Aging & Health A to Z
Diagnosis & Tests
A thorough physical examination will reveal whether or not you have heart failure. Tell your healthcare provider if you have any heart failure symptoms, especially if you’ve already been diagnosed with high blood pressure or coronary artery disease, or have had a heart attack.
Your healthcare professional may be able to tell if your heart isn’t pumping efficiently or if you have fluid buildup by listening to your heart and lungs, feeling your liver to see if it’s enlarged, or looking at the veins in your neck to see if they’re bulging.
You’ll probably need additional tests to confirm the type and severity of heart failure, and to determine the best treatments. These may include a variety of blood and urine tests and some of the common cardiac tests:
A chest x-ray can show whether parts of your heart are enlarged, or if there’s fluid buildup in your lungs. These can be signs of heart failure, a heart valve problem, or thickening of the heart muscle.
Echocardiogram (or “Echo”) and Echo Stress Test
This is the most common test for evaluating heart function and for diagnosing heart valve problems as well as other heart conditions. It uses sound waves (ultrasound) to create an image of the inside of your heart while it’s beating. This test is often done while you’re exercising, on a treadmill or exercise bicycle to see how your heart responds to increased physical activity.
Electrocardiogram (ECG or EKG) and ECG Stress Test
This simple, painless test measures the electrical activity of your heart using electrodes (wires) placed on the chest and other parts of your body. You might have the test lying down, or while you’re exercising on a treadmill or bicycle to monitor how your heart responds to increasing levels of physical activity. If you can’t exercise, your health care professional might give you a drug that makes your heart pump harder.
CT Coronary Angiogram
This scan is being used more often to shows your heart and the arteries that bring blood to your heart muscle. It uses an advanced x-ray technique that involves some exposure to radiation, an injection of dye, and possibly a dose of a drug to slow your heart slightly. There is no need to thread a catheter into your heart as is done during a regular angiogram, so there is usually no recovery time needed after the test. However, if a narrow spot is found in an artery, the cardiac specialist will not be able to treat it right then with a treatment called angioplasty, as would be possible with a regular (non-CT) angiogram.
Nuclear Stress Test
If you have symptoms like chest pain or shortness of breath, your healthcare professional may order a nuclear stress test. You will receive an injection of radioactive dye and images will be taken of your heart while you are at rest. Afterwards, you may be asked to exercise on a treadmill or stationary bicycle, or you may receive an injection to speed up your heart. Another dose of radioactive dye may be given during the test through a small intravenous (IV) tube, and your blood pressure and heartbeat (ECG) will be monitored during the test. Another set of images will be taken at that time. After resting for a prescribed time you might have another set of images taken. The nuclear stress test shows the specialist who is interpreting your images if there are any damaged areas in your heart. The images may also show whether the arteries that bring blood to your heart muscle are blocked or narrowed, or if your heart is enlarged. It also measures how well your heart is pumping blood (called the ejection fraction).
Updated: March 2012
Posted: March 2012