These tests are done if you have heart failure


Elderly people often develop heart failure or heart failure. Almost 20% of the> 60-year-olds and almost 40% of the> 70-year-olds in Germany suffer from heart failure, whereby women are less frequently affected than men.
Heart failure is incurable and is one of the leading causes of death. Early diagnosis and consistent therapy are decisive for a longer life expectancy. A doctor should be consulted early and specific tests carried out.

Read more on the topic: Heart failure

These tests are there

Various online questionnaire tests are circulating on the Internet, which inquire about the various symptoms that indicate a heart failure. The stronger the symptoms and the more symptoms appear at the same time, the more likely it is that the diagnosis of heart failure is. There are now standardized and scientifically evaluated questionnaires that doctors also use in everyday practice. Each question corresponds to a certain point value.
If a certain amount is exceeded at the end, e.g. Blood test (BNP test) and a referral to the cardiologist initiated. The BNP rapid blood test is a newer method for assessing the stress on the heart. BNP (= B-natriuretic peptide) is released from cells in the heart chambers. The more the chambers are stretched (= loaded), the more BNP is in the blood. In addition, the doctor will always carry out a physical examination, during which the heart and lungs will be monitored and the body examined for possible signs of congestion (leg edema, neck vein congestion).
However, in order to be able to safely rule out or confirm cardiac insufficiency, echocardiography (heart ultrasound) is performed in any case. The ventricular system is examined from different angles. Heart movements, heart muscle thickness, heart valves, blood flows and ejection volumes can be determined and interpreted here. In the further course, ECG, X-ray or blood tests can be useful to uncover possible causes.

Read more on the topic: Echocardiography

How useful are online tests?

The quality of the online tests vary widely. For all variants, symptoms are queried to a different extent. However, the symptoms of heart failure are often very unspecific. Shortness of breath, for example, can have many causes and can quickly lead you on the wrong track. It therefore makes sense to first ask a wide range of questions in order to then go into more detail on certain symptoms in the next step.
However, this is difficult to implement in a standardized online tool. Scientifically evaluated questionnaires usually have a larger scope and are more differentiated in their analysis. In principle, online questionnaires can be a first step to sensitize those affected to the topic. If an online test turns out positive, however, you should not immediately assume that you really have a weak heart. A visit to the doctor and further tests are essential!

Also read the article on the topic: Symptoms of heart failure

Ultrasound examination

The heart ultrasound is usually performed on the patient lying on his back and on his left side. A special ultrasound probe is guided along the left chest and the lower edge of the rib. The heart chambers, heart walls and valves are shown from different perspectives. The Doppler effect can also make the blood flow through the heart visible.
During the examination, the doctor can assess the contraction of the heart muscle and detect any wall movement disorders. A scar in the heart muscle after a heart attack leads e.g. to the fact that the heart muscle in the affected area hardly moves or moves unevenly. The thickness of the heart muscle and the volume of the individual chambers can also be measured. If the heart is heavily stressed, the heart muscle becomes thicker (hypertrophy) and the volume in the heart chamber increases.
The Doppler effect shows whether the heart lobes are leaking and whether blood is flowing back into the heart. Lastly, the volume that the heart ejects per beat can be determined (LVEF left ventricular ejection fraction). This is the most important measure to classify heart failure. Normally the value should be over 54%.

Find out more about the topic: Echocardiography

Blood test

One possible blood test to confirm the suspicion of heart failure is the BNP or NT-pro BNP rapid test. BNP is a hormone that is formed in the cells of the heart chamber and is released primarily when the heart muscle is stretched. The more the chambers are stretched (= loaded), the more BNP is in the blood.
Possible causes of an increase in BNP are heart failure, kidney / liver failure, pulmonary hypertension and pulmonary embolism. If the values ​​are normal, heart failure is unlikely (BNP: female <150 pg / ml; male <100 pg / ml).
A greatly increased BNP, on the other hand, suggests cardiac insufficiency. It becomes problematic with slightly increased values, since the BNP also increases with increasing age and kidney dysfunction. Further blood tests to determine blood sugar, the number and size of red blood cells or thyroid values ​​are used to rule out other diseases that cause similar symptoms or promote heart failure. These include diabetes, anemia and thyroid dysfunction.


Cardiac insufficiency can have different manifestations in the ECG. If blood backlog occurs as a result of the weakness of the heart, the cause may be a disturbed transmission of stimuli by the heart. This would show up in an irregular rhythm in the ECG (extended PQ time).
In addition, there are a number of EKG changes that suggest a heart attack has passed. In the course of suspicion of coronary artery disease (CHD) or to assess resilience, an exercise ECG can be performed. Physical activity and light sport are essential for the success of the therapy, so that an optimal therapy can be recommended, the performance limit must first be determined.

Also read the article on the topic: Can you recognize a heart failure in the EKG?

Physical tests for heart failure

At the beginning of a medical examination, a physical examination is carried out based on the symptoms described. The heart is first listened to, paying attention to heart murmurs that indicate heart valve defects. On the other hand, one can possibly perceive a third heart sound (gallop rhythm), which indicates an increased pressure in the heart chambers.

Find out more about the topic: Heart murmurs

Next, the lungs are monitored. A backlog of blood in the lungs can lead to pulmonary edema, which causes wet rattling noises. Another sign of congestion can be seen on the neck. If the outflow from the right heart is difficult, the blood builds up in the neck veins, especially when the patient is lying down, the veins protrude clearly.
The affected person's legs are also examined for leg edema. To do this, the skin over the shin is pressed in. If there is fluid in the tissue, a dent will remain in the soft skin that will only go away after a few minutes. The toes are not affected by the edema, and both legs are usually equally affected.