Your doctor can use an x-ray to look at your heart, lungs, and blood vessels. He or she can see if your heart is enlarged or if there is fluid around your lungs. Pulmonary congestion shows up as cloudy areas on the x-ray. A chest x-ray requires only a brief exposure to x-rays and is generally considered safe.
The echocardiogram is a procedure used to visualize the pumping action of the heart. It is an ultrasound examination of the heart that can also measure blood flow into and out of the heart.
This test also known as an “ECG” or “EKG“, measures the electrical activity of the heart. An electrocardiogram can check the heart’s rhythm, evidence of enlargement, and the presence of a prior or recent heart attack. Electrical wires with adhesive ends are attached to the skin on your chest, arms, and legs. The electrical activity of the heart is then recorded on a piece of paper.
Radioactive tracers given through a hand or arm IV are another tool used in the diagnosis of heart failure. Radioactivity is detected as the blood moves through the heart. In this way, doctors can outline the chambers of the heart, measure the ejection fraction, and assess blood flow to regions of the heart muscle.
This test is known as a “stress test” because your heart’s activity is being monitored with an electrocardiogram during exercise. By walking on a treadmill for specific intervals of time at differing intensity levels, your doctor can see if your symptoms are brought on by exertion and if they correlate with patterns on an electrocardiogram.
Stress tests can be done using radioactive tracers such as thallium, Sesta MIBI, and Myoview. First, the tracer is injected into an IV tube in the arm before and during exercise on the treadmill. After exercise, pictures of the heart can be taken to see where the tracer has been deposited, telling the doctor which areas are getting enough blood and which are not.
Alternatively, stress testing can be done without exercise. The effects of stress on heart blood flow can be simulated through the use of an IV drug such as adenosine or persantine that dilates heart blood vessels, or dobutamine that increases heart rate and function.
Doctors can insert a catheter, or small tube, into a leg (femoral) artery via a needle stick and direct it to a region of the heart with x-ray guidance. Once in place, the catheter can measure pressures in the heart and direct a dye used to visualize heart chambers or blood vessels. This visualization technique is called angiography. The x-rays show areas of narrowing or blockage. Catheters are also used to open blocked heart arteries with angioplasty and stenting.