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Congestive Heart Failure

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An initial evaluation for congestive heart failure (CHF) may include:

  • A medical history, including an evaluation of risk factors such as age, family history, coronary artery disease (CAD), diabetes, and high blood pressure
  • A physical examination—a healthcare practitioner may listen to the heart and lungs with a stethoscope to detect fluid buildup and look for swelling of the hands, feet, and legs.

Additionally, a combination of laboratory and non-laboratory tests may be used to assess CHF.

Laboratory tests that may be ordered include:

There are two relatively new tests that may be used for people diagnosed with heart failure to help predict the course of the disease (prognosis). Galectin-3 and ST2 are tests that measure the levels of these proteins in blood. Elevated levels of these biomarkers may be used to indicate if a person with heart failure is at increased risk for complications and needs more aggressive treatment.

Non-laboratory tests may include:

  • An electrocardiogram (ECG or EKG)—a test that looks at the heart's electrical activity and rhythm
  • Chest X-ray—may show whether the heart is enlarged or if fluid is present in the lungs

Based on the findings of these tests, other procedures may be necessary, including:

  • An exercise stress test
  • Nuclear heart scan—a radioactive compound is injected into the blood to evaluate blood flow and show images of narrowed blood vessels around the heart.
  • Echocardiography—ultrasound imaging of the heart
  • Cardiac catheterization—in this procedure, a thin flexible tube is inserted into an artery in the leg and threaded up to the heart; it allows the physician to evaluate pressure and blood flow within the chambers of the heart.
  • Coronary angiography—this test is performed during cardiac catheterization; X-rays of the coronary arteries, which supply blood to the heart, are taken after injecting a radiopaque dye to help diagnose coronary artery disease.

For more information on these, visit the National Heart, Lung and Blood Institute: How is Heart Failure Diagnosed?

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