心力衰竭:诊断

University's 先进的心脏衰竭 Center

1350年沃顿的方式
奥古斯塔、乔治亚州30901 - 2629
电话: 706-774-7855 
传真. 706-364-0516 
小时: 8 a.m.-4:30 p.m.


Doctors can often make a preliminary 诊断 of heart failure by medical history and careful physical examination.

A thorough medical history may identify risks for heart failure that include:

  • 心力衰竭:高血压高血压
  • 糖尿病
  • 不正常的胆固醇水平
  • 心 disease or history of heart attack
  • 甲状腺问题
  • 肥胖
  • Lifestyle factors (such as smoking, alcohol use, and drug use)
  • Family history of dilated cardiomyopathy (disease of the heart muscle)
  • The following physical signs, along with medical history, strongly suggest heart failure:
  • 大的心
  • 异常心音
  • 肺部的异常声音
  • 肝脏肿大或压痛
  • 液体滞留在腿部和腹部
  • Elevation of pressure in the veins of the neck

实验室测试

Both blood and urine tests are used to check for problems with the liver and kidneys and to detect signs of diabetes. 实验室测试包括:

  • Complete blood counts to check for anemia.
  • Blood and urine tests to check kidney function.
  • Sodium, potassium, and other electrolyte levels.
  • 胆固醇和脂质水平.
  • 血糖(葡萄糖)水平.
  • 甲状腺功能.
  • 脑钠肽(BNP)水平. BNP is a hormone that increases during heart failure. BNP testing can be very helpful in correctly diagnosing heart failure in patients who come to the emergency room complaining of shortness of breath (dyspnea).

心电图

An electrocardiogram (ECG) is a test that measures and records the electrical activity of the heart. 它也被称为心电图. 心电图不能诊断心力衰竭. But it may indicate underlying heart problems. The test is simple and painless to perform. 它可用于诊断:

  • 以前心脏病.
  • 异常心脏节律.
  • Enlargement of the heart muscle, which may help to determine long-term outlook.
  • A finding called a prolonged QT interval may indicate people with heart failure who are at risk for severe complications and therefore need more aggressive therapies or medication adjustments.

心电图(心电图, EKG) is used extensively to diagnose heart disease, from congenital heart disease in infants to myocardial infarction and myocarditis in adults. There are several different types of electrocardiograms.

超声心动图

The best diagnostic test for heart failure is echocardiography. 超声心动图 is a noninvasive test that uses ultrasound to image the heart as it is beating. Cardiac ultrasounds provide the following information:

  • 阀门功能评价
  • 信息 about how well the heart is pumping, especially a measurement called left ventricle ejection fraction (LVEF)
  • 信息 about how well the heart relaxes (fills) with blood
  • 心力衰竭的类型
  • Changes in the structure of the heart that may be a result of heart failure

Doctors use information from the echocardiogram for calculating the EF (how much blood is pumped out during each heartbeat), which is important for determining the severity of heart failure. Stress echocardiography may be needed if coronary artery disease is suspected.

血管造影术

Doctors may recommend angiography if they suspect that blockage of the coronary arteries is contributing to heart failure. 这个过程是侵入性的.

  • A thin tube called a catheter is inserted into one of the large arteries in the arm or leg.
  • It is gently guided through the artery until it reaches the heart.
  • The catheter measures internal 血压 at various locations, giving the doctor a picture of the extent and severity of the heart failure.
  • Dye is then injected through the tube into the heart.
  • X-rays called angiograms are taken as the dye moves through the heart and arteries.
  • These images help locate problems in the heart's pumping action or blockage in the arteries.

放射性核素脑室造影术

Radionuclide ventriculography is an imaging technique that uses a tiny amount of radioactive material (called a trace element). It is very sensitive in revealing heart enlargement or evidence of fluid accumulation around the heart and lungs. It is an accurate way to measure the EF, although an echocardiogram is a much more common way to do this.

其他成像测试

Chest x-rays can show whether the heart is enlarged. Computed tomography (CT) and magnetic resonance imaging (核磁共振成像) may also be used to evaluate the heart valves and arteries. Myocardial PET scans may be performed on certain patients to evaluate blood flow to the heart muscle.

运动压力测试

The exercise stress test measures heart rate, 血压, and electrocardiographic changes while a patient is performing physically, 通常在跑步机上行走. It can help determine heart failure symptoms. Doctors also use exercise tests to evaluate long-term outlook and the effects of particular treatments. A stress test may be done using echocardiography or may be done with nuclear imaging (called myocardial perfusion imaging).