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Diagnostic Tests Used to Confirm CHF
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Chest x-ray: A chest x-ray images the heart and
surrounding thoracic anatomy, shows heart size and shape and reveals whether the heart is
misshapen or enlarged due to disease. Abnormal calcification (hardened blockage due to
cholesterol build up) in the main blood vessels and fluid in the lungs (possible
indication of CHF) can also be seen. Chest x-rays can also be used to image pacemakers and
artificial heart valves to check for correct positioning.
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- Electrocardiogram (ECG or EKG): An electrocardiogram is a graphical record of the
electrical activity of the heart. A normal ECG, in most cases, rules out the presence of
other cardiac diseases. An abnormal ECG indicates the presence of a cardiac disease and
further investigations are performed. An ECG can be beneficial in detecting the disease
and sometimes even the extent of the disease.
- Echocardiogram (heart ultrasound): This diagnostic technique is an excellent
tool to provide details of the cardiac structures – vessels, valves, and muscle.
Echocardiography is a non-invasive exam in which images are acquired and viewed in real
time without the use of radiation. Echocardiography is often useful in studying the
beating heart and provides some information on functional abnormalities of the heart wall,
valves and blood vessels. Echocardiography with Doppler is used to measure blood flow
across valves, across septal defects (shunts), extent of regurgitations, etc. Color flow
mapping capability is extremely useful in the detection of shunts. Abnormal operation of
the valves can be detected by studying the opening and closing function versus normal
valve function. Echocardiography may also be used to study congenital heart defects such
as a septal defect (a hole in the wall that separates the two chambers of the heart).
- Stress test: A stress test involves taking an ECG before, during and a treadmill
workout to detect possible heart disease and/or damage, including the extent of coronary artery disease. However, false positive results are
possible with stress tests.
- Nuclear cardiology: Nuclear cardiology (also called radionuclide scanning or stress
thallium imaging) allows visualization of the function of the heart. Myocardial perfusion
imaging is the most common nuclear cardiology test to assess coronary artery disease. This
noninvasive test can identify and quantify areas of inadequate blood supply within the
myocardium (heart muscle), detect scaring of the myocardium, and assess the heart's
pumping function. Nuclear cardiology is a cost-effective tool to help determine which
patients are candidates for coronary angiography,
revascularization, or coronary artery bypass surgery. Nuclear cardiology is also useful to
monitoring the effectiveness of coronary revascularization or bypass surgery.
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Coronary angiography: The procedure, performed in a cardiac catheterization
laboratory, is minimally invasive and involves placing a catheter in a major blood vessel
and injecting a dye (radio-opaque material) to create an image of the heart and coronary
arteries. Angiography is excellent for imaging blockages in
the coronary vessels. Angiography can also image the beating heart in real time and may be
useful in evaluating the function of the heart chambers. Angiography is often used for
diagnosing heart disorders, but is also a valuable tool for guiding therapeutic treatment
of the coronary arteries (e.g. angioplasty). In addition to diagnosing coronary artery
disease, angiography is useful for diagnosing or treating children with congenital heart
diseases and is also used during pacemaker implantation to help position the pacemaker
leads.
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Updated: August 2006
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