In the course of checking your heart during your annual physical, your doctor may ask you a number of questions about your health. Your truthful, candid answers will help your doctor determine whether you're at risk for heart disease.

If heart disease or congestive heart failure is suspected, your doctor will order a number of tests before a definitive medical diagnosis of congestive heart failure is made. The results of these tests, along with the symptoms you report and the signs your doctor observes make up the data used to arrive at a medical diagnosis.

The Tests For Congestive Heart Failure Indicators

A variety of tests may be needed to achieve a medical diagnosis. Typically, your physician orders most of these tests. Some of the tests are performed when your doctor has reason to suspect diabetes or other conditions that can affect your heart function.

• Blood tests: Blood tests allow the doctor to detect diseases such as diabetes or a thyroid condition. The status of your kidneys and liver are also assessed by blood tests.
• EKG or ECG: Electrocardiograms are easy to administer. They can reveal information about previous heart attacks and provide information about the degree to which the heart muscle is experiencing stress.
• Chest x-rays: A regular x-ray can be taken to view the heart and lungs. Your physician can tell whether your heart is enlarged and whether your lungs are filling up with fluids. In cases of advanced congestive heart failure, the sac surrounding the lungs fills with fluid, which is visible on an x-ray.
• Echocardiography: Your physician can order ultrasound imaging that shows your heart beating. This type of medical imaging is safe and non-invasive while allowing assessment of heart function, valve integrity, the degree to which the heart chambers fill properly with blood, and the amount of blood your heart is able to pump out — the ejection fraction.
• Treadmill test: Also known as an exercise stress test, this test allows doctors to see how well the heart adapts to increased energy demands.

The New York Heart Association Classification System

Doctors can efficiently communicate how advanced your condition is by using a staging system. The various stages are a function of your functional limitations. That is, the earlier stages show little impairment, while substantial impairments are indicators of a more advanced stage.

The stages are useful for organizing survival data. Only about fifty percent of patients with CHF are still alive five years after diagnosis. Patients in the advanced stages have a particularly poor prognosis.

The stages of the New York Heart Association Classification System are:

• Class I: Measurable signs of heart dysfunction, but no symptoms.
• Class II: Mild heart failure. Symptoms such as fatigue and breathlessness occur during normal physical activity.
• Class III: Moderate heart failure. Fatigue and breathlessness occur more frequently, even with minimal activity.
• Class IV: Severe heart failure. Fatigue and breathlessness present even while resting.