$Unique_ID{BRK01257}
$Pretitle{}
$Title{Is a Complete Workup Needed When a Diagnosis is Already Worked Out?}
$Subject{heart failure congestive circulatory system congestive breathing chf
cardiac radiography echocardiography blood flow rate failures systems breath
radiographies echocardiographies}
$Volume{G-3}
$Log{}

Copyright (c) 1991-92,1993   Tribune Media Services, Inc.


Is a Complete Workup Needed When a Diagnosis is Already Worked Out?


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QUESTION:  My increasing difficulty with breathing has been finally diagnosed
as "congestive heart failure".  Now I face a whole bunch of tests and am
worried that perhaps much of this is unnecessary, and even expensive.  Do you
think that a complete workup is needed when the diagnosis is already worked
out?

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ANSWER:  Not only are your doctor's tests necessary, they may be critical in
pinpointing your actual condition and saving your life.  Congestive heart
failure (CHF) can take either of two forms:  a reduced level of cardiac
performance not capable of meeting the needs of your body, or hypertension
resulting from the after effects of a heart attack or chronic salt and water
retention.
     Chest radiography--standard x-rays--can uncover signs of hypertension and
measure the amount of fluid retention taking place in the chest.  The size and
silhouette of the heart itself can be studied on the x-rays in order to
diagnose specific types of heart disease.
     Echocardiography uses sound waves to analyze the heart's function,
particularly in cases where the organ is performing poorly.  The activity
within the different chambers of the heart can be studied individually,
pinpointing the site of reduced function.  The technology allows the doctor to
compare the heart while pumping and at rest to determine its "ejection
fraction," (which tells how much of the blood in the heart has been pumped out
to the body); with a lower than normal reading indicating that your heart has
become weakened.
     Refinements of the craft include two-dimensional echocardiography, in
which the ultrasound beam reveals a cross-section of the heart's activity, and
doppler echocardiography to learn the blood flow rate.  (Previously, a
catheter had to be inserted into the heart to determine these findings).
Based on his or her preliminary findings, your doctor will determine which
tests are appropriate to your situation.  While follow-up tests may be called
for to clarify a difficult diagnosis, they serve one purpose:  to eliminate
any doubt as to your best course of treatment, and help assure your recovery.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.