Heart Failure Diagnosis: Why Echocardiograms Are More Effective Than ECGs

Heart failure is primarily diagnosed using echocardiography and blood tests. Key indicators include enlargement of the heart chambers, reduced cardiac motion, and elevated levels of BNP (B-type natriuretic peptide). In later stages, complications such as anemia may also appear. While electrocardiograms (ECGs) are commonly used in cardiac diagnostics, their value in diagnosing heart failure is quite limited.

The Limitations of ECG in Heart Failure Diagnosis

ECGs are highly effective in detecting specific conditions like myocardial infarction or angina, where they can accurately identify the affected area. However, when it comes to diagnosing heart failure or other non-ischemic heart conditions, the accuracy rate of ECGs drops to between 50% and 70%. This is largely due to the lack of specific ECG changes associated with heart failure.

Why ECG Results Can Be Misleading

As the heart enlarges in heart failure, the typical electrical patterns captured by an ECG become less distinct. During heart failure episodes, the most commonly observed changes are an increased heart rate or non-specific ST-T wave alterations. These findings are not unique to heart failure and can occur in a variety of other cardiac and non-cardiac conditions.

Better Alternatives for Accurate Diagnosis

Given the limitations of ECGs, healthcare providers are encouraged to rely more on echocardiograms for diagnosing heart failure. Echocardiography provides a clear visual of the heart's structure and function, allowing for accurate assessment of chamber size, wall motion, and overall cardiac performance. This imaging technique, combined with blood tests like BNP measurement, offers a far more reliable and comprehensive approach to diagnosing heart failure than ECG alone.