Your doctor will review your medical history and ask for details about your symptoms, including how many blocks you can walk without becoming short of breath, the number of pillows you sleep on and whether you suddenly wake up after falling asleep because of severe shortness of breath.
During your physical examination, your doctor will check your vital signs (such as blood pressure and temperature), check your heart rate and rhythm, and listen for abnormal heart sounds with a stethoscope. He or she will listen to your lungs for abnormal breathing sounds that indicate fluid is building up in your lungs. Your doctor will press on the skin of your legs and ankles to check for edema (swelling). He or she may feel your abdomen to check the size of your liver because fluid backup from the heart may cause liver swelling.
You also will have diagnostic tests, including an electrocardiogram and a chest X-ray, to check for enlargement of the heart and fluid in the lungs. Other diagnostic tests may be needed to find the cause of your heart failure. For example, a test called an echocardiogram may likely be done to look for heart valve abnormalities, abnormal movement of the heart wall (a sign of heart attack) or other cardiac abnormalities. The echocardiogram is a particularly important test because it can determine whether the heart muscles have weakened or become stiff. The treatment can differ depending on the type of heart failure.