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Heart & Vascular

How heart failure is assessed


June 3, 2022

Follow-up with a specialist can help determine how serious your heart failure diagnosis is.

If your health-care provider thinks you may have heart failure, you can expect a physical exam and a conversation about your medical history. Your provider will order heart failure diagnosis tests to confirm whether you have it and help determine how serious it is.

The provider also will look for any other health problems that may have led to heart failure. The results of your evaluation will help your provider form a treatment plan. 

Health history and physical exam

Your visit will start with a review of your health history. Tell your provider about your known medical problems, symptoms and medications. 

Then you will have a physical exam. Your provider will listen to your heartbeat and your breathing, and check for swelling (edema) in your legs, abdomen, lungs and other parts of the body. Any buildup of fluid that’s found may be from congestive heart failure.

Heart failure diagnosis process

In addition to a physical exam, these diagnostic tests may help diagnose heart failure:

  • Chest X-ray.  This can indicate the size of your heart and may show fluid that’s built up in your lungs.
  • Electrocardiogram (ECG). This test shows your heart rhythm. Small pads (electrodes) are placed on your chest. Wires connect the pads to the ECG machine, which records your heart’s electrical activity and gives the provider information about your heart rate and rhythm. 
  • Echocardiogram. This test uses ultrasound waves to take pictures of your heart. A technician will place gel on your chest and then place a probe on the surface of your chest to take these pictures.  An echocardiogram reveals the structure and movement of your heart muscle. It determines how well the heart muscle pumps, whether the heart valves are working normally, and whether or not the heart is enlarged. 
  • Lab tests. Your provider may order lab tests that check small amounts of blood or urine for signs of problems. A BNP (B-type natriuretic peptide) lab test can help diagnose and evaluate heart failure. Other lab tests can also give information about other heart problems or illnesses such as diabetes, anemia or kidney disease. 

Your treatment plan after a heart failure diagnosis

Based on your medical history, physical exam and test results, you and your provider will make a treatment plan. This heart failure management plan aims to ease some of your symptoms and help make you more comfortable. Your treatment plan may include: 

  • Medicine to help the heart work better and improve your quality of life.
  • Changes in what you eat and drink to help prevent fluid from building up in your body. 
  • Weighing yourself daily and watching your symptoms to see how well your treatment is working.
  • Exercise to help you stay healthy.
  • Help with quitting smoking if you are a smoker.
  • Referrals to other specialists.
  • Support to help you adjust to these changes.
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Vanderbilt University Medical Center has one of the top heart failure programs in the nation with the expertise to care for all stages and causes of heart failure, from the most basic to the most complex. Innovative treatments offer hope when you need it most.

Download our treatment guide