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Diagnostic Tests (II)

Echocardiography - takes a picture of the heart while it beats

Public Domain Image by Kjetil Lenes.

  • Can determine which side of the heart is failing

  • Can be used to analyze valve function, pericardium, heart wall motion

  • Systolic failure can be assessed by measuring the ejection fraction of the left ventricle.

  • Ejection fraction is calculated by dividing stroke volume by the volume of blood remaining in the ventricle after contraction.   An ejection fraction of less than 40% indicates heart failure

Note: the measurement of ejection fraction can be potentially deceiving. If the wall of the ventricle has thickened significantly, a safe ejection fraction does not necessarily mean that the heart is pumping an adequate amount of blood.



Radionuclide ventriculography or multi-gated acquisition scanning

  • Uses a small amount of injected, radioactive dye to take pictures of the heart as it pumps

  • Can be used to measure ejection fraction



Catheterization - a catheter is passed into the right side of the heart via the jugular vein to measure pressures

  • This is the most definitive test for heart failure

  • Measures pressure in the right atrium and ventricle

  • Measures pressure is the pulmonary artery

  • Allows for the estimation of the pressures in the left side of the heart by wedging the catheter into a small pulmonary artery