Tests for Heart Failure
In people with confirmed or suspected heart failure, tests and investigations can guide the diagnosis and treatment plan. The number and type of tests undertaken are decided on an individual bases.
It is common for a number of blood tests to be taken at the point of diagnosis and during the on-going management of heart failure. These can look at a number of different aspects. Commonly we check how the kidneys are working, we may do this on a number of occasions. We often check that you are not anaemic and that the iron levels are not low.
Echocardiogram (frequently referred to as an echo)
An echocardiogram uses high frequency sound waves to form a detailed picture of the structure and function of your heart. The echo can identify a weakness or abnormality with how the heart muscle is moving and problems with the heart valves. This test is not painful and involves a probe being placed in different positions around your chest along with some gel, this allows pictures to be taken from different angles. This often takes 15 to 20 minutes but in some situations it can last up to an hour. The information needs careful consideration before a report is completed, so the results are often not available immediately. This is a common test for people with suspected or confirmed heart failure.
This is a very common test and is easily completed. A number of small sticky patches are applied to your chest, wrists and ankles, these are then connected to a machine and a reading of the electrical activity of the heart is undertaken. This usually only takes minutes to undertake. This test may even have been undertaken at the GP surgery before being referred to the specialist team.
An x-ray of your chest can help to decide if there is any additional fluid in your lungs or if there is another cause for your symptoms. This is not uncomfortable but usually involves standing still and holding your breath for a short period of time.
This is a specialist test and undertaken at James Cook. This helps to investigate if heart problems are caused by narrowing or blockages in the heart arteries (heart attacks or angina) . A small tube is passed along an artery from the wrist or groin area to the arteries of the heart. Special dye seen by x-ray equipment can then take relevant pictures to give a clear out line of the heart arteries. Often only a local anaesthetic is required. People requiring this test will be reviewed beforehand so any questions can be fully discussed. Most people having this test go home the same day.
Transoesophageal echocardiogram (TOE)
A transoesophageal echo is a specialist echo that is undertaken from the gullet (oesophagus). This means that the echo probe is closer to the heart and can take more detailed pictures. A small tube needs to be ‘swallowed’. A local anaesthetic and mild sedative are usually given when undertaking this test.
This is a specialist echo undertaken when the heart is put under stress by either exercise or medication. This will show how the heart functions when it is working harder. In some heart conditions the heart can work less efficiently when under stress. Sometimes people are asked to avoid taking some of their medications just before the test, this information will be included in the appointment letter.
Myocardial perfusion scan
Small amounts of radioactive material are used to undertake this test. This is injected into the blood and pictures using a special camera are taken to record how this passes through your heart. Information maybe recorded at rest and when the heart is working harder (stressed). Often this test involves a wait between the different parts or between being given the radioactive material and taking the pictures as a specific amount of time is required for the radioactive material to be absorbed by the heart. Some people will have instructions regarding avoiding some foods and drink and will be asked to miss some tablets just before the test, these instructions will be provided in the appointment letter.
A cardiac MRI can help to determine why some people have heart problems. It can provide detailed pictures of the heart. Magnetic fields and radio waves are used to create these pictures. This is not painful but you do need to be still and it can take up to an hour. Some people can feel claustrophobic during the scan or find it quite noisy. If you have an MRI planned and suffer with a dislike of small spaces please let the team know. Because this test uses magnets it is import that the staff know if you have any metal in your body, such as artificial joints. If you have a pacemaker the staff undertaking the test will check that it is a pacemaker that is safe to have an MRI test with.