How to Diagnose Heart Failure

Three Parts:Identifying the Symptoms of Heart FailureGetting a Medical ExamUndergoing Tests for Heart Failure

Heart failure, or congestive heart failure, is a condition where your heart stops pumping blood like it should. Early detection of heart failure and proper treatment can help you live longer and have an active life. Learn how to diagnose heart failure so you can get the proper treatment and maintain a better quality of life.

Part 1
Identifying the Symptoms of Heart Failure

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    Look for shortness of breath. Shortness of breath is a common symptom of heart failure. This breathlessness may happen at any time. You may experience it when you participate in a physical activity, or you may feel breathless when you are sitting around. You may also experience shortness of breath when you are sleeping, which may wake you up.[1]
    • This shortness of breath can impact your daily activities and exercise routines. You may even wake up feeling tired or restless because you are not getting a good night’s sleep.
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    Monitor for coughing. Coughing can be a symptom of heart failure. You may find yourself coughing more than usual, or wheezing when you breathe. You may find that you are coughing up mucus that is white or pink tinged, but not green or yellow.[2]
    • This coughing is caused by fluid building up in the lungs. The lungs can't pump the blood fast enough, so as it slows returning to the heart, it runs into slow-moving blood, which causes it to back up into the lungs.
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    Watch for swelling. Swelling is a sign of heart disease because swelling indicates a buildup of fluid in the body. You may see swelling in your lower body, like your feet, ankles, legs, and even abdomen. Because of this, your shoes, socks, or pants may fit more tightly.[3]
    • When you experience heart failure, the blood pumps slower, which causes a bit of a "traffic jam" effect as blood returns to the heart. When the blood returning to the heart can't get to the heart, it finds somewhere else to go, like your tissues. This causes swelling.
    • You may experience weight gain that is due to the swelling in your abdomen region.
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    Notice any unusual fatigue. Fatigue or a feeling of being overly tired is another symptom of heart disease. You may feel tired no matter how many hours of sleep you get, and common everyday tasks wear you out. Your limbs or body may feel overly weak when you try to do things.[4]
    • This occurs because the heart has trouble pumping blood to the brain, so the rest of your body gets less blood pumped to it.
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    Check for changes in appetite. You may notice that your appetite has changed. You may feel less hungry than usual or you may feel full all the time. You also may experience bouts of nausea or feeling sick to your stomach that affects your appetite.[5]
    • The appetite changes are caused by a lack of blood flow to your stomach and other digestive organs.
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    Look for any heart irregularities. If you are experiencing heart failure, you may experience irregular heartbeats or a rapid heartbeat. They may feel like heart palpitations, or like your heart is racing in your chest. This may cause chest pain, and be accompanied by fainting or a shortness of breath.[6]
    • Your heart beats faster as it tries to get blood to the rest of your body.

Part 2
Getting a Medical Exam

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    Go see your doctor. If you are experiencing two or more of these symptoms, you may be experiencing heart failure. You should make an appointment with your doctor as soon as possible to get checked out. You should never rely on your own diagnosis, but go get checked out by a doctor immediately.[7]
    • The symptoms of heart failure are not very specific and may be symptoms of other conditions. Heart failure causes your heart to get worse if left untreated. This is why it’s important to be seen by a doctor as soon as possible.
    • If you experience any chest pain, fainting, weakness that impairs your functioning, severe shortness of breath, or pink, foamy mucus when you cough, you should contact emergency services.
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    Get a physical exam. The first step in diagnosing heart failure is for your doctor to give you a physical exam. During this exam, the doctor will take your blood pressure and weigh you. They will check over your body, looking for signs of swelling in your legs and feet and around the abdomen.[8]
    • Your doctor will also use a stethoscope to listen to your heart, checking for anything that sounds abnormal. They will also check the sound of the lungs for any fluid.
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    Share important information about yourself. When you go to your appointment, your doctor will need certain information from you. You need to give them a list of your symptoms, including those that you may not believe are related to your heart failure. Be as detailed as possible.[9]
    • You will need to tell your doctor about any personal or family medical history that is pertinent. You should share any personal or family history of heart disease, heart failure, high blood pressure, stroke, or even diabetes. You may need to tell your doctor about recent life changes or major stresses.
    • Tell your doctor about all your medications, including vitamins and supplements you take.
    • Your doctor may want to know about your dietary or exercise habits.
    • Your doctor will ask you if you smoke, if you used to smoke, and about your alcohol consumption.[10]
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    Ask your doctor questions. If you think you are experiencing heart failure, you should ask your doctor questions about your symptoms, condition, and possible tests. You should ask your doctor if there are other conditions that may be causing your symptoms instead of heart failure or what else could be causing your symptoms.[11]
    • If your doctor believes you have heart failure, talk with them about the tests they will need to perform, when you will be able to get these tests, and if you will have to do anything special (like fast) before the tests.
    • Ask your doctor if you should avoid certain foods or make any dietary changes. You can also ask about what types of physical activities should be done or avoided.

Part 3
Undergoing Tests for Heart Failure

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    Get a blood test. Blood tests are one of the tests used to determine if a person has heart failure. Blood tests will check various levels in your blood that can help your doctor figure out if you are having heart trouble, and if you are, how severe it is.[12]
    • Your doctor will check your sodium and potassium levels, along with kidney and thyroid function through the blood test. They will also check cholesterol levels. The blood test will also reveal if you have anemia.[13]
    • A B-type Natriuretic Peptide (BNP) blood test may also be performed. Increased levels of BNP indicates heart failure, and the more BNP, the more severe the condition.[14]
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    Get other tests. There are multiple different kinds of tests your doctor may perform to check for heart function. These tests include chest x-rays, echocardiograms, and electrocardiograms (EKG/ECG).[15]
    • Your doctor may take x-rays to check the size of your heart and if there is any congestion or problem with the lungs.
    • In an EKG, you will have electrodes attached to your chest that sends information to the EKG machine. The electrodes will monitor your heart’s function by showing the rhythm and number of beats. This can let a doctor know if you’ve had a heart attack or if there are abnormalities with your heart.
    • Echocardiography uses sound waves to detect the structure and motion of the heart. For this procedure, you would receive a transthoracic echocardiogram, not a transesophageal echocardiogram. A device is moved over your chest while you remain motionless. The images it gathers can show the thickness of the heart and the way it pumps, as well as assess the function of the valves that may be contributing to the heart failure. An echo can also help your doctor figure out if the heart has poor blood flow or any damage to the muscle.[16]
    • A cardiac computerized tomography (CT) scan or magnetic resonance imaging (MRI) may be ordered. These tests gather images of your heart and chest.[17]
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    Get a coronary angiogram.[18] Cardiac catheterization is an invasive test. The doctor will put a catheter in a blood vessel in your arm or your leg so they can guide the catheter to your heart. The catheter can help your doctor see inside your heart and collect information about it. You doctor can collect blood samples from the heart and check blood flow.[19]
    • In one type of test, the catheter will put dye in your heart to take x-ray movies of the function of the different parts of the heart.[20]
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    Do a stress test. Your doctor may decide to have you do a stress test. This test helps the doctor see how your heart does when you exert yourself. Generally, you will be asked to walk on a treadmill or ride a stationary bike. While you do this activity, you will be hooked up to an ECG machine. Sometimes, patients have to wear a mask to measure the way oxygen brought into the body and carbon dioxide released.[21]
    • This helps doctors figure out if you have heart failure and the way your body reacts to this heart failure. This can help your doctor decide on a treatment plan.
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    Get a MUGA test. In this test, you will receive a shot or an IV that sends radionuclides into your bloodstream (there is no negative impact from this). Then a computer will use the radionuclides' location to make a picture of your heart that will measure if the heart has been damaged, if the chambers of the heart are working correctly, and if the heart has enough blood pumping through it. It's the most accurate assessment for an ejection fraction, which is a way to measure heart failure.[22]

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Categories: Cardiovascular Health and Blood Pressure