Heart Failure Tests, Treatments and Devices

Heart failure tests

  • If your healthcare provider suspects that you may have heart failure, a number of tests may be arranged.
  • Some common heart failure tests are explained below:
    • Bloodwork: Bloodwork may be ordered to look at your blood counts, kidney, liver, and thyroid function.
    • Electrocardiogram (ECG or EKG): An ECG may provide clues that a chamber in the heart is enlarged and can sometimes show evidence of a previous heart attack. An ECG records your heart’s electrical activity.
    • Chest X-ray: A chest X-ray can give information about the size of the heart. It also looks at the lungs and can show if there is extra fluid built up in the lungs, which may cause shortness of breath.
    • Echocardiogram (ECHO): An ECHO is an ultrasound of the heart. It provides detailed information about the heart’s structure and function – including the pumping function of the heart (referred to as the left ventricular ejection fraction, or LVEF) as well as the function of the valves in the heart.
    • Exercise stress ECHO: An exercise stress ECHO is a test that shows how well your heart works during stress/activity. This test checks your heart function, determines how well blood and oxygen flow through the arteries and checks the function of your heart valves. During this test, you will be asked to either walk on a treadmill or pedal a stationary bicycle. A picture of the heart will be taken both before and after exercise.
    • Coronary angiogram: A coronary angiogram allows a very detailed look at the arteries around the heart, and can detect narrowing or blockages that may be contributing to heart failure.
    • Multigated acquisition (MUGA): A MUGA scan involves the injection of a small amount of a radioactive tracer. After the radioactive tracer is injected, several pictures of your heart will be taken using a special camera.
    • Nuclear perfusion scan: This test is a special type of stress test that uses a small dose of an intravenous radioactive material to look at the blood flow to the heart at rest then after stress
    • Cardiopulmonary test (CPT): A CPT is a special type of exercise stress test. It involves exercising on a treadmill or bike. You will wear a special mask that allows for the measurement of the amount of oxygen you are consuming and the amount of carbon dioxide you are producing.
    • Cardiac MRI: A cardiac MRI may be used to look at the heart structure, and to look for inflammation or scar within the heart.
    • Cardiac positron emission tomography (PET) scan: A cardiac PET scan is a specialized nuclear test that is used to take pictures of the heart. It may be ordered to find out if the tissue of the heart is still living (or viable).

Heart failure treatments

  • Establishing a healthy lifestyle is an essential part of managing heart failure. In heart failure, your heart is not functioning normally. This means your body is not able to deal with extra amounts of sodium or fluid.
  • This means that you need to:
    • Pay extra attention to your diet, particularly the amount of fluid you drink and the amount of sodium (salt) you eat.
    • Monitor your weight daily (use a weight log or calendar).
    • Participate in regular exercise, including strength training.
    • Manage your stress levels, practice relaxation exercised, and deep breathing.
    • Always take your medications as prescribed.

Heart failure devices

  • Device therapies refer to specialized pacemakers that may either make your heart pump more efficient or may protect you from life-threatening arrhythmias (abnormal heart rhythms).
  • The decision about which (if any) device is right for you depends on several factors, including how severe your symptoms are, and how impaired your heart function is (measured by the ejection fraction).
  • Some common heart failure devices are explained below:
    • Implantable cardioverter-defibrillator (ICD): An ICD is an implantable device that is intended to protect you against fast heart rhythms that are potentially life-threatening.
    • Cardiac resynchronization therapy (CRT, CRT-D): A CRT is a special type of pacemaker that helps your heart pump more efficiently. It may also be combined with a defibrillator referred to as CRT-D.
    • Left ventricular assist devices (LVADs): LVADs are specialized mechanical pumps that take over the pumping function of the left side of the heart.
    • Implantable Hemodynamic Sensors (PA sensor): This device is a miniaturized, wireless monitoring sensor that is implanted in the pulmonary artery during a minimally invasive procedure to directly measure PA pressure (which is a precursor to fluid retention). The system allows patients to transmit PA pressure data from their homes to their health care providers allowing for personalized and proactive management to reduce the likelihood of hospitalization. The sensor is designed to last the lifetime of the patient.
    • Heart Transplantation: while not a device per se, heart transplantation can be a lifesaving therapy. It is an option for the sickest patients who continue to have symptoms of heart failure or require frequent readmission to the hospital for heart failure.

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