Heart Failure Diagnosis
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 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. A chest x-ray can show an enlarged heart and fluid accumulation in the lungs.
Chest x-rays can show heart enlargement and build-up of fluid in the lungs.
Electrocardiography (ECG) is almost always performed 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 (ECHO), 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. Other scans may be done using injections of radioactive tracers to look for correctable causes of heart failure.
Cardiac catheterization in which a catheter is inserted into the heart to measure the pressures and flows to see how well the heart is working to fill and empty as a pump. In another test, dye is injected into the coronary arteries to check for blockages as a possible cause of heart failure. One or both parts may be necessary.