Diagnosis of Congestive Heart Failure (CHF)

by Michelle Badash, MS

The first step your doctor will take to assess whether you have CHF is to discuss your medical history and conduct a complete physical exam. Afterwards, your doctor may recommend some or all of the following tests to make the diagnosis and assess the degree of damage:

Chest x-ray � An x-ray image will show whether the heart is enlarged, or congestion is present in the lungs.

Electrocardiogram (EKG or ECG) � Records the electrical activity of your heart through electrodes attached to the skin. This test will help diagnose heart rhythm problems and damage to the heart from a heart attack.

Echocardiogram � Uses sound waves to produce an image of the heart. Helps evaluate the valves and chambers of the heart, and determines the amount of blood ejected from the heart with each heartbeat (ejection fraction). An echocardiogram also can detect damage, tumors, or excess fluid around the heart.

Coronary catheterization � Contrast dye is injected via a thin, flexible tube (catheter) that is threaded into the aorta or heart. X-rays are then taken to view blood flow and highlight the arterial blood vessels. This test helps to detect obstruction in the arteries and assess heart function.

Blood tests � A blood sample may be taken and tested to identify levels of various substances (such as protein, electrolytes, creatinine, etc.). Abnormal levels may indicate a strain on the body�s organs.

Diagnostic Indicators

As your doctor examines you, he or she will be looking for some characteristic signs of CHF, on the physical exam, which include:

Sound of fluid in the lungs (rales)
Enlargement of the jugular vein in the neck (jugular venous distention)
Enlargement of the liver (hepatomegaly)
High blood pressure (hypertension)
Low blood pressure (hypotension)
Fast heart rate (tachycardia)
Edema (swelling of the ankles, legs, feet)
Fluid in the abdominal cavity (ascites)
Fluid in the space between the lungs and ribs (pleural effusion)

SOURCES:

American Heart Association

National Heart, Lung, and Blood Institute, National Institutes of Health

Last reviewed December 2003 by Rhonda Kaufman, MD

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