If your doctor thinks that your heart might not be working as it should, you will have to go through a full evaluation that includes a physical exam and a few diagnostic tests.
This will help your physician understand both the cause of your condition and the extent of its progression. These investigations will allow your physician to determine the best course of treatment for your specific condition.
Let’s take a look at what the physical exam and the diagnostic tests entail.
Physical Examination In Heart Failure
This includes a thorough examination of your body and looking for any visible signs of swelling in the abdomen, legs, or ankles. Then, your physician will proceed to check your blood pressure and heart rate. He/she will also listen to your heart and lungs for a full assessment.
Some of the most common findings seen during a physical exam include:
- Noticeable leg swelling (pitting edema) – This can extend from the foot all the way up to the abdomen.
- Bulging neck veins (due to increased pressures in the heart), depends on the type and severity of your heart failure.
- Sudden weight gain – Some patients can gain between 5 to 20 kilograms.
Although these findings are common, they may not be present in all patients. Therefore, the next set of investigations will help your doctor further evaluate your condition.
Blood Tests In Heart Failure
Complete Blood Count
This is a simple blood test that looks at hemoglobin and similar parameters. Patients who have heart failure sometimes have low hemoglobin. Correcting this with iron injections is very helpful.
Rarely do patients require a blood transfusion.
Kidney Function Tests
This evaluates electrolytes, creatinine, and other kidney-related parameters. Patients with heart failure can have a condition called cardio-renal syndrome. Here both the kidneys and heart are weak, with one worsening the other.
Brain Natriuretic Peptide
Blood natriuretic peptide, or BNP, is a hormone that is produced by the lower chambers of the heart. Higher levels of this hormone indicate that the ventricle (lower chamber of the heart) is under stress. This parameter is usually elevated in heart failure.
A similar parameter that is related to BNP is called N-Terminal Pro BNP, or NT-ProBNP. This is quite high in patients with heart failure. Often, the values are checked frequently when patients are treated. Reducing levels over time indicate that patients are getting better.
Electrocardiogram (ECG)
This is a simple test that is used to check the rhythm and electrical activity of the heart. This test provides the doctor with information regarding the size of your heart, how fast your heart is beating, and whether there are any issues with blood circulation to the heart muscle.
Chest X-ray
This is done to look at the size of the heart and also see if there are any fluid accumulations in the lungs. It is one of the most commonly performed tests for heart failure, especially in an urgent situation.
Learn more about this test here.
Echocardiogram (ECHO)
It is an ultrasound scan of the heart and nearby blood vessels. This is a very useful tool in assessing the exact size of the heart, its pumping capacity, and evaluating the damage to the heart muscle and valves.
By performing this test, your doctor can estimate the functional capacity of the heart and take necessary measures to improve it further through medication.
Read more about echocardiogram here.
Coronary Angiogram
This test is sometimes done to determine whether the heart function is poor due to blockages in the heart arteries.
Read more about coronary angiogram here.
Cardiac MRI Scan
A cardiac MRI scan is useful when looking for rarer causes of heart failure such as amyloidosis and sarcoidosis. It is not routinely performed unless it adds value to patient care.
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