If you are wondering what the procedure and guidelines are for a doctor’s diagnostic exam in chronic adult heart failure, the National Guideline Clearinghouse of the U.S. Department of Health and Human Services has provided a thorough summary. Below is a brief excerpt from the guideline:
Guideline Objective(s)
To assist health care providers in clinical decision-making by describing a range of generally acceptable approaches for the prevention, diagnosis, and management of heart failure
Target Population
- Adults with chronic heart failure associated with normal or low left ventricular ejection fraction , including consideration of the following special populations:
- Women and men
- High-risk ethnic minority groups (e.g., blacks)
- Elderly patients
- Adults at high risk of developing heart failure
Initial Assessments
- Thorough history and physical examination, including history of current and past alcohol and drug use, orthostatic blood pressure changes, weight and height, and calculation of body mass index
- Assessment of ability to perform routine and desired activities of daily living
- Laboratory testing: complete blood count, urinalysis, serum electrolytes (including calcium and magnesium), blood urea nitrogen, serum creatinine, fasting blood glucose, lipid profile, liver function tests, and thyroid-stimulating hormone.
- 12-lead electrocardiography
- Chest radiography (PA and lateral)
- Two-dimensional echocardiogram coupled with Doppler flow studies
- Coronary arteriography in appropriate patients
- Maximal exercise testing with or without measurement of respiratory gas exchange and/or blood oxygen saturation in appropriate patients
- Screening for hemochromatosis, sleep-disturbed breathing, or human immunodeficiency virus, in selected patients
- Diagnostic tests for rheumatologic diseases, amyloidosis, or pheochromocytoma, if indicated
- Endomyocardial biopsy, when specific diagnosis is suspected that would influence therapy
- Holter monitoring, if indicated.
The rest of the summary can be found here.
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