STEPS IN HEART FAILURE DIAGNOSIS
1. History and Physical
Heart failure diagnosis is a two part process. The first part is to determine if the symptoms are heart failure and not some other condition. The second part is to determine the cause of the heart failure, if in fact it is heart failure.
Both of these parts of diagnosis are approached simultaneously by sequentially following a series of testing steps.
The first step of all medical detective work is always a good history and physical. This is where the patient is questioned about their symptoms, signs they’ve noticed and any medical problems or risk factors they have.
Common Signs and Symptoms
- Dyspnea (shortness of breath)
- Leg edema (swelling)
- Abdominal swelling and bloating
- Exercise intolerance
- Orthopnea (hard breathing lying down)
- Paroxysmal nocturnal dyspnea (waking up breathless)
- Excessive weight gain
4. Imaging Studies
To assess the status of the heart itself a few imaging tests are done on almost all patients presenting with heart failure. An echocardiogram is the most important test and gives the most information. An electrocardiogram (EKG) and chest x-ray are also done on most patients.