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Diagnosis of Heart Failure
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Diagnosis of Heart Failure

 

According to the European Society of Cardiology guidelines, in addition to typical symptoms suggestive of the diagnosis of heart failure, objective evidenceof cardiac dysfunction has to be present to establish the presence of heart failure.1

 

The initial evaluation should include

  • A complete history
  • Physical examination
  • A chest radiograph
  • An electrocardiogram (ECG)

Chest radiography:
The typical radiographic findings include cardiomegaly (enlarged heart), pulmonary edema and pleural effusion. 


An electrocardiogram:

No specific ECG feature is indicative of heart failure, but atrial and ventricular arrhythmias are common findings.

 

An echocardiogram:

The presence of heart failure can be confirmed by an echocardiogram. The Doppler echocardiogram can identify systolic and diastolic dysfunction, presence of valvular stenosis, cardiomyopathy or pericardial disease.

 

Angiography: 

Radionuclide angiography may be performed, when the echocardiogram is ambiguous despite a high clinical suspicion of heart failure. Magnetic resonance imaging (MRI) and computed tomography (CT) can measure the ejection fraction and assess the regional wall motion.

Folowing routine blood investigations found to be elevated in heart failure.

  • A complete blood count
  • Liver function test
  • Serum electrolyte
  • Kidney function test
  • Lipid profile
  • Thyroid profile
  • B-type natriuretic peptide (BNP)

Following patients are at high-risk for heart failure and they may benefit from routine screening.2                 

  • CAD
  • Hypertension
  • Diabetes mellitus
  • Exposure to cardiotoxic drugs
  • Alcohol abuse


Next page: Treatment of Heart failure

Written by: Healthplus24 team
Date last updated: April 15, 2012

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References 
  1. Remme WJ, Swedberg K. Guidelines for the diagnosis and treatment of chronic heart failure. Task Force for the diagnosis and treatment of chronic heart failure, European Society of Cardiology. Eur. Heart J. 2001; 22: 1527–1560.
  2. Hunt SA, Baker DW, Chin MH, Cinquegrani MP, Feldman AM, Francis GS, et al. ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2001; 38: 2101–2113.
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