In case of sudden chest pain, shortness of breath or fainting, call 112.
Heart failure: diagnosis and follow-up
Heart failure is a condition in which the heart cannot pump as much blood as the body needs. This page explains the symptoms, the tests used for diagnosis and how regular follow-up works.
What is it?
Heart failure does not mean that the heart has stopped. It is a condition in which the heart cannot pump as much blood as the body needs, or can only do so with raised pressures inside the heart. Common causes include coronary artery disease, high blood pressure, heart valve disease and heart muscle disease. Heart failure broadly takes two forms. In some patients the heart muscle squeezes weakly and the proportion of blood pumped out with each beat (the ejection fraction) falls. In others the squeezing strength is preserved, but the heart cannot relax and fill properly; this is called heart failure with preserved ejection fraction. Some patients fall between the two. Treatment and follow-up are planned according to this distinction. Heart failure is usually a long-term condition. Regular follow-up, taking medicines without missing doses and following your doctor's advice can help keep symptoms under control and reduce the need for hospital admission.
Who is it for?
- People with symptoms such as breathlessness (especially when lying flat or waking them at night), tiring easily or swollen legs
- People who have had a heart attack, or who have high blood pressure, diabetes or heart valve disease
- Patients already diagnosed with heart failure who need regular follow-up
Before the procedure
When you come for your appointment, bring a list of all your medicines and any previous blood test, ECG and echocardiography results. If you measure your weight or blood pressure at home, bring those records too. Noting when your symptoms started and what makes them worse helps the consultation. Do not stop your heart failure medicines or change their dose on your own. Any change to your medicines is made together with your doctor.
How is it done?
- Consultation and history: You are asked about your symptoms, past illnesses and medicines. The heart and lungs are listened to, and signs of fluid build-up such as leg swelling are checked.
- ECG: The electrical activity of the heart is recorded. Rhythm disturbances and signs of a previous heart attack can be seen on this test.
- Blood tests: Natriuretic peptide (BNP or NT-proBNP), which is released into the blood when the heart is under strain, is measured; a normal result makes heart failure less likely. Kidney function, blood count and other tests are also checked.
- Echocardiography: A heart ultrasound shows how strongly the heart squeezes (the ejection fraction), how it relaxes, the valves and the pressures inside the heart. It is the key test for diagnosis.
- Further tests if needed: To find the cause of heart failure, tests such as coronary angiography, cardiac MRI, an exercise test or ambulatory rhythm (Holter) monitoring may be requested.
- Regular follow-up: At check-ups your symptoms, weight, blood pressure and blood tests are reviewed; echocardiography is repeated when needed and your medicines are adjusted accordingly.
Recovery
Follow-up in heart failure is ongoing. Your doctor sets how often you are seen, depending on your symptoms and on any medicines that are new or have had a dose change. Taking your medicines without missing doses, at the recommended times, is the basis of follow-up. You may be advised to weigh yourself every morning under the same conditions (after using the toilet and before breakfast). A marked weight gain over a short time can be a sign that fluid is building up in the body. Your doctor will tell you at what weight gain you should get in touch. Follow your doctor's personal advice on salt and fluid intake; the amounts are not the same for everyone. Regular physical activity at the level your doctor recommends, stopping smoking and having the recommended vaccinations are also part of follow-up.
Risks
Contact your doctor without delay if your breathlessness gets worse, you become breathless when lying flat or wake up at night short of breath, you gain a marked amount of weight in a short time, or swelling in your legs or abdomen increases. In case of sudden severe breathlessness, chest pain or fainting, call 112. The ECG and echocardiography used for diagnosis are painless and involve no radiation. There may be a small bruise where blood is taken. Tests such as angiography, if needed, have their own risks; if they are recommended, your doctor will explain the risks to you in detail. Some medicines used in heart failure can affect kidney function and blood levels such as potassium. This is why blood tests are repeated at check-ups.
Frequently asked questions
- Does heart failure mean the heart has stopped? No. It means the heart is working but cannot pump enough blood to meet the body's needs.
- I feel well. Can I stop my medicines? No. Feeling well may be the effect of your medicines. Any change to your medicines should be made together with your doctor.
- How often should I come for check-ups? It depends on your symptoms and on any medicines that are new or have had a dose change. Your doctor will set the right interval for you.
- Can I exercise? For most patients whose condition is stable, regular physical activity at the level their doctor recommends is advised. Talk to your doctor about how much and what kind is right for you.
Medical content reviewed and approved by Prof. Dr. Barış Kılıçaslan. Last updated: 4 October 2026. Editor: Baran Zeydan (info@clinixcrm.app).