Screenings if you have heart failure

Regular review

NICE says the primary care team should lead a full review of the person's heart failure care, which may form part of a long-term conditions review, and recall the person at least every 6 months. (NICE NG106) NICE says to set how often monitoring happens by the person's clinical status and how stable their condition is: a short timeframe (days to every 2 weeks) if their condition or medicines have changed, and at least every 6 months for stable people with proven heart failure. (NICE NG106) MedlinePlus says follow-up visits are at least every 3 to 6 months, but sometimes much more often, with tests to check heart function. (MedlinePlus)

NICE says monitoring for all people with heart failure should include, as a minimum: (NICE NG106)

a clinical assessment of functional capacity, fluid status, cardiac rhythm (minimum of examining the pulse), cognitive status and nutritional status
a review of medication, including need for changes and possible side effects
an assessment of renal function
iron status and haemoglobin measurement

NICE adds that people with other conditions, or whose condition has got worse since the last review, should have more detailed monitoring. (NICE NG106) See questions to ask your doctor.

Kidney, salt and blood count tests

MedlinePlus says blood urea nitrogen (BUN) and serum creatinine tests help monitor how well your kidneys are working, and that you will need them regularly if you take certain medicines, if the doses of your medicines change, or if you have more severe heart failure. (MedlinePlus tests) It says sodium and potassium levels need to be measured on a regular basis when some medicines are changed. (MedlinePlus tests) The NHS lists chronic kidney disease and anaemia among the possible causes of heart failure. (NHS) See kidney test results and screenings if you have kidney disease.

For people with heart failure with reduced ejection fraction, NICE says to assess iron status and check for anaemia with all of these blood tests: transferrin saturation (TSAT), serum ferritin and haemoglobin. (NICE NG106) MedlinePlus says anaemia (a low red blood cell count) can make heart failure worse, and that your provider will check your complete blood count on a regular basis or when your symptoms get worse. (MedlinePlus tests) See complete blood count results.

Pulse and heart rhythm

NICE includes cardiac rhythm, at minimum examining the pulse, in the clinical assessment for all people with heart failure. (NICE NG106) When heart failure is being looked into, NICE says to perform an ECG. (NICE NG106) MedlinePlus lists some types of abnormal heart rhythms among the heart problems that may cause heart failure, and says people with heart failure may be at risk for dangerous heart rhythms. (MedlinePlus) See atrial fibrillation screening and ECG at a checkup.

Blood pressure, blood sugar and cholesterol

MedlinePlus says high blood pressure that is not well controlled is one of the most common causes of heart failure, and that at home you should watch for changes in your heart rate, pulse, blood pressure and weight. (MedlinePlus) NICE says to measure blood pressure, or ask the person to measure their own, before and after each dose increase of heart failure medicines. (NICE NG106) When heart failure is being looked into, NICE lists kidney, thyroid, liver and lipid (cholesterol) profiles, HbA1c and a full blood count among the blood tests to consider, along with urinalysis and peak flow or spirometry. (NICE NG106) See blood pressure readings, A1C and blood sugar results, cholesterol test results and thyroid test results.

Memory and thinking

NICE lists cognitive status among the things to assess when monitoring all people with heart failure. (NICE NG106) See memory screening (Mini-Cog and MoCA).

Depression and anxiety

The NHS says being told you have a heart condition can be very scary, and cause stress, anxiety and worries about the future, and that you can refer yourself directly to an NHS talking therapies service. (NHS) For depression in people with heart failure, NICE NG106 points to the NICE guideline on depression in adults with a chronic physical health problem. (NICE NG106) See depression screening: what to expect, anxiety screening (GAD-7) and mental health screenings by age.

Usual screening on schedule

Heart failure does not change the general schedules for cancer and other screening in the sources on this page. (NICE NG106)(MedlinePlus) See heart screenings by age, preventive screenings for older adults, cancer screenings by age and screenings by age and gender.

When to contact a provider

MedlinePlus, heart failure, when to contact a medical professional: (MedlinePlus)

Contact your provider if you develop: Increased cough or phlegm; Sudden weight gain or swelling; Weakness; Other new or unexplained symptoms.
Go to the emergency room or call the local emergency number (such as 911) if: You faint; You have fast and irregular heartbeat (especially if you also have other symptoms); You feel a severe chest pain.

Where they differ:

How often. NICE says to monitor stable people with proven heart failure at least every 6 months; (NICE NG106) MedlinePlus says follow-up visits are at least every 3 to 6 months. (MedlinePlus)
Blood count. NICE sets iron status and haemoglobin as minimum monitoring for all people with heart failure, and a full iron panel (TSAT, ferritin and haemoglobin) for heart failure with reduced ejection fraction; (NICE NG106) MedlinePlus describes a complete blood count on a regular basis or when symptoms get worse. (MedlinePlus tests)

Your doctor decides what your result means for you.

Questions people ask

How often should someone with heart failure be reviewed?

NICE says the primary care team should recall people with heart failure at least every 6 months, and that stable people with proven heart failure should be monitored at least every 6 months, with a shorter timeframe (days to every 2 weeks) if their condition or medicines have changed. MedlinePlus says follow-up visits are at least every 3 to 6 months, and sometimes much more often. (NICE NG106) (MedlinePlus)

Which blood tests are part of a heart failure review?

NICE says monitoring for all people with heart failure includes an assessment of kidney (renal) function and measurement of iron status and haemoglobin. MedlinePlus says kidney tests, sodium and potassium levels and a complete blood count are checked regularly in some situations. (NICE NG106) (MedlinePlus tests)

Will memory be checked at a heart failure review?

NICE lists cognitive status among the things to assess when monitoring all people with heart failure, alongside functional capacity, fluid status, heart rhythm and nutritional status. (NICE NG106)

Does heart failure change the usual cancer screening schedule?

The sources on this page do not set a different schedule for cancer or other routine screening in people with heart failure. (NICE NG106) (MedlinePlus)