Congestive Heart Failure Diagnosis

Diagnosis

Doctors can often make a preliminary diagnosis of heart failure by medical history and careful physical examination.

The medical history risks for heart failure include:

• Hypertension
• Diabetes
• Poor cholesterol levels
• Heart or peripheral vascular disease
• Sleep apnea
• Thyroid problems
• Obesity
• Lifestyle factors (smoking, alcohol use)

The following physical signs, along with medical history, strongly suggest heart failure:

• Enlarged heart
• Irregular 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

Laboratory Tests

Both blood and urine tests are used to check for problems with the liver and kidneys and to detect signs of diabetes. Lab tests can measure:

• Cholesterol and lipid levels
• Blood sugar (glucose)
• Red blood cell count (to rule out anemia)
• Blood sugar levels
• Thyroid function

Urine tests can be used to assess the presence of a protein called albumin. Albumin in the urine is usually a sign of kidney disease, but even tiny amounts (microalbumin) signal an increased risk for heart failure in people with and without diabetes.

Exercise Stress Test

The exercise stress test measures heart rate, blood pressure, and oxygen consumption while a patient is performing physically, usually walking on a treadmill. It is an important diagnostic component in determining heart failure symptoms. Doctors also use exercise tests to gauge long-term outlook and the effects of particular treatments.

Electrocardiogram

An electrocardiogram (ECG) cannot diagnose heart failure, but it can indicate underlying heart problems. It is sometimes called an EKG. The test is simple and painless to perform. It may be used to diagnose:

• Enlargement of the heart muscle, which may help to determine long-term outlook.
• The presence of coronary artery disease.
• Abnormal cardiac rhythms. A rhythm pattern called a prolonged QT interval, for example, might predict people with heart failure who are at risk for severe complications and would need more aggressive therapies.