Congestive heart failure diagnosis is based on certain aspects such as the relevant medical history of a patient, risk factors, selected medical test and a prudent physical examination. A thorough history of the patient may divulge the presence of one or more warning signs of cardiac failure. Additionally, a history of prior cardiac arrest, significant use of alcohol, diabetes, hypertension or coronary heart disease can be clues. The physical evaluation focuses on detecting the quantity of the fluid accumulated in the body (neck veins, leg swelling, or breath sounds) as well as cautiously characterizing the heart’s condition (murmurs, heart sounds, pulse and heart size).
The doctors who deal with the heart related issues are called cardiologists. Some doctors have training in advanced and additional areas which involve non-invasive studies where they use radioactive drugs or dyes for studying the function and structure of the heart (nuclear cardiology), echocardiography, cardiac rhythm disorders or abnormal heart beats (electrophysiology), cardiac catheterization and radiologic heart imaging.
Why Tests and Exams ?
Once the patient visits the cardiac center, the doctor will examine his/her signs and symptoms of cardiac failure:
- Edema (swelling on the leg)
- Breathing problems or fast breathing
- Veins in the neck are distended
- Swelling on the abdomen or liver
- Abnormal heart sounds with fast, irregular or uneven heart beat
- Doctors use their stethoscope to listen the sound that develops during the build up of fluid (crackles) into the lungs.
Many tests are performed to find the cause, monitor the cardiac failure and diagnose the exact condition.
An X-ray, echocardiogram, electrocardiogram and MRI are best for having a visual idea about the cardiac system. The cardiologists often use these images as a guide for opting the right treatment.
- Diagnosing and monitoring heart failure
- Finding out possible causes and other disorders that may lead to this medical condition
- Identifying the risk factors
- Monitoring the side effects of drugs that a patient might be taking
Medical Tests for Diagnosing Congestive Cardiac Failure
Cardiac specialists use various medical tests for diagnosing the cardiac failure. The most preferred tests are as below:
Chest X-ray: This technique helps to get an x ray image that shows the shape and size of the heart and lungs. In cardiac failure, the accumulated fluid in the lungs can be seen and the enlarged shape of the heart is also visible. An X ray is also used to detect other medical conditions.
Blood Tests: This test may indicate the presence of other disorders that impair the cardiac system. A blood test is helpful in checking the levels of B-type natriuretic peptide or BNP (hormone). When your heart overworks, it tends to secrete B-type natriuretic peptide in excess or at greater level, and this levels indicates that a patient is undergoing heart failure.
Electrocardiogram (ECG): Electrocardiogram is used to measure the electrical impulses produced by your heart. In this process, doctors locate electrodes or sensor patches attached with wires on your skin. Electrocardiogram helps to reveal any damage to the cardiac system and heart rhythm disorder due to a previous attack.
Angiogram or Coronary Catheterization: This test uses a catheter (a thin, elastic tube), which is inserted into a blood vessel of the elbow or groin (upper thigh) and guided to the heart. A dye that makes the arteries visible under the x-ray is injected into the arteries that move towards the heart. Angiogram helps to identify the narrowed arteries moving towards the heart (coronary heart disease), which may develop congestive cardiac failure. This test is also beneficial to know the health of the heart valves and the strength of the left ventricle (main pumping chamber of the cardiac system).
Myocardial Biopsy: In this test, a tiny flexible biopsy cord is inserted into a vein in your groin or neck to take off some tiny pieces of the cardiac muscle. Myocardial biopsy is performed to detect certain forms of cardiac muscle diseases that may result into cardiac failure.
Magnetic Resonance Imaging or MRI: In this technique, radio waves and magnetic field are used to develop detailed and clear visuals of the cardiac system.
Echocardiogram: This technique uses sound waves to create a clear and detailed picture of certain factors such as the size, function and stricture of the cardiac system. These images allow doctors to determine the pumping capacity of the heart and differentiate between various forms of heart failure. An echocardiogram also measures the ejection fraction (how much percentage of blood is pumped by the major blood supplying chamber of the heart).
Right Heart Catheterization: This technique requires a catheter (a thin elastic tube) to be inserted into a vein (blood vessel) in the groin or neck of the patient. They direct the catheter to the cardiac system and thus measure the pressure within the chambers of the heart. This process helps to opt for heart failure treatment.
Multiple-gated Acquisition Scanning(MUGA) or Radionuclide ventriculography: This is a nuclear medicine test in which a small amount of radioactive dye is injected into the vein and a special camera is used to see the percentage of blood pumped by your heart with each beat. Outcome of these tests allows the doctors to determine the causes of the symptoms and schedule a treatment plan. Cardiologists categorize or measure the cardiac failure on the basis of a standard scale that ranges between I to IV. A cardiac failure of class I type is considered as the moderate form, in which the patient is able to perform the routine activities normally without feeling stressed, fatigued or winded, whereas the patients at class IV level are considered to be in the extreme severe condition in which they experience shortness in breathing even while resting.
Stress Tests: This is an exercise test in which the patient is asked to workout on a stationary bicycle or a treadmill or take a dose of drug that will boost the activity of the heart during the workout. An electrocardiogram is used to monitor each activity of the heart when a person in performing activities. The stress test allows your doctor to judge the effectiveness of your therapy and plan for more advanced therapies. Various form of stress examinations measure the response of the cardiac system to workout in various manners and situations. Few cardiac centers throughout the world have the advanced equipment to measure the relaxation effect of the cardiac system to the exercise. They perform a test to analyze diastolic cardiac failure.
The above mentioned medical techniques require expertise and specialization for appropriate diagnosis. All the methods are commonly used for congestive heart failure diagnosis. The symptoms of this medical condition develop with build up of plaque deposits and the process of deposition is gradual. If the patient observes the symptoms in the early stages and gets it diagnosed immediately, his/her chances of recovering from this medical condition increases.