INITIAL HEART FAILURE BLOOD TESTS
UNDERSTANDING THE LAB WORK NEEDED TO DIAGNOSE HEART FAILURE
Blood is usually drawn when a patient starts developing symptoms of heart failure. The reason for lab testing is to see is any other disease are present and contributing to the failure. The other reason to assess for other conditions with bloodwork is because heart failure treatment may be more complicated depending on any other conditions a person has. Some common blood tests used in initial assessment of heart failure include:
Albumin blood test measures the amount of albumin in your blood. Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn’t leak into other tissues. It is also carries various substances throughout your body, including hormones, vitamins, and enzymes. Low albumin levels can indicate a problem with your liver or kidneys.
ALT (Alanine Transaminase)-ALT, which stands for alanine transaminase, is an enzyme found mostly in the liver. When liver cells are damaged, they release ALT into the bloodstream. An ALT test measures the amount of ALT in the blood. High levels of ALT in the blood can indicate a liver problem, even before you have signs of liver disease, such as jaundice , a condition that causes your skin and eyes to turn yellow. An ALT blood test may be helpful in early detection of liver disease.
AST (aspartate aminotransferase) is an enzyme that is found mostly in the liver, but also in muscles. When your liver is damaged, it releases AST into your bloodstream. An AST blood test measures the amount of AST in your blood. The test can help your health care provider diagnose liver damage or disease.
Bilirubin blood test measures the levels of bilirubin in your blood. Bilirubin is a yellowish substance made during the body’s normal process of breaking down red blood cells. Bilirubin is found in bile, a fluid in your liver that helps you digest food. If your liver is healthy, it will remove most of the bilirubin from your body. If your liver is damaged, bilirubin can leak out of your liver and into your blood. When too much bilirubin gets into the bloodstream, it can cause jaundice , a condition that causes your skin and eyes to turn yellow. Signs of jaundice, along with a bilirubin blood test, can help your health care provider find out if you have liver disease .
Blood glucose test measures the glucose levels in your blood. Glucose is a type of sugar. It is your body’s main source of energy. A hormone called insulin helps move glucose from your bloodstream into your cells. Too much or too little glucose in the blood can be a sign of a serious medical condition. High blood glucose levels ( hyperglycemia ) may be a sign of diabetes , a disorder that can cause heart disease , blindness , kidney failure and other complications . Low blood glucose levels ( hypoglycemia ) can also lead to major health problems, including brain damage, if not treated.
BUN, or blood urea nitrogen test, can provide important information about your kidney function. The main job of your kidneys is to remove waste and extra fluid from your body. If you have kidney disease , this waste material can build up in your blood and may lead to serious health problems, including high blood pressure , anemia , and heart disease . The test measures the amount of urea nitrogen in your blood. Urea nitrogen is one of the waste products removed from your blood by your kidneys. Higher than normal BUN levels may be a sign that your kidneys aren’t working efficiently. A BUN test can help uncover kidney problems at an early stage when treatment can be more effective.
C-reactive protein test measures the level of c-reactive protein (CRP) in your blood. CRP is a protein made by your liver. It’s sent into your bloodstream in response to inflammation. Inflammation is your body’s way of protecting your tissues if you’ve been injured or have an infection. It can cause pain, redness, and swelling in the injured or affected area. Some autoimmune disorders and chronic diseases can also cause inflammation. Normally, you have low levels of c-reactive protein in your blood. High levels may be sign of a serious infection or other disorder.
Calcium blood test measures the amount of calcium in your blood. Calcium is one of the most important minerals in your body. You need calcium for healthy bones and teeth. Calcium is also essential for proper functioning of your nerves, muscles, and heart. About 99% of your body’s calcium is stored in your bones. The remaining 1% circulates in the blood. If there is too much or too little calcium in the blood, it may be a sign of bone disease , thyroid disease , kidney disease , or other medical conditions.
Carbon dioxide (CO2) is an odorless, colorless gas. It is a waste product made by your body. Your blood carries carbon dioxide to your lungs. You breathe out carbon dioxide and breathe in oxygen all day, every day, without thinking about it. A CO2 blood test measures the amount of carbon dioxide in your blood. Too much or too little carbon dioxide in the blood can indicate a health problem.
Chloride blood test measures the amount of chloride in your blood. Chloride is a type of electrolyte. Electrolytes are electrically charged minerals that help control the amount of fluids and the balance of acids and bases in your body. Chloride is often measured along with other electrolytes to diagnose or monitor conditions such as kidney disease , heart failure , liver disease , and high blood pressure .
Cholesterol is a waxy, fat-like substance that’s found in your blood and every cell of your body. You need some cholesterol to keep your cells and organs healthy. Your liver makes all the cholesterol your body needs. But you can also get cholesterol from the foods you eat, especially meat, eggs, poultry, and dairy products. Foods that are high in dietary fat can also make your liver produce more cholesterol. There are two main types of cholesterol: low-density lipoprotein (LDL), or “bad” cholesterol, and high-density lipoprotein (HDL), or “good” cholesterol. A cholesterol test is a blood test that measures the amount of each type of cholesterol and certain fats in your blood. Too much LDL cholesterol in your blood may put you at risk for heart disease and other serious conditions. High LDL levels can cause the build-up of plaque, a fatty substance that narrows the arteries and blocks blood from flowing normally. When blood flow to the heart is blocked, it can cause a heart attack . When blood flow to the brain is blocked, it can lead to stroke and peripheral artery disease.
Complete blood count or CBC is a blood test that measures many different parts and features of your blood, including:
- Red blood cells, which carry oxygen from your lungs to the rest of your body
- White blood cells, which fight infection. There are five major types of white blood cells. A CBC test measures the total number of white cells in your blood. A test called a CBC with differential also measures the number of each type of these white blood cells
- Platelets, which help your blood to clot and stop bleeding
- Hemoglobin, a protein in red blood cells that carries oxygen from your lungs and to the rest of your body
- Hematocrit, a measurement of how much of your blood is made up of red blood
A complete blood count may also include measurements of chemicals and other substances in your blood. These results can give your health care provider important information about your overall health and risk for certain diseases.
Creatinine is a waste product made by your muscles as part of regular, everyday activity. Normally, your kidneys filter creatinine from your blood and send it out of the body in your urine. If there is a problem with your kidneys, creatinine can build up in the blood and less will be released in urine. If blood and/or urine creatinine levels are not normal, it can be a sign of kidney disease.
D-dimer test looks for D-dimer in blood. D-dimer is a protein fragment (small piece) that’s made when a blood clot dissolves in your body. Blood clotting is an important process that prevents you from losing too much blood when you are injured. Normally, your body will dissolve the clot once your injury has healed. With a blood clotting disorder , clots can form when you don’t have an obvious injury or don’t dissolve when they should. These conditions can be very serious and even life-threatening. A D-dimer test can show if you have one of these conditions.
Ferritin blood test measures the level of ferritin in your blood . Ferritin is a protein that stores iron inside your cells. You need iron to make healthy red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body. Iron is also important for healthy muscles, bone marrow, and organ function. Too little or too much iron in your system can cause serious health problems if not treated.
Flu Test-Influenza, known as the flu , is a respiratory infection caused by a virus . The flu virus usually spreads from person to person through coughing or sneezing. You can also get the flu by touching a surface that has the flu virus on it, and then touching your own nose or eyes. The flu is most common during certain times of the year, known as flu season. In the United States, flu season can begin as early as October and end as late as May. During each flu season, millions of Americans get the flu. Most people who get the flu will feel sick with muscle aches, fever , and other uncomfortable symptoms, but will recover within a week or so. For others, the flu can cause very serious illness, and even death. A flu test can help your health care provider figure out if you have the flu, so you can get treated earlier. Early treatment may help lessen the symptoms of the flu. There are a few different types of flu tests. The most common is called the rapid influenza antigen test, or rapid influenza diagnostic test. This type of test can provide results in less than half an hour, but is not as accurate as some other types of flu tests. More sensitive tests may require your health care provider to send samples to a specialized lab.
Free Light Chains Test-Light chains are proteins made by plasma cells, a type of white blood cell. Plasma cells also make immunoglobulins (antibodies). Immunoglobulins help protect the body against illness and infections. Immunoglobulins are formed when light chains link up with heavy chains, another type of protein. When light chains link up with heavy chains, they are known as bound light chains. Normally, plasma cells make a small amount of extra light chains that don’t bind with heavy chains. They are instead released into the bloodstream. These unlinked chains are known as free light chains. There are two types of light chains: lambda and kappa light chains. A free light chains test measures the amount of lambda and kappa free light chains in the blood. If the amount of free light chains is higher or lower than normal, it can mean you have a disorder of the plasma cells. These include multiple myeloma , a cancer of plasma cells, and amyloidosis , a condition that causes a dangerous buildup of proteins in different organs and tissues.
Hemoglobin A1c (HbA1c) test measures the amount of blood sugar (glucose) attached to hemoglobin. Hemoglobin is the part of your red blood cells that carries oxygen from your lungs to the rest of your body. An HbA1c test shows what the average amount of glucose attached to hemoglobin has been over the past three months. It’s a three-month average because that’s typically how long a red blood cell lives. If your HbA1c levels are high, it may be a sign of diabetes , a chronic condition that can cause serious health problems , including heart disease , kidney disease , and nerve damage .
Hematocrit test is a type of blood test. Your blood is made up of red blood cells, white blood cells, and platelets . These cells and platelets are suspended in a liquid called plasma. A hematocrit test measures how much of your blood is made up of red blood cells. Red blood cells contain a protein called hemoglobin that carries oxygen from your lungs to the rest of your body. Hematocrit levels that are too high or too low can indicate a blood disorder , dehydration , or other medical conditions.
Hemoglobin test measures the levels of hemoglobin in your blood. Hemoglobin is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body. If your hemoglobin levels are abnormal, it may be a sign that you have a blood disorder .
Iron tests measure different substances in the blood to check iron levels in your body. Iron is a mineral that’s essential for making red blood cells. Red blood cells carry oxygen from your lungs to the rest of your body. Iron is also important for healthy muscles, bone marrow, and organ function. Iron levels that are too low or too high can cause serious health problems.
Different types of iron tests include:
- Serum iron test, which measures the amount of iron in the blood
- Transferrin test, which measures transferrin, a protein that moves iron throughout the body
- Total iron-binding capacity (TIBC), which measures how well iron attaches to transferrin and other proteins in the blood
- Ferritin blood test , which measures how much iron is stored in the body
LDH Test-This test measures the level of the different lactate dehydrogenase (LDH) isoenzymes in the blood. LDH, also known as lactic acid, is a type of protein, known as an enzyme. LDH plays an important role in making your body’s energy. It is found in almost all the body’s tissues.
There are five types of LDH. They are known as isoenzymes. The five isoenzymes are found in different amounts in tissues throughout the body.
- LDH-1: found in heart and red blood cells
- LDH-2: found in white blood cells. It is also found in heart and red blood cells, but in lesser amounts than LDH-1.
- LDH-3: found in lung tissue
- LDH-4: found in white blood cells, kidney and pancreas cells, and lymph nodes
- LDH-5: found in the liver and muscles of skeleton
When tissues are damaged or diseased, they release LDH isoenzymes into the bloodstream. The type of LDH isoenzyme released depends on which tissues are damaged. This test can help your provider find out the location and cause of your tissue damage.
Liver function tests (also known as a liver panel) are blood tests that measure different enzymes, proteins, and other substances made by the liver. These tests check the overall health of your liver. The different substances are often tested at the same time on a single blood sample, and may include the following:
- Albumin , a protein made in the liver
- Total protein. This test measures the total amount of protein in the blood.
- ALP (alkaline phosphatase), ALT (alanine transaminase), AST (aspartate aminotransferase), and gamma-glutamyl transpeptidase (GGT). These are different enzymes made by the liver.
- Bilirubin , a waste product made by the liver.
- Lactate dehydrogenase (LD) , an enzyme found in most of the body’s cells. LD is released into the blood when cells have been damaged by disease or injury.
- Prothrombin time (PT), a protein involved in blood clotting.
If levels of one or more of these substances are outside of the normal range, it may be a sign of liver disease .
Magnesium blood test measures the amount of magnesium in your blood. Magnesium is a type of electrolyte. Electrolytes are electrically charged minerals that are responsible for many important functions and processes in your body. Your body needs magnesium to help your muscles, nerves, and heart work properly. Magnesium also helps control blood pressure and blood sugar. Most of your body’s magnesium is in your bones and cells. But a small amount is found in your blood. Magnesium levels in the blood that are too low or too high can be a sign of a serious health problem.
Natriuretic peptides are substances made by the heart. Two main types of these substances are brain natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP). Normally, only small levels of BNP and NT-proBNP are found in the bloodstream. High levels can mean your heart isn’t pumping as much blood as your body needs. When this happens, it’s known as heart failure , sometimes called congestive heart failure. Natriuretic peptide tests measure the levels of BNP or NT-proBNP in your blood. Your health care provider may order a BNP test or an NT-proBNP test, but not both. They are both useful in diagnosing heart failure, but rely on different types of measurements. The choice will depend on the equipment available in your provider’s recommended laboratory.
Phosphate blood test measures the amount of phosphate in your blood. Phosphate is an electrically charged particle that contains the mineral phosphorus. Phosphorus works together with the mineral calcium to build strong bones and teeth. Normally, the kidneys filter and remove excess phosphate from the blood. If phosphate levels in your blood are too high or too low, it can be a sign of kidney disease or other serious disorder.
Potassium blood test measures the amount of potassium in your blood. Potassium is a type of electrolyte . Electrolytes are electrically charged minerals in your body that help control muscle and nerve activity, maintain fluid levels, and perform other important functions. Your body needs potassium to help your heart and muscles work properly. Potassium levels that are too high or too low may indicate a medical problem.
Prealbumin blood test measures prealbumin levels in your blood. Prealbumin is a protein made in your liver. Prealbumin helps carry thyroid hormones and vitamin A through your bloodstream. It also helps regulate how your body uses energy. If your prealbumin levels are lower than normal, it may be a sign of malnutrition . Malnutrition is a condition where your body does not get the calories, vitamins , and/or minerals needed for good health. Procalcitonin test measures the level of procalcitonin in your blood. A high level could be a sign of a serious bacterial infection , such as sepsis . Sepsis is the body’s severe response to infection. Sepsis happens when an infection in one area of your body, such as your skin or urinary tract, spreads into your bloodstream. This triggers an extreme immune reaction. It can cause a rapid heartbeat, shortness of breath, decreased blood pressure, and other symptoms. Without quick treatment, sepsis can lead to organ failure or even death. A procalcitonin test can help your health care provider determine if you have sepsis or another serious bacterial infection in the early stages. This may help you get treated promptly and avoid life-threatening complications.
Protein C and protein S work together to prevent your blood from clotting too much. Normally, your body makes blood clots to stop bleeding after a cut or other injury. If you don’t have enough protein C (protein C deficiency) or enough protein S (protein S deficiency), your blood can clot more than you need it to. If this happens, you may get a clot that partly or completely blocks blood flow in a vein or artery. These clots can form in the arms and legs and travel to your lungs. When a blood clot forms in the lungs it’s called a pulmonary embolism . This condition is life-threatening. Protein C and protein S deficiencies can be mild or severe. Some people with mild deficiencies never have a dangerous blood clot. But certain factors can increase the risk. These include surgery , pregnancy , certain infections, and extended periods of inactivity, such as being on a long airline flight. Protein C and protein S deficiencies are sometimes inherited (passed down from your parents), or can be acquired later in life. Testing may help find ways to prevent the formation of clots, regardless of how you got the deficiency.
Sodium blood test measures the amount of sodium in your blood. Sodium is a type of electrolyte . Electrolytes are electrically charged minerals that help maintain fluid levels and the balance of chemicals in your body called acids and bases. Sodium also helps your nerves and muscles work properly. You get most of the sodium you need in your diet. Once your body takes in enough sodium, the kidneys get rid of the rest in your urine. If your sodium blood levels are too high or too low, it may mean that you have a problem with your kidneys, dehydration , or another medical condition.
TSH Test-TSH stands for thyroid stimulating hormone. A TSH test is a blood test that measures this hormone. The thyroid is a small, butterfly-shaped gland located near your throat. Your thyroid makes hormones that regulate the way your body uses energy. It also plays an important role in regulating your weight, body temperature, muscle strength, and even your mood. TSH is made in a gland in the brain called the pituitary. When thyroid levels in your body are low, the pituitary gland makes more TSH. When thyroid levels are high, the pituitary gland makes less TSH. TSH levels that are too high or too low can indicate your thyroid isn’t working correctly.
Thyroxine test helps diagnose disorders of the thyroid. The thyroid is a small, butterfly-shaped gland located near the throat. Your thyroid makes hormones that regulate the way your body uses energy. It also plays an important role in regulating your weight, body temperature, muscle strength, and even your mood. Thyroxine, also known as T4, is a type of thyroid hormone. This test measures the level of T4 in your blood. Too much or too little T4 can indicate thyroid disease .
The T4 hormone comes in two forms:
- Free T4, which enters the body tissues where it’s needed
- Bound T4, which attaches to proteins, preventing it from entering body tissues
A test that measures both free and bound T4 is called a total T4 test. Other tests measure just free T4. A free T4 test is considered more accurate than a total T4 test for checking thyroid function.
Triiodothyronine (T3) Test-T3 is one of two major hormones made by your thyroid, a small, butterfly-shaped gland located near the throat. The other hormone is called thyroxine (T4.) T3 and T4 work together to regulate how your body uses energy. These hormones also play an important role in controlling your weight, body temperature, muscle strength, and nervous system.
The T3 hormone comes in two forms:
- Bound T3, which attaches to protein
- Free T3, which does not attach to anything
A test that measures both bound and free T3 is called a total T3 test. Another test called free T3 just measures free T3. Either test may be used to check T3 levels. If T3 levels are not normal, it can be a sign of thyroid disease .