Blood test
A possible blood test to confirm the suspicion of heart failure is the BNP or NT-pro BNP rapid test. BNP is a hormone that is produced in the cells of the ventricle and is mainly released when the heart muscle is stretched. The more the chambers are stretched (= loaded), the more BNP is in the blood.
Possible causes of an increase in BNP are cardiac insufficiency as well as kidney/liver failure, pulmonary hypertension and pulmonary embolism. If normal values are present, heart failure is unlikely (BNP: female < 150 pg/ml; male < 100pg/ml). A strongly increased BNP, on the other hand, indicates cardiac insufficiency.It becomes problematic with slightly elevated values, since with increasing age and kidney dysfunction the BNP is also increased. Further blood tests with determination of blood sugar, number and size of red blood cells or thyroid gland values serve to exclude other diseases that cause similar symptoms or promote heart failure. These include diabetes, anemia and thyroid dysfunction.
ECG
A cardiac insufficiency can have different manifestations in the ECG. If blood backflow occurs as a result of heart failure, the cause may be a disturbed transmission of stimuli by the heart. This would show up in an irregular rhythm in the ECG (extended PQ time).
In addition, there are a number of ECG changes that indicate that a heart attack has elapsed. In the course of the disease, if coronary heart disease (CHD) is suspected or to assess exercise tolerance, a stress ECG can be performed. Physical activity and light sports are essential for the success of therapy. In order to recommend an optimal therapy, the performance limit must first be determined.
Physical tests for heart failure
At the beginning of a medical examination, a physical examination is performed based on the symptoms described above. First of all, the heart is listened to, and attention is paid to heart murmurs, which indicate heart valve defects. On the other hand, a 3rd heart sound may be heard (gallop rhythm), which indicates increased pressure in the heart chambers.
Next, the lungs are listened to. Blood backflow into the lungs can cause pulmonary edema, which causes wet rales. Another congestion sign can be visible on the neck.
If the outflow from the right heart is difficult, the blood accumulates in the neck veins, and the veins are clearly visible, especially in patients lying down. In addition, the legs of the affected person are examined for leg edema. For this purpose, the skin above the shinbone is pressed in.
If there is fluid in the tissue, a dent will remain in the soft skin, which will only disappear after a few minutes. The toes are not affected by the edema, and both legs are usually equally affected.
