Heart Failure

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 provider may be able to tell if your heart isn’t pumping efficiently or if you have fluid buildup. They will listen to your heart and lungs, feel your liver to see if it’s enlarged, or look at the veins in your neck to see if they are bulging. 

You will probably need additional tests to confirm the type and severity of your heart failure, and to determine the best treatments. These may include a variety of blood and urine tests and some common cardiac tests.

Chest X-ray

A chest x-ray can show whether parts of your heart are enlarged, or if there is 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 and other heart conditions.  It uses ultrasound (sound waves) 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. It uses electrodes (wires) placed on the chest and other parts of your body.  You might have the test while you are lying down, or while you are 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 provider might give you a medication to make your heart pump harder.

CT Coronary Angiogram

This scan is used to show your heart and the arteries that bring blood to your heart muscle. It uses an advanced x-ray technique. If you have this test, you will be exposed to some radiation, have an injection of dye, and possibly take a dose of a medication that slows your heart slightly.

There are differences between a regular angiogram and a CT angiogram. During a regular angiogram, a catheter is threaded into your heart. This is not done during a CT angiogram, so there is usually no recovery time needed after the test. However, if a narrow spot is found in an artery during a regular angiogram, the cardiac specialist can treat it right then with a treatment called angioplasty. This treatment is not possible during a CT angiogram. 

Nuclear Stress Test

If you have symptoms like chest pain or shortness of breath, your healthcare provider may order a test called 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 certain amount of time you might have another set of images taken.

A specialist will interpret the images from the nuclear stress test. The images will show 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 (this is called the ejection fraction).


Last Updated November 2017