Medical Devices for Diagnosis and Evaluation - Medical / Health Care

The provider may order a series of diagnostic tests which may include one or more of the following:

• Blood tests
• Electrocardiogram (EKG)
• Chest X-ray
• Stress test
• Echocardiogram

The last of these, the echocardiogram (or Echo) is perhaps the most informative of the tests in terms of diagnosing heart failure. An echo is a sort of picture of the heart taken with high-frequency sound waves (ultrasound) delivered through a hand-held wand placed on your chest. The resulting picture is a graphic depiction of the heart’s actual movements healthcare providers can use to visualize the heart’s valves and chambers. Findings can help them to evaluate anatomical condition of the heart and it’s various structures, but among the most important measures of an echocardiogram is an evaluation of the heart’s pumping capacity.

The chambers of your heart fill and empty with each beat. The right ventricle pumps to supply the arteries of the lungs, and the left ventricle pumps to supply the rest of the body. An echocardiogram can reveal how much of the blood that fills the ventricles is pumped out with each beat. This measure is known as the ejection fraction or EF. In so called “systolic” heart failure, it is the ejection fraction of the left ventricle (LVEF) that means the most.
People with a healthy heart have an LVEF of 50% or higher, which means that more than half the blood in your ventricle is pumped to your body on each beat. When your ejection fraction is under 40%, it is considered a compromised ejection fraction and may be an indicator of heart failure. In some cases heart failure can occur even with a normal ejection fraction. This happens if the heart muscle becomes stiff from conditions such as high blood pressure. In any case, your healthcare provider will use the LVEF measure to make appropriate medical decisions about how to help you care for your heart failure and may even communicate the exact percentage with you.

Once you are diagnosed as living with heart failure, your healthcare provider will occasionally ask questions designed to evaluate how capable or willing you are to engage in the daily activities that healthy people of your age typically participate in. The answers to these questions allow your provider to use well-established classification systems to manage your ongoing care. The two most common classification systems are the New York Heart Association (NYHA) classification which uses a symptom-based scale with four categories ranging from Class I to Class IV., and the American College of Cardiology/ American Heart Association (ACC/AHA) scale which uses a stage-based classification system using the letters from A through D. These classification systems are not independent of each other. Your physician will often use them together to help decide the most appropriate treatment option for you. You should ask your physician about your classification to understand the severity of your heart failure.