Heart failure is a complex medical condition. There are several types of heart failure and a variety of causes. For these reasons, you will likely have several different tests over a period of time to help diagnose the cause of the disease and find out how severe it is. In some cases the cause of heart failure can be fixed (such as a heart valve defect) or is easily treatable (such as a thyroid problem), but this is usually the exception.

If you have symptoms that suggest heart failure, you may have the following tests:

• A review of your medical history and a physical exam.
• Lab tests.
• Electrocardiogram (EKG, ECG).
• Chest X-ray.
• Echocardiogram (echo).
• Brain natriuretic peptide (BNP). This test is currently available only at specialized medical research centers.
• Cardiac catheterization.

An echocardiogram is the best and simplest way to find out whether you have heart failure and whether it is systolic or diastolic heart failure.² An echocardiogram also can help determine the cause of heart failure and help guide treatment decisions.

The following tests also may be done to identify areas of the heart that are not getting enough blood (ischemic areas) and help assess how well the left ventricle is working. These tests include:

• Cardiac perfusion scan. This test can detect poor blood flow to the heart.
• Cardiac blood pool scan (radionuclide ventriculogram). This test is often used when echocardiogram results are less likely to be accurate (caused by a person's weight or breast size or the presence of severe lung disease). It checks the pumping ability of the left ventricle. However, it is less useful for finding heart valve disease and thickening of the heart muscle.
• Cardiac catheterization. This test can be used to check for blocked or narrowed heart arteries and to measure pressures inside the heart. Test results can help diagnose conditions that might cause heart failure symptoms or make them worse.

You will need regular appointments with your doctor to monitor your condition and how well your treatment is working. Depending on the severity of the disease and its progression, your doctor may want to see you within days to weeks after your diagnosis.

Testing will help your doctor determine which type of heart failure you have. Your heart failure may also be classified according to its severity or its stage.

Early Detection

Identifying people who are at high risk of developing heart failure before they show any evidence of heart failure on an echocardiogram is important so that they can be monitored, any underlying conditions (such as high blood pressure or high cholesterol) can be treated, and medicines such as angiotensin-converting enzyme (ACE) inhibitors can be started when needed.²

Talk to your doctor if you are concerned that you may be at risk for heart failure.

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