Heart Failure Diagnosis: Symptoms, Causes, and Medical Evaluation

Heart failure is a serious condition that occurs when the heart is unable to pump blood effectively throughout the body. One of the most common symptoms is shortness of breath, especially during physical activity or when lying flat. In severe cases, patients may find it difficult to lie down and may need to sit upright to breathe more comfortably. This posture, known as orthopnea, often indicates significant fluid buildup in the lungs.

Key Signs and Physical Symptoms

Individuals suffering from heart failure may also experience poor circulation in the extremities, a faster than normal heart rate, and fine crackling sounds in the lungs, known as rales. These symptoms can be accompanied by fatigue, swelling in the legs and ankles, and weight gain due to fluid retention. In some cases, patients may develop secondary complications such as lung infections, which can further worsen breathing difficulties.

Diagnostic Tools and Laboratory Tests

Accurate diagnosis of heart failure involves a combination of clinical evaluation and diagnostic testing. An electrocardiogram (ECG) can detect abnormal heart rhythms and signs of previous heart damage. Echocardiography provides detailed images of the heart's structure and function, helping to determine whether the failure originates from the left ventricle, right ventricle, or both.

Blood tests are also crucial in assessing heart failure. One of the most important biomarkers is NT-proBNP (N-terminal pro-B-type natriuretic peptide), which is elevated when the heart is under stress. High levels of this protein suggest heart strain and support the diagnosis of heart failure.

Understanding the Types of Heart Failure

Heart failure can be categorized into three main types: left-sided, right-sided, and congestive (global) heart failure. Left-sided heart failure typically leads to fluid accumulation in the lungs, while right-sided failure often results in swelling in the legs, abdomen, and other peripheral areas. Congestive heart failure involves both sides of the heart and presents with a combination of symptoms from both left and right dysfunction.

Common Causes and Underlying Conditions

Heart failure can stem from various underlying conditions, including heart-related (cardiogenic) issues such as valvular disease, coronary artery disease, and hypertension-induced heart disease. Other potential causes include respiratory conditions, kidney disease, and diabetes. While the final symptoms may appear similar, identifying the root cause is essential for effective treatment planning.

Past medical history plays a vital role in diagnosis. A history of high blood pressure, coronary artery disease, diabetes, or chronic kidney disease can provide valuable clues in determining the origin of heart failure. Physicians in cardiology departments commonly manage heart-related causes, but a multidisciplinary approach may be necessary for cases involving other organ systems.