From the Guidelines
Blood tests recommended for diagnosing heart failure include a complete blood count, urinalysis, serum electrolytes, blood urea nitrogen, serum creatinine, fasting blood glucose, lipid profile, liver function tests, and thyroid-stimulating hormone, as well as B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) to confirm the diagnosis and assess the severity of heart failure. These tests are essential for distinguishing between heart failure and other conditions that cause similar symptoms, such as shortness of breath. The initial laboratory evaluation should include:
- Complete blood count to check for anemia, which can worsen heart failure or mimic its symptoms
- Basic metabolic panel to assess kidney function and electrolyte levels
- Liver function tests to evaluate if heart failure is causing liver congestion
- Thyroid function tests to identify thyroid disorders that can contribute to or mimic heart failure
- Cardiac troponin levels to rule out myocardial injury or infarction
- Lipid profile assessment to identify cardiovascular risk factors According to the most recent guidelines, including those from the European Society of Cardiology 1, these blood tests, combined with clinical evaluation, imaging studies, and other diagnostic tools, provide a comprehensive approach to diagnosing heart failure and understanding its underlying causes and severity.
From the Research
Blood Work for Diagnosing Heart Failure
The following blood work is recommended for diagnosing heart failure:
- Complete blood count (CBC) 2
- Blood glucose measurement 2
- Liver function tests 2
- Serum electrolyte, blood urea nitrogen, and creatinine measurements 2
- Lipid panel 2
- Urinalysis 2
- Thyroid-stimulating hormone level 2
- Serum ferritin level (in selected patients) 2
- Human immunodeficiency virus test (in selected patients) 2
- Antinuclear antibody assays (in selected patients) 2
- Rheumatoid factor test (in selected patients) 2
- Metanephrine measurements (in selected patients) 2
- N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement 3, 4, 5
- B-type natriuretic peptide (BNP) levels 3
Additional Testing
Additional testing may be necessary to confirm the diagnosis of heart failure, including:
- Echocardiogram 2, 6, 4
- Chest radiograph 2, 6, 4
- Electrocardiogram 2, 6, 4
- Radionuclide angiography or contrast cineangiography (in selected patients) 2
- Spirometry 4
Biomarkers
Biomarkers such as NT-proBNP and BNP can be used to diagnose and monitor heart failure: