Diagnosis
The National Institute for Health and Care Excellence recommends measuring brain natriuretic peptide (BNP) a blood test, followed by ultrasound of the heart if BNP found positive. This is recommended in those with shortness of breath. In those with heart failure which worsen both a BNP and a troponin are recommended to help determine likely outcomes. Apart from Ultra sound and blood test there are few more ways to diagnose the heart failure. Chest X-rays are frequently used to aid in the diagnosis of CHF. In a person who is compensated, this may show cardiomegaly (visible enlargement of the heart). An electrocardiogram (ECG/EKG) may be used to identify arrhythmias, ischemic heart disease, right and left ventricular hypertrophy (enlargement of chamber). There are various algorithms for the diagnosis of heart failure. For example, the algorithm used by the Framingham Heart Study adds together criteria mainly from physical examination. In contrast, the more extensive algorithm by the European Society of Cardiology (ESC) weights the difference between supporting and opposing parameters from the medical history, physical examination, further medical tests as well as response to therapy.