Heart Failure Symptoms & Diagnosis

Symptoms

Symptoms include:

• Fatigue, weakness
• Shortness of breath—at first only with activity, progressing to shortness of breath at rest
• Wheezing
• Cough—may be dry and hacking or wet sounding with a pink, frothy sputum
• Need to sleep propped up
• Swelling of feet, ankles, or legs
• Frequent urination, especially at night
• Unexplained weight gain
• Abdominal pain and tenderness

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. In particular, the physical exam will include:

• Listening to the lungs and heart with a stethoscope
• Feeling the abdomen for tenderness and liver swelling
• Checking the legs for swelling

Tests may include:

• Blood tests—to look for certain markers in the blood that help the doctor determine what is happening with your heart
• Urine tests—to look for certain markers in the urine that help the doctor determine what is happening with your heart
• Electrocardiogram (ECG, EKG) —records the heart's activity by measuring electrical currents through the heart muscle
• Echocardiogram —uses high-frequency sound waves (ultrasound) to examine the size, shape, function, and motion of the heart
• Exercise stress test —records the heart's electrical activity during increased physical activity, may be coupled with echocardiogram
  • Patients who cannot exercise may be given a medication to simulates physical exertion
• Nuclear scanning—radioactive material (such as thallium) is injected into a vein and highlights areas with diminished flow
• Electron-beam CT scan (coronary calcium scan, heart scan, CT angiography )—measures the amount of calcium deposits in the coronary arteries to help to determine the risk of heart disease, including heart attacks
  • The American Heart Association (AHA) published guidelines in 2006 that heart scans are not for everyone and those most likely to benefit from the procedure are patients at intermediate risk of coronary artery disease
• Coronary angiography —x-rays with a special dye that allows the doctor to look for abnormalities (narrowing, blockage) in the arteries and evaluate the function of the heart