratory tests. These tests will determine kidney, liver, and thyroid function. They will also check for diabetes and anemia. The FDA has recently approved a blood test call B-type natiuretic peptide or BNP. This tests the amount of the BNP hormone that is released by the heart when the heart function worsens. The person may or may not have symptoms of heart failure.

An electrocardiogram (EKG, ECG) will also be done to evaluate the heart rate and rhythm, and possibility of a heart attack in the past.

You will also have a chest x-ray to determine if fluid is being retained in the lungs, size of the heart, and presence of other lung diseases.

The echocardiogram is the most effective test to determine the function of the heart. It is an ultrasound that can evaluate the heart size, shape, motion and strength of the muscle when it pumps (contraction), function of the valves, and amount of blood ejected with each heartbeat (ejection fraction). Currently, this test cannot evaluate the arteries that nourish the heart muscle.

If you have not been evaluated for the presence of coronary artery disease, it is important that you have a test to determine if there is a severe blockage to one or more arteries that nourish your heart muscle. The doctor may order a stress test to evaluate for the presence of poor circulation to the heart. The most effective way to evaluate the coronary arteries is with a cardiac catheterization.