The evaluation of congestive heart failure begins with a medical history and physical examination.

Physical findings in those with congestive heart failure may include:

• Irregular heartbeat
• Rapid pulse
• Mild or moderate leg swelling (bilateral)
• Distension of the veins in the neck
• High blood pressure
• Abnormal lung sounds:
• During examination with a stethoscope

Less common findings in those with congestive heart failure include:

• Jaundice
• Yellow skin
• Yellow eyes
• Brown urine
• Ascites
• Severe leg swelling

Testing is usually required to confirm the diagnosis of congestive heart failure and to determine the underlying cause.

Tests that may be used to evaluate congestive heart failure include:

• Complete blood count
• BNP testing
• Electrolyte profile
• Kidney profile
• Liver profile
• Thyroid profile
• Urinalysis
• Chest x-ray:
• May be normal or show heart enlargement
• Normal chest x-rays
• Enlarged heart
• Heart failure
• Electrocardiogram
• MUGA scan
• Thallium heart scan
• Thallium stress test
• Echocardiography
• Cardiac catheterization
• Heart biopsy:
• May be necessary to determine the underlying cause.

Less commonly performed tests that may be used to evaluate congestive heart failure include:

• MRI scan of the heart:
• Shows detailed images of the heart and coronary arteries
• Detects structural abnormalities of the heart
• SPECT scanning of the heart:
• Detects blood flow abnormalities to heart muscle
• Coronary artery CT scanning:
• Checks for possible obstructions in the coronary arteries
• Can show a build-up of calcium in a coronary artery