Heart failure can range from mild to severe. Although your symptoms provide one indication of your condition, they don’t always tell the whole story. Your healthcare providers will want to do other tests to assess the nature and degree of your heart failure. This will help them determine a treatment plan that suits your specific condition.

Initial Assessment

To determine whether or not you have heart failure, your healthcare providers will first ask you about your medical history, your symptoms, and your health in general. They will also perform a physical examination of your entire body, head to toe.

Further Assessment

After learning your health history and performing a physical examination, your healthcare providers may then recommend additional tests to measure your heart function and determine the cause of your heart failure. Some of these tests are described below.

  • Blood tests. Blood tests can assess a variety of health factors, including your red cell count, electrolytes, and the function of your kidney, liver, and thyroid. In some instances, blood tests can identify the cause of your heart failure.
  • Urinalysis. Studying a sample of your urine will help detect any problems with your kidneys or bladder that may be contributing to your heart failure.
  • Chest x-ray. An x-ray image of your chest shows the size of your heart and can help determine the presence of fluid buildup in your lungs.
  • EKG (ECG, electrocardiogram). This test records the electrical activity of your heart and displays it on a screen for your healthcare providers to study. The procedure involves placing electrical wires with patches or suction cups on your chest, arms, and legs. These additional tests can help detect heart damage, assess heart function, and determine your body’s response to treatment.
  • Stress tests. This test shows how your heart responds to stress. It involves stressing your heart either with physical exertion (walking on a treadmill or riding a stationary bike) or with medication. During this period of stress, your healthcare provider checks your vital signs and monitors your EKG to assess your heart’s response. Sometimes you may have a nuclear imaging test (see below) along with a stress test to provide even more information.
  • Echocardiogram (echo). An echocardiogram uses sound waves to create an image of the structure and movement of your heart. This will show your healthcare providers how efficiently your heart is pumping. The test will also look at how well your heart valves are working and how enlarged the heart is.
  • Imaging tests. Imaging tests can involve injecting a special dye into your bloodstream and then taking x-rays. The resulting images can show blood flow and distribution, and reveal the heart’s structure and movement. This helps your providers detect problems with blood flow and determine how effectively your heart is pumping.
  • Angiogram. This test produces an image of the heart and helps assess for clogged vessels. A long, thin tube (a catheter) is inserted into a blood vessel (usually in the groin area). The catheter is carefully guided through the vessel until it reaches the heart. At this point, a dye is injected through the catheter and special x-rays can track the flow of blood to your heart muscle.

Timing of Tests

It’s not uncommon to need repeated tests. Most of the tests discussed here are useful not only for initial diagnosis, but also for ongoing monitoring. By repeating tests at various time intervals, your healthcare providers can get an accurate picture of your response to treatment.

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