Diagnosis of congestive heart failure

Congestive heart failure, also known as CHF, is a chronic and long-term heart condition that results in significant symptoms which impact an individual\’s life. When symptoms occur they are often significant enough to send an individual to their primary care physician for diagnosis. People may experience shortness of breath, fatigue, difficulty with exertion, swelling of the feet or ankles, or chest pain. (1)

The diagnosis of congestive heart failure is usually confirmed by a physical examination in combination with a thorough medical history and a variety of noninvasive tests. Your physician and will start with a thorough medical history which will determine when you first notice symptoms, your past medical history, any history of infectious diseases which may have negatively affected the health of your heart and any past familial history of coronary artery disease or congestive heart failure.

During the patient history the physician will have their information about any alcohol and drug use, any history of high blood pressure including any treatment you may have already been through, prior chest pain or heart attack, any recent viral illnesses or recent pregnancies.

Your physician will also perform a thorough physical examination looking for any underlying causes of heart failure and to assess the current function of the heart. A stethoscope is used to detect abnormal heart sounds that can indicate a leaky valve. The stethoscope will also be used to detect any fluid that has accumulated in the lungs. During a physical examination the doctor will look for veins which are distended or enlarged on the neck as well as swelling in the legs around the ankles and feet.

Risk factors for developing congestive heart failure include previous heart attacks, coronary artery disease, high blood pressure, irregular heartbeats, heart disease, cardiomyopathy, congenital heart defects and alcohol and drug abuse.(2)

If your physician suspects congestive heart failure then a chest x-ray may be done to determine if the heart muscle is enlarged and if there is any fluid around the lungs. An EKG can be used to check for regular heartbeats, also called arrhythmias, and estimate the amount of stress placed on the heart. And echocardiogram can be used to see the function of the heart, including the valves, heart wall motion and overall heart size. (3)

During an echocardiogram another measurement may be taken, the left ventricular ejection fraction. This is a measurement of how much blood comes out of the ventricles during contraction. A healthy heart has an ejection fraction between 55% and 70%. These numbers will be lower if the heart muscle has been damaged. (4)

During an echocardiogram ultrasonic waves are used to \”see\” inside the chest. The reflection of these sound waves is translated into images on a computer screen which reflects the images of the heart, valves, chambers and walls. And echocardiogram is also used to measure the pressure change between the left ventricle and the aorta as well as to assess the thickening of the walls of the heart and evaluate the function of this pump.

Patients who have had a previous history of heart attack or angina may also undergo a cardiac catheterization to determine if coronary artery disease or coronary heart disease is causing heart failure. During cardiac catheterization a small amount of contrast dye is injected into the left ventricle through a catheter. A special camera is used to determine how much of the dye leaves the heart with each beat. (5)

If a cardiac catheterization suggests that there may be coronary artery disease a referral to a cardiologist will be made in order to receive the best possible treatment protocols. By solving the problem of coronary artery disease the stress load on the heart will be reduced in the progression of congestive heart failure will be slowed.

If you experience any of the signs or symptoms of congestive heart failure it is important that you seek the advice of your primary care physician as soon as possible. Only through early diagnosis and early treatment are physicians able to determine the underlying causative agent for congestive heart failure and recommend treatment protocols which will improve the success rate of treatment.

(1) University of Maryland Medical Center: Heart Failure

(2) Archives of Internal Medicine: Risk Factors for Congestive Heart Failure in US Men and Women

(3) Children\’s Hospital of Wisconsin: Congestive Heart Failure

(4) Cleveland Clinic: Understanding Your Ejection Fractions