May 1, 2016

Congestive Heart Failure (CHF)

How is congestive heart failure diagnosed? (Continued)

The neck may be examined looking for jugular venous distention. The jugular veins will dilate if there is extra fluid in the body and may be a sign of right heart failure. Peripheral edema (tissue swelling) is also found in right heart failure. The doctor will often look at the feet and ankles first to see if they are swollen. The abdominal examination may reveal an enlarged liver or ascites (fluid accumulation in the abdominal cavity).

Congestive heart failure can be a medical emergency, especially if it acutely decompensates and the patient can present extremely ill with the inability to breathe adequately. In this situation, the ABCs of resuscitation (Airway, Breathing, Circulation) need to be addressed while at the same time, the diagnosis of congestive heart failure is made.

Common tests that are done to help with the diagnosis of congestive heart failure include the following:

  • Electrocardiogram (EKG, ECG) to help assess heart rate, rhythm, and indirectly, the size of the ventricles and blood flow to the heart muscle.
  • Chest X-ray to look at heart size and the presence or absence of fluid in the lungs.
  • Blood tests may include a complete blood count (CBC), electrolytes, glucose, BUN, and creatinine (to assess kidney function).
  • B-type natriuretic peptide (BNP) may be helpful in deciding if a patient has shortness of breath from congestive heart failure or from a different cause. It is a chemical that is located in the heart ventricles and may be released when these muscles are overloaded.
  • Echocardiography or ultrasound testing of the heart is often recommended to assess the anatomy and the function of the heart. In addition to being able to evaluate the heart valves and muscle, the test can look at blood flow within the heart, watch the chambers of the heart contract, and measure the ejection fraction (percentage of blood ejected with each beat - normal = 50% to 75%).

Other tests may be considered to evaluate and monitor a patient with suspected congestive heart failure, depending upon the clinical situation. Continue Reading

Reviewed on 12/3/2015