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Diagnosis always starts with a detailed medical history, in which the doctor asks about symptoms such as shortness of breath, coughing, rapid weight gain (due to fluid retention), recent illness/heart attacks etc. This is followed by a careful examination, which includes
- Checking neck veins for distension
- Checking the abdomen and legs for signs of fluid retention
- Listening to the lungs for signs of fluid overload
- Listening to the heart sounds for a characteristic sound heard in heart failure, evidence of any valve lesions, and abnormal rhythms.
Specific tests are then done to verify the heart failure diagnosis, measure its extent, and determine whether there are underlying, potentially reversible causes. These tests may include:
- Blood tests – to determine anaemia; kidney, liver and thyroid function; blood sugar measurements.
- ECG – to detect any rhythm abnormalities
- Chest x-ray – gives valuable information on the size of the heart, the presence of other contributing lung disease, and the amount of congestion(fluid build-up) in the lungs.
- Echocardiogram - this test uses sound waves to produce a video image of the heart. This gives information about valve structure and function, the contractility of the heart muscle, and can be used to compute the Ejection Fraction.
- Coronary angiogram – this shows any narrowing or blockages in the heart’s arteries, and shows the contractility of the left (main) ventricle.
- Nuclear scan – this test uses a small amount of radioactive material to actually measure the EF.
Reviewed by Dr AG Hall, July 2007.
