Other tests

Chest X-ray: An enlarged heart is a sign of heart failure; the X-ray shows the size of the heart and reveals any buildup of fluid around the heart and lungs, which is another sign. You can learn more about this test at our chest X-ray page.

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Echocardiogram: A wand placed on the surface of the chest bounces ultrasound waves off the internal structures of the heart to create pictures of the valves and chambers, permitting the heart's pumping action to be assessed. An echocardiogram is often combined with another ultrasound test to detect changes in the velocity of blood flow through the valves and to gauge the pressure within the pumping chambers. You can learn more about this test at our echocardiogram page.

Ejection fraction (EF): This is a more advanced test, which determines how much of the blood held in the heart's pumping chambers is ejected with each heartbeat. A normal EF is generally greater than 50 percent, meaning more than half of the blood volume is pumped out. Below 40 percent usually confirms a diagnosis of systolic heart failure. Someone with diastolic failure can have a normal EF. EF is measured with various types of nuclear scans, such as a multigated acquisition scan (MUGA), a nuclear ventriculogram, or a radionuclide scan. During a MUGA scan, for example, adhesive electrodes are attached to the chest and connected to an electrocardiograph monitor to chart the heart's electrical activity. An intravenous line is inserted into a vein in the arm. A small amount of blood is withdrawn, mixed with a radioactive tracer that binds to the red blood cells, and reinjected. A large overhead camera focused on the heart analyzes the volume of red blood cells pumped out with each heartbeat. The test takes one to two hours.

Electrocardiogram (EKG): If the doctor has any reason to suspect a heart problem, you will have an electrocardiogram. A large number of adhesive sensors will be placed on your chest and other parts of the body. The electrical impulses traveling through the heart will be monitored and transcribed out on a strip of paper. The test itself is painless, but men with hairy chests will have to endure a few "ouch" moments when the sensors are removed.