Heart Failure Diagnosis

How will I find out if I have heart failure?

Your doctor will diagnose heart failure based on your medical history, a physical exam, and test results. Bring a list of your symptoms to your appointment, including how often they happen and when they started. Also, bring a list of any prescription and over-the-counter medicines you take. Let your provider know if you have any risk factors for heart failure.

You may also be referred to a cardiologist for these tests and treatment. A cardiologist is a doctor who specializes in diagnosing and treating heart diseases.

Diagnostic tests and procedures

This animation discusses some of the tests used to diagnose heart failure. These tests may include an electrocardiogram to look at your heart’s electrical activity, an echocardiogram to measure how well your heart is working and look at the structure, and a chest X-ray to see if your heart is enlarged or there is fluid in your lungs. Other tests may include blood tests and an exercise, or stress test. Medical Animation Copyright © 2021 Nucleus Medical Media Inc. All rights reserved.

Blood tests

Your provider may order blood tests to check the levels of certain molecules, such as brain natriuretic peptide (BNP). These levels rise during heart failure. Blood tests can also show how well your liver and your kidneys are working.

Tests to measure your ejection fraction

Your provider may order an echocardiography (echo) or other imaging tests to measure your ejection fraction. Your ejection fraction is the percent of the blood in the lower left chamber of your heart (the left ventricle) that is pumped out of your heart with each heartbeat. Ejection fraction measures how well your heart pumps. This helps diagnose the type of heart failure you have and guides your treatment.

If 40% or less of the blood in your left ventricle is pumped out in one beat, you have heart failure with reduced ejection fraction.
If 50% or more of the blood in your left ventricle is pumped out in one beat, you have heart failure with preserved ejection fraction.
If your ejection fraction is somewhere in between 41% to 49%, you may be diagnosed with heart failure with borderline ejection fraction.

Other tests

Other imaging tests show how well your heart is working, such as a cardiac CT scan, cardiac MRI, or nuclear heart scan. You may also need cardiac catheterization with coronary angiography to look inside the arteries in your heart and see if they are blocked.
Tests for your heart’s electrical activity may also be necessary. This might include an electrocardiogram (EKG) or a Holter or event monitor that you wear for 24 to 48 hours or more while going about your normal activities.
A stress test measures how much exercise your body can handle and how well it works during physical activity. Some heart problems are easier to diagnose when your heart is working hard and beating fast.