Congestive Heart Failure (cont.)
How is congestive heart failure diagnosed?
The diagnosis of congestive heart failure is most often a clinical one that is based on knowledge of the
patient's pertinent medical history, a careful physical examination, and selected laboratory tests.
A thorough patient history may disclose the presence of one or more of the symptoms of
congestive heart failure described above.
In addition, a history of significant coronary artery disease, prior
heart attack,
hypertension,
diabetes,
or significant alcohol use can be clues.
The physical examination is focused on detecting the presence of extra fluid in the
body (breath sounds, leg swelling, or neck veins) as well as carefully characterizing the
condition of the heart (pulse, heart size, heart sounds, and murmurs).
Useful diagnostic tests include the
electrocardiogram (ECG) and chest x-ray to explore
the possibility of previous heart attacks, arrhythmia, heart enlargement, and fluid in and
around the lungs. Perhaps the single most useful diagnostic test is the echocardiogram, in which
ultrasound is used to image the heart muscle, valve structures, and blood flow patterns.
The echocardiogram is very helpful in diagnosing heart muscle weakness. In addition, the test
can suggest possible causes for the heart muscle weakness (for example, prior
heart attack, and severe
valve abnormalities). Virtually all patients in whom the diagnosis of
congestive heart failure is suspected
should ideally undergo echocardiography early in their assessment.
Nuclear medicine studies assess the overall pumping capability of the heart and
examine the possibility of inadequate blood flow to the heart muscle.
Heart
catheterization allows the arteries to the heart to be visualized with
angiography
(using dye inside of the blood vessels that can be seen using x-ray methods).
During catheterization the pressures in and around the heart can be measured and the
heart's performance assessed. In rare cases, a
biopsy of the heart tissue may be
recommended to diagnose specific diseases. This biopsy can often be accomplished
through the use of a special catheter device that is inserted into a vein and maneuvered into the right
side of the heart.
Another helpful diagnostic test is a blood test called a BNP or
brain natriuretic peptide level. This level can vary with age and
gender but is typically elevated from heart failure and can aid in the diagnosis, and can be useful in following the response to treatment of
congestive heart failure.
The choice of tests depends on each patient's case and is based on the suspected diagnoses.
Next: What is the treatment of congestive heart failure? »
- ACE Inhibitors - Read about ACE inhibitors like Altace, lisinopril, enalapril, ramparil, Zestril and more. Information includes side effects, drug interactions, and pregnancy safety information.
- Pneumococcal Vaccination - Learn about pneumococcal vaccination (pneumonia vaccine) recommendations and side effects, and find out who should and should not be vaccinated.
- Low Blood Pressure - Learn about low blood pressure (hypotension). Low blood pressure is blood pressure below normal and symptoms may include: lightheadedness, dizziness, fainting upon standing (orthostatic hypotension). There are many causes of low blood pressure, and treatment is dependant upon the cause.
Latest Medical News
Heart RSS