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Diagnosing Congestive Heart Failure

Congestive heart failure (CHT) has a number of causes, which means that diagnosing congestive heart failure not only determines if a person has CHT but also what the cause might be. Even after the cause is determined and heart failure is diagnosed, a doctor will need to apply one of two classification systems following guidelines from either The New York Heart Association or the American College of Cardiology/American Heart Association before beginning to discuss treatment options.

How Is Congestive Heart Failure Diagnosed?

Because there are so many underlying conditions that could be causing or aggravating congestive heart failure, diagnose usually involves a variety of tests. Doctors may conduct one or more of the following:

Physical Exam

A doctor usually listens to the lungs and heart for any signs of congestion or abnormal heart sounds. The doctor also examines the neck veins and checks for fluid buildup in the legs and/or abdomen. Finally, they ask about and/or test for risk factors, such as diabetes, high blood pressure, or coronary artery disease.

Blood Tests

A doctor may use blood tests to check for signs of diseases that can affect the heart and/or for the chemical N-terminal pro-B-type natriuretic peptide. NT-proBNP levels help doctors differentiate between heart failure and other conditions, as these levels rise as heart failure develops or worsens.

Chest X-Rays

Chest X-rays help a doctor to see the condition of the lungs and heart. X-rays can also be used to diagnose other conditions besides congestive heart failure that may be causing similar symptoms.


Also known as an ECG, this test is used to record the electrical activity of the heart through electrodes attached to the skin. It can help a doctor diagnose problems with heart rhythm as well as heart damage.


Echocardiograms use sound waves to create a video image of the heart. They enable a doctor to view the condition of the heart and detect any abnormalities. An echocardiogram also can be used to measure ejection fraction, which indicates how well the heart pumps, helping to classify the degree of heart failure present.

Stress Tests

A stress test measures how healthy the heart is by measuring how it responds to physical exertion. A person who is attached to an ECG machine is either asked to walk on a treadmill or receives an intravenous drug to stimulate the heart in a way that is similar to exercise. A stress test may be conducted while wearing a mask that measures the ability of the heart and lungs to take oxygen in and push carbon dioxide out. Images of the heart may also be taken while undergoing a stress test.

Computerized Tomography Scan

Cardiac CT scans rotate an X-ray tube around the patient?s prone body while they are lying within a machine shaped like a doughnut, collecting images of the heart and chest.

Magnetic Resonance Imaging

For cardiac MRIs, a person lies still on a table within a long tube-like machine which creates a magnetic field, aligning atomic particles in some of the cells. Radio waves are broadcast toward these particles that have been aligned, producing signals that create images of the heart.

Coronary Angiogram

Used to find blockages, a coronary angiogram, a thin, flexible tube, or catheter, is inserted into a vein in the groin or arm and guided through the aorta and into the coronary arteries. Dye is then injected through the catheter to make the arteries supplying the heart visible on an X-ray.

Myocardial Biopsy

Used to diagnose certain types of heart muscle disease, a myocardial biopsy involves having a thin, tube-like biopsy cord inserted into a vein in the groin or neck and guided down to take small samples of the heart muscle.

If you or a loved one has been diagnosed with congestive heart failure, some of our in-home health care services may help to make things easier. Specialty Care Services is available to talk to 24 hours a day, 7 days a week. Contact us at 301.585.6300 to learn more about our home care in Silver Spring and the surrounding areas.

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