Blood and urine tests - these will check the patient’s blood count and liver, thyroid, and kidney function. The doctor may also want to check the blood for specific chemical markers of heart failure, such as BNP (brain natriuretic peptide) – this hormone is secreted at high levels by the heart if it is injured or overburdened, but is first identified in the brain.
Chest X-ray – an X-ray will show whether the heart is enlarged. It will also show whether there is fluid in the lungs. Other conditions other than heart failure which may have similar signs and symptoms may be detected with a chest X-ray.
An ECG (electrocardiogram) – this device records the electrical activity and rhythms of the patient’s heart. Electrodes are attached to the patient’s skin and impulses are recorded as waves and displayed on a screen (or printed on paper). The test may also reveal any damage to the heart from a heart attack. Heart attacks are often the underlying cause of heart failure.
An echocardiogram – this is an ultrasound scan that checks the pumping action of the patient’s heart. This test also helps distinguish systolic heart failure from diastolic heart failure (the heart is stiff and does not fill properly). Sound waves are used to create a video image of the patient’s heart, which helps the doctor see how well the heart is pumping. The doctor measures the percentage of blood pumped out of the patient’s left ventricle (the main pumping chamber) with each heartbeat – this measurement is call the ejection fraction.
An ejection fraction is a crucial measurement which determines how well the heart is pumping. It is used to help classify heart failure and determine the best treatment. A healthy heart pumps out approximately 60% of the blood that fills the ventricle with each beat – a healthy heart has an ejection factor of 60%.
The doctor may also carry out the following additional tests:
Stress test
Cardiac MRI (magnetic resonance imaging) or CT (computed tomography) scan
Angiogram (coronary catheterization)
A combination of medication and lifestyle changes will hopefully help you continue to do the things you enjoy, by helping you manage your symptoms and keeping your condition as stable as possible. For most people, the treatment of heart failure involves a balance of the right medications and, in some cases, use of devices that help the heart beat and contract properly.
