Congestive Heart Failure Diagnosis

Congestive heart failure (CHF) can be confused with other illnesses that cause breathing
difficulties, such as bronchitis, pneumonia, emphysema, and asthma. Talking to a medical
professional, along with a physical exam and tests available only at a medical office or hospital,
is necessary to make an exact diagnosis.
Chest x-ray film: This is very helpful in identifying the buildup of fluid in the lungs. Also, the
heart usually enlarges in CHF, and this may be visible on the x-ray film.
Electrocardiogram (ECG): This painless test measures the electrical activity (rhythm) of the
 It can reveal several different heart problems that can cause heart failure, including heart
attacks, rhythm disorders, long-standing strain on the heart from high blood pressure, and
certain valve problems.
 The ECG gives clues as to the underlying cause of heart failure.
 For this test, which takes just a few minutes, you lie on a table with electrodes fastened to
the skin of your chest, arms, and legs.
 The ECG result may, however, be normal in heart failure.
Blood tests: You may have blood drawn for lab tests.
 Blood cell counts: Low blood cell counts (anemia) may cause symptoms much like CHF
or contribute to the condition.
 Sodium, potassium, and other electrolyte levels, especially if the person has been treated
with diuretics and/or has kidney disease
 Tests of kidney function
 B-type natriuretic peptide (BNP)
o This is a hormone produced at higher levels by the failing heart muscle. This is a
good screening test; the levels of this hormone generally increase as the severity
of heart failure worsens.
o Interestingly, BNP has been produced by recombinant DNA technology and can
be used as a treatment for heart failure in the hospital (see Medications).
Echocardiogram: This is a type of ultrasound that shows the beating of the heart and the various
cardiac structures.
 An echocardiogram can be useful in determining the cause of heart failure (such as
muscle, valves, or pericardium), and it provides an accurate measurement of ejection
 This very safe, painless technique is similar to that used to look at a fetus during
MUGA scan: This stands for multiple-gated acquisition scanning.
 A small amount of a mildly radioactive dye is injected into a vein and travels to the heart.
 As the heart pumps the blood with the dye in it, pictures are taken. The pumping
performance of the left and right ventricles can be determined.
 People with an allergy to iodine or shellfish have special considerations and may not be
able to have this test because the dye contains iodine.
Stress test: A treadmill or medication (nonwalking) stress test is used to help evaluate the cause
or causes of heart failure, in particular, regarding coronary artery disease. This test is frequently
combined with nuclear imaging or echocardiography to improve accuracy.