The First Step – Be Active
Your heart matters! even if you don’t notice any specific symptoms you should go for regular health check-ups. In the majority of the cases, heart disease is diagnosed by chance (unexpectedly). If you get some hints or notice any potential warning signs, you must take action and see your cardiologist.
The Next step – Report your symptoms to your doctor
If you or any of your family member has a combination of or a few of the following potential signs and symptoms of heart failure, then meet your cardiologist and report those symptoms:
- Unexplained fatigue
- Shortness of breath
- Nausea or lack of appetite
- Unsteady mind (impaired thinking)
- Persistent coughing or wheezing
- Increased heart rate
- Edema (build-up of fluid in the legs)
Your cardiologist may order a few blood tests to check for the signs of heart disease that can affect your heart. Blood tests measure electrolytes, some proteins and biomarkers.
One such blood test to detect heart failure include N-terminal pro-B-type natriuretic peptide (NT-proBNP).
X-ray of the Chest
This is helpful to see how well are your lungs working. This will also help your cardiologist to rule out any conditions of the lungs other than heart could be causing the signs and symptoms.
Heart Failure Diagnosis – Ejection Fraction
Echocardiogram: In addition to detecting any abnormalities in the heart and also helping in determining the size and shape of your heart, an echocardiogram is helpful in measuring ejection fraction. This is an important measurement as it helps in determining the pumping ability of the heart – which is helpful in classifying heart failure and guiding treatment accordingly.
It is the measurement of the heart’s pumping ability. It is expressed as a percentage. For instance, an ejection fraction of 70 percent means 70 percent of the total amount of blood in the left ventricle has passed out from it with each heartbeat.
The normal range can be anywhere between 50 to 70 percent. Under 40% is an indication of heart failure. Between 41 to 49% is considered as borderline heart failure. Ejection fraction can be quite low in severe cases of heart failure.
An echocardiogram is the most widely used test for measuring ejection fraction. MUGA scan, CAT scan and Cardiac catheterization are the other tests to measure ejection fraction.
It is helpful in measuring the health of your heart. The patient is instructed to walk on a treadmill while an ECG machine attached measures the heart activity. The objective of this test is to see how the heart responds to stress.
The other tests that could be ordered include CT scan, MRI and coronary angiogram.
The above tests help your doctor determine the cause of your signs and symptoms and then classify heart failure. Your cardiologist gives the best possible treatment according to the stage of heart failure you have.
Heart Failure Diagnosis Criteria
Your doctor may classify your heart failure in the following ways:
Symptom-based scale classification of Heart Failure according to New York Heart Association.
Class I: Asymptomatic heart failure
Class II: Everyday activity can be performed with ease but exertion can cause fatigue
Class III: Completing everyday activities is a bit difficult in this case
Class IV: It is the most severe type. Shortness of breath even at rest.
Stage-based classification of heart failure determines the category of people who are at risk of developing heart failure. This is according to the American Heart Association guidelines. This system uses letter A to D.
Stage A: There are several risk factors of heart failure but no signs and symptoms.
Stage B: A person has heart disease but no symptoms of heart failure.
Stage C: A person has heart disease and is experiencing symptoms of heart failure.
Stage D: An individual with advanced heart failure that requires treatment.
Your cardiologist may use the above classification system or a combination of both as they are not independent of each other. In this way, the doctor evaluates the risks and severity of heart failure. After determining the severity, your cardiologist plan treatment. Delay in diagnosis and treatment of heart failure can make the condition worse. Early diagnosis and aggressive treatment can help prevent or delay heart failure.