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Diagnosis

Medical History

Your doctor will ask about your symptoms and medical history.

Physical Examination

Your doctor will perform a physical exam, which will include checking your heart, lungs, abdomen, and legs.

Diagnostic Tests

Some of the following tests may be done to help confirm the diagnosis. Using these tests and others, along with certain lab tests, your doctor can determine if you have heart failure and begin treatment which will most likely include taking certain medications, following a low salt diet, and leading a healthy lifestyle.

These diagnostic tests may include:

Chest X-Ray

This can help assess the size and shape of the heart. It can detect fluid in the lungs.

ECG/EKG WavesElectrocardiogram (ECG)

This is a painless, simple test in which patches with electrodes are attached to your skin to measure electrical impulses produced by your heart.

These impulses are recorded as waves displayed on a monitor or printed out on graph paper. It shows how fast your heart is beating and its rhythm. It also records the timing of the electrical signals as they pass through each part of the heart.

Echocardiogram

This test uses ultrasound waves to create an image of the heart and the pattern of blood flow through it.

  • Provides information about the size and shape of your heart and how well your heart chambers and valves are functioning.
  • Identify areas of poor blood flow through the heart, areas of the heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow.

The test is noninvasive and is performed by placing a probe on your chest. It is the same technique used in sonograms in pregnant women.

Ejection Fraction

This measure is taken during an echocardiogram and can also be measured during a stress test and catheterization. It shows how well your heart is pumping and is used to determine your level of heart failure and helps in deciding treatments. A normal, healthy heart has an ejection fraction of usually around 60%.

Stress Test

During a stress test, you exercise to make your heart work hard and beat fast while heart tests are done. The test can reveal abnormal changes to your heart rate or blood pressure, symptoms such as shortness of breath, or abnormal changes to your heart's electrical activity.

Sometimes, the test is given using a radioactive dye, sound waves, or other imaging devices to take pictures of your heart when it's working hard and when it's resting.

Insertion of Catheter with Guide WireCoronary Catheterization

To see the blood flowing to your heart, your doctor may want to perform a coronary catheterization. This involves injecting a dye into your arteries in what is called an angiogram.

The dye is delivered through a long, thin, flexible tube called a catheter that is threaded through a leg artery into the coronary arteries. This is called catheterization.

AngiographyThe dye outlines areas of blockages on x-ray images in the arteries that deliver blood to the heart. If a blockage is found and needs treatment, a balloon can be pushed through the catheter and inflated to open the artery or arteries in question. A stent or tiny wire mesh tube can then be inserted to keep the artery open.

This procedure is done in the hospital.

Watch Video Animation

To watch a video animation of a coronary angiography, click here .

Contact Information

Cardiovascular Medicine
Division of the CardioVascular Institute
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
617-667-8800

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