Diagnosing congestive heart failure

A clinician asks about breathlessness, tiredness, cough, palpitations and ankle swelling, then checks your pulse, blood pressure, heart sounds and fluid retention. Blood tests can identify strain on the heart or other explanations for symptoms. An ECG records the heart rhythm, while an echocardiogram uses ultrasound to show chambers, valves and movement. Chest imaging may add information about the lungs and heart size. Atrial fibrillation and hypertension can affect the assessment; they do not make a diagnosis by themselves. Explore [Heart Failure](/conditions/heart-failure/) or [Atrial Fibrillation](/conditions/atrial-fibrillation/).

Record when symptoms occur, what activities bring them on and whether they change when you lie down. Bring medicine details and previous heart results. Complete the tests arranged and ask when results will be reviewed. A chronic disease review may help coordinate monitoring and treatment. Do not alter heart medicines without clinical advice.

Seek emergency help for severe or sudden breathlessness, chest pain, fainting, new confusion or blue lips. Contact a clinician promptly if swelling, cough or breathlessness is worsening, or if you gain fluid-related weight quickly. These warning signs need assessment regardless of the eventual diagnosis.

Ask which test is being used to assess pumping function, whether rhythm or blood pressure is contributing, and when symptoms require urgent review. Ask what to track at home and whether a [Chronic Disease Review](/treatments/consultations-and-assessment/chronic-disease-review/) is appropriate.