Doctors can often make a preliminary diagnosis of heart failure by medical history and careful physical examination.
A thorough medical history may identify risks for heart failure that include:
- High blood pressure
- Abnormal cholesterol levels
- Heart disease or history of heart attack
- Thyroid problems
- Lifestyle factors (such as smoking, alcohol use, and drug use)
The following physical signs, along with medical history, strongly suggest heart failure:
- Enlarged heart
- Abnormal heart sounds
- Abnormal sounds in the lungs
- Swelling or tenderness of the liver
- Fluid retention in legs and abdomen
- Elevation of pressure in the veins of the neck
Heart Failure Tests
After a physical exam, your doctor may order some tests.
Blood tests are used to:
- Help diagnose and monitor heart failure
- Identify risks for heart disease
- Look for possible causes of heart failure, or problems that may make your heart failure worse
- Monitor for side effects of medicines you may be taking
This procedure (sometimes called a coronary angiogram, heart catheterization or, simply, a “cath”) is basically an x-ray of the heart while dye fills the coronary arteries. This allows the cardiologist to visualize the coronary arteries to evaluate possible blockage.
Chest x-rays can show whether the heart is enlarged.
An echocardiogram is often the best test for heart failure. It is a non-invasive, painless test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain x-ray image and involves no radiation exposure. Heart and Vascular Specialists at Alegent Creighton Health who perform Trans Es
An electrocardiogram (ECG) is a test that measures and records the electrical activity of the heart. It is also called an EKG. An electrocardiogram cannot diagnose heart failure, but it may indicate underlying heart problems. The test is simple and painless to perform. It may be used to diagnose:
A completely normal ECG means that heart failure is unlikely.
- Previous heart attack
- Abnormal cardiac rhythms
- Enlargement of the heart muscle, which may help to determine long-term outlook
- A finding called a prolonged QT interval may indicate people with heart failure who are at risk for severe complications and therefore need more aggressive therapies.
Myocardial Perfusion Imaging (MPI) Stress Test
The test is basically a noninvasive way to assess the blood flow to the muscle of the heart. We inject a nuclear tracer into the blood stream and the tracer is taken up by the heart muscle cells that receive good blood flow. We image the heart with a camera that senses gamma rays released by the tracer. This basically provides us with a map of where the blood flow to the heart is adequate.