CHF - tests; Congestive heart failure - tests; Cardiomyopathy - tests; HF - tests
The diagnosis of heart failure is made largely on a person's symptoms and a physical exam. However, there are many tests that can help give more information about the condition.
An echocardiogram (echo) is a test that uses sound waves to create a moving picture of the heart. The picture is much more detailed than a plain x-ray image.
This test helps your health care provider learn more about how well your heart contracts and relaxes. It also provides information about the size of your heart and how well the heart valves are working.
An echocardiogram is the best test to:
Heart failure can be diagnosed if the echocardiogram shows that the pumping function of the heart is too low. This is called an ejection fraction. A normal ejection fraction is around 55% to 65%.
If only some parts of the heart are not working correctly, it may mean that there is a blockage in the artery of the heart that delivers blood to that area.
Many other imaging tests are used to look at how well your heart is able to pump blood and the extent of heart muscle damage.
You may have a chest x-ray done in your provider's office if your symptoms suddenly become worse. However, a chest x-ray cannot diagnose heart failure.
Ventriculography is another test that measures the overall squeezing strength of the heart (ejection fraction). Like an echocardiogram, it can show parts of the heart muscle that are not moving well. This test uses x-ray contrast fluid to fill the pumping chamber of the heart and evaluate its function. It is often done at the same time as other tests, such as coronary angiography.
Stress tests are done to see whether the heart muscle is getting enough blood flow and oxygen when it is working hard (under stress). Types of stress tests include:
Your provider may order a heart catheterization if any imaging tests show that you have narrowing in one of your arteries, or if you are having chest pain (angina) or a more definitive test is desired.
Several different blood tests can be used to learn more about your condition. Tests are done to:
Anemia, or low red blood cell count, can make your heart failure worse. Your provider will check your CBC or complete blood count on a regular basis or when your symptoms become worse.
Greenberg B, Kim PJ, Kahn AM. Clinical evaluation of heart failure. In: Felker GM, Mann DL, eds. Heart Failure: A Companion to Braunwald's Heart Disease. 4th ed. Philadelphia, PA: Elsevier, 2020:chap 31.
Mann DL. Management of patients with heart failure with reduced ejection fraction. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 25.
Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/ AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Cardiac Failure. 2017;23(8):628-651. PMID: 28461259 pubmed.ncbi.nlm.nih.gov/28461259/.
Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128(16):e240-e327. PMID: 23741058 pubmed.ncbi.nlm.nih.gov/23741058/.BACK TO TOP
Review Date: 5/8/2021
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2021 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.