Congestive Heart Failure (CHF)

Do you experience signs of heart failure such as shortness of breath and swelling in your ankles, feet, legs, or abdomen? 

Congestive Heart Failure (CHF) is a condition in which the heart is unable to pump enough blood to fulfill the demands of the body. When your heart has been injured by a heart attack or high blood pressure, it's more likely to happen. Shortness of breath and swelling in the ankles, feet, legs, or belly are signs of CHF. If you suspect you might have this illness, order our BNP test right away! If this is the case, it's critical to keep an eye on your health. A BNP blood test is an accurate approach to check the amounts of a protein produced by your heart and blood arteries called brain natriuretic peptide. These levels are higher than normal in people with CHF. You may order tests directly from Ulta Lab Tests and learn more about your health right now! 

You have the right to know what's going on within your body so that you can improve your health. With Ulta Lab Tests, getting the answers you need is as simple as clicking a few buttons - we make ordering tests easy and affordable for everyone! When most tests are received at the lab, we provide results within 1-2 business days. It's safe and secure to place an order here with Ulta Lab Tests if you have any questions about taking charge of your health today, our friendly customer service team.

Read more about how a BNP test might save your life!

 


Name Matches
Serum alkaline phosphatase levels are of interest in the diagnosis of hepatobiliary disorders and bone disease associated with increased osteoblastic activity. Moderate elevations of alkaline phosphatase may be seen in several conditions that do not involve the liver or bone. Among these are Hodgkin's disease, congestive heart failure, ulcerative colitis, regional enteritis, and intra-abdominal bacterial infections. Elevations are also observed during the third trimester of pregnancy.

When the Total Alkaline Phosphatase activity is increased, the Isoenzymes are useful in determining the source of the increased activity.

BNP is increased in congestive heart failure, left ventricular hypertrophy, acute myocardial infarction, coronary angioplasty, and hypertension. Elevations are also observed in pulmonary hypertension (indicating right ventricular dysfunction), acute lung injury, hypervolemic states, chronic renal failure and cirrhosis. Decreasing levels indicate therapeutic response to anti-hypertensive therapy.

See individual tests

The BUN/Creatinine ratio is useful in the differential diagnosis of acute or chronic renal disease. Reduced renal perfusion, e.g., congestive heart failure, or recent onset of urinary tract obstruction will result in an increase in BUN/Creatinine ratio. Increased urea formation also results in an increase in the ratio, e.g., gastrointestinal bleeding, trauma, etc. When there is decreased formation of urea as seen in liver disease, there is a decrease in the BUN/Creatinine ratio. In most cases of chronic renal disease the ratio remains relatively normal.

C-Reactive Protein Cardiac (hs CRP) Useful in predicting risk for cardiovascular disease.


BNP is used to aid in the diagnosis of left ventricular dysfunction in heart failure. In contrast with BNP, a drug to treat left ventricular dysfunction does not interfere with the measurement of N-terminal pro-BNP.

Clinical Significance

Urine chloride excretion approximates the dietary intake. The chloride content of most foods parallel that of sodium. An increase in urine chloride may result from water deficient dehydration, diabetic acidosis, Addison's disease, and salt-losing renal disease. Decreased urine levels are seen in congestive heart failure, severe diaphoresis and in hypochloremic metabolic alkalosis due to prolonged vomiting.


HDL cholesterol is inversely related to the risk for cardiovascular disease. It increases following regular exercise, moderate alcohol consumption and with oral estrogen therapy. Decreased levels are associated with obesity, stress, cigarette smoking and diabetes mellitus.

Most Popular
Total LDL and HDL cholesterol, in conjunction with a triglyceride determination, provide valuable information for the risk of coronary artery disease. Total serum cholesterol analysis is useful in the diagnosis of hyperlipoproteinemia, atherosclerosis, hepatic and thyroid diseases.

A Complete Blood Count (CBC) Panel is used as a screening test for various disease states including anemia, leukemia, and inflammatory processes.

A CBC blood test includes the following biomarkers: WBC, RBC, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet count, Neutrophils, Lymphs, Monocytes, Eos, Basos, Neutrophils (Absolute), Lymphs (Absolute), Monocytes(Absolute), Eos (Absolute), Basos (Absolute), Immature Granulocytes, Immature Grans (Abs)

NOTE: Only measurable biomarkers will be reported.

Reflex Parameters for Manual Slide Review
  Less than  Greater Than 
WBC  1.5 x 10^3  30.0 x 10^3 
Hemoglobin  7.0 g/dL  19.0 g/dL 
Hematocrit  None  75%
Platelet  100 x 10^3  800 x 10^3 
MCV  70 fL  115 fL 
MCH  22 pg  37 pg 
MCHC  29 g/dL  36.5 g/dL 
RBC  None  8.00 x 10^6 
RDW  None  21.5
Relative Neutrophil %  1% or ABNC <500  None 
Relative Lymphocyte %  1% 70%
Relative Monocyte %  None  25%
Eosinophil  None  35%
Basophil  None  3.50%
     
Platelet  <75 with no flags,
>100 and <130 with platelet clump flag present,
>1000 
Instrument Flags Variant lymphs, blasts,
immature neutrophils,  nRBC’s, abnormal platelets,
giant platelets, potential interference
     
The automated differential averages 6000+ cells. If none of the above parameters are met, the results are released without manual review.
CBC Reflex Pathway

Step 1 - The slide review is performed by qualified Laboratory staff and includes:

  • Confirmation of differential percentages
  • WBC and platelet estimates, when needed
  • Full review of RBC morphology
  • Comments for toxic changes, RBC inclusions, abnormal lymphs, and other
  • significant findings
  • If the differential percentages agree with the automated counts and no abnormal cells are seen, the automated differential is reported with appropriate comments

Step 2 - The slide review is performed by qualified Laboratory staff and includes: If any of the following are seen on the slide review, Laboratory staff will perform a manual differential:

  • Immature, abnormal, or toxic cells
  • nRBC’s
  • Disagreement with automated differential
  • Atypical/abnormal RBC morphology
  • Any RBC inclusions

Step 3 If any of the following are seen on the manual differential, a Pathologist will review the slide:

  • WBC<1,500 with abnormal cells noted
  • Blasts/immature cells, hairy cell lymphs, or megakaryocytes
  • New abnormal lymphocytes or monocytes
  • Variant or atypical lymphs >15%
  • Blood parasites
  • RBC morphology with 3+ spherocytes, RBC inclusions, suspect Hgb-C,
  • crystals, Pappenheimer bodies or bizarre morphology
  • nRBC’s

Comprehensive Metabolic Panel


Digoxin is a cardiac glycoside derived from the digitalis plant. It is used to treat congestive heart failure and atrial dysrhythmias. Digoxin levels are monitored to assure adequate therapeutic levels are achieved and to avoid toxicity.

See individual tests

Most Popular

Useful in the diagnosis of hypochromic, microcytic anemias. Decreased in iron deficiency anemia and increased in iron overload.


Galectin-3

Clinical Significance

A galectin-3 test may be ordered for the identification of individuals with chronic heart failure at elevated risk of disease progression.

Performing Laboratory 

Cleveland HeartLab, Inc 
6701 Carnegie Avenue, Suite 500
Cleveland, OH 44103-4623

Most Popular
Elevated levels of homocysteine are observed in patients at risk for coronary heart disease and stroke.

Serum iron quantification is useful in confirming the diagnosis of iron-deficiency anemia or hemochromatosis. The measurement of total iron binding in the same specimen may facilitate the clinician''s ability to distinguish between low serum iron levels caused by iron deficiency from those related to inflammatory neoplastic disorders. The assay for iron measures the amount of iron which is bound to transferrin. The total iron binding capacity (TIBC) measures the amount of iron that would appear in blood if all the transferrin were saturated with iron. It is an indirect measurement of transferri

Most Popular

Lipid Panel includes: Total Cholesterol, HDL Cholesterol, Triglycerides, LDL-Cholesterol (calculated), Cholesterol/HDL Ratio (calculated), Non-HDL Cholesterol (calculated)Total cholesterol —this test measures all of the cholesterol in all the lipoprotein particles.High-density lipoprotein cholesterol (HDL-C) — measures the cholesterol in HDL particles; often called "good cholesterol" because it removes excess cholesterol and carries it to the liver for removal.Direct LDL - Low-density lipoprotein cholesterol (LDL-C) — calculates the cholesterol in LDL particles; often called "bad cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to atherosclerosis. Usually, the amount of LDL cholesterol (LDL-C) is calculated using the results of total cholesterol, HDL-C, and triglycerides.Triglycerides — measures all the triglycerides in all the lipoprotein particles; most is in the very low-density lipoproteins (VLDL).


A lipid panel includes:Total cholesterol —this test measures all of the cholesterol in all the lipoprotein particles.High-density lipoprotein cholesterol (HDL-C) — measures the cholesterol in HDL particles; often called "good cholesterol" because it removes excess cholesterol and carries it to the liver for removal.Low-density lipoprotein cholesterol (LDL-C) — calculates the cholesterol in LDL particles; often called "bad cholesterol" because it deposits excess cholesterol in walls of blood vessels, which can contribute to atherosclerosis. Usually, the amount of LDL cholesterol (LDL-C) is calculated using the results of total cholesterol, HDL-C, and triglycerides.Triglycerides — measures all the triglycerides in all the lipoprotein particles; most is in the very low-density lipoproteins (VLDL).Very low-density lipoprotein cholesterol (VLDL-C) — calculated from triglycerides/5; this formula is based on the typical composition of VLDL particles.Non-HDL-C — calculated from total cholesterol minus HDL-C.Cholesterol/HDL ratio — calculated ratio of total cholesterol to HDL-C.


Metanephrines, Fractionated, Free, LC/MS/MS, Plasma

Patient Preparation: Patient should avoid alcohol, coffee, tea, tobacco and strenuous exercise prior to collection. Overnight fasting is preferred. Patients should be relaxed in either a supine or upright position before blood is drawn.

Limitations: False-positive results have been observed in patients with either chronic kidney disease or hypertension.

Clinical Significance: Normetanephrine (NM) and metanephrine (MN) are the extra-neuronal catechol-o-methyl transferase (COMT) metabolites of the catecholamines norepinephrine and epinephrine, respectively. Measurement of plasma metanephrines is more sensitive (but may be less specific) than measurement of catecholamines for the detection of pheochromocytoma. Proper interpretation of results requires awareness of recent medication/drug history (e.g., antyhypertensive agents, alcohol, cocaine) and other pre-analytical factors (e.g., stress, severe congestive heart failure, myocardial infarction) that influence release of catecholamines and metanephrines.


Metanephrines, Fractionated, LC/MS/MS, 24-Hour Urine

Includes: Metanephrine, Normetanephrine, Total Metanephrines

Patient Preparation : It is preferable for the patient to be off medications for three days prior to collection. Patient should avoid tobacco, tea, coffee, for three days prior to specimen collection. Common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Medications which are alpha agonists (Aldomet), alpha blockers (Dibenzyline) should be avoided 18-24 hours prior to specimen collection.

Preferred Specimen(s) : 5 mL 24-hour urine with 25 mL 6N HCl collected in a 24-hour urine container 

Clinical Significance: Test is useful in the evaluation of pheochromocytoma.


Metanephrines, Fractionated, LC/MS/MS, Random Urine 

Includes: Metanephrines, Normetanephrines, Total Metanephrines, Creatinine

Patient Preparation: It is preferable for the patient to be off medications for three days prior to collection. Patient should avoid tobacco, tea, coffee, for three days prior to specimen collection. Common antihypertensives (diuretics, ACE inhibitors, calcium channel blockers, alpha and beta blockers) cause minimal or no interference. Medications which are alpha agonists (Aldomet), alpha blockers (Dibenzyline) should be avoided 18-24 hours prior to specimen collection.

 


Plasma norepinephrine is an independent risk factor in patients with chronic congestive heart failure that relates to subsequent mortality. Norepinephrine is useful in evaluating patients with hypertension



Congestive Heart Failure is also known as CHF or heart failure. Whatever you call it, this condition is one where the human heart is unable to pump blood with the efficiency that it once did. This means that blood, as well as other various fluids, start backing up inside the body. The effect is particularly pronounced in the feet, hands, lungs, and liver. 

The human heart has two different sides to it, as well as four different chambers. The right side is what takes in blood depleted of oxygen from throughout the body, sending it into the lungs. Once the lungs replenish the oxygen in the blood, it’s the left side that pumps this fresh blood back out into the overall body. 

Congestive Heart Failure is a very serious condition, one that is progressive. It’s often chronic, and it can threaten your life. It might impact the left side of the heart, the right side, or even both sides. Those with CHF have lowered amounts of nutrients and oxygen delivered to their organs, resulting in lost functions and damage. 

CHF can happen for several different reasons. Most frequently, the heart undergoes damage, which might be hypertension/high blood pressure, prior heart attacks, or even cardiomyopathy, which is direct damage right to the actual heart muscle. Congestive Heart Failure can also happen if there is any damage to the heart valves or pericardium scarring to the membrane that physically surrounds the human heart. On rare occasions, CHF happens if the heart must start beating with more force than is typical, as which can happen with hyperthyroidism, where it simply can’t keep up with the current demand. Congestive Heart Failure risks are elevated among those with diabetes, the overweight and obese, smokers, and anyone who abuses cocaine and/or alcohol. 

CHF is very common in elderly individuals since the human heart tends to lose efficiency with age. The National Heart, Lung and Blood Institute has estimates showing that between 5.5 and 6 million Americans have heart failure at any given time. For those older than 65, it’s among the most frequent reasons for hospitalization. 

Symptoms/Signs 

When blood backs up starting from the heart’s right side, then Congestive Heart Failure symptoms typically start with ankles and legs swelling in ways that get worse if a person stands up but gets better if they lie down. If blood starts backing up from the heart’s left side, then it moves into the lungs, resulting in coughing or breathing, particularly during periods of lying down flat or exercise, even if it’s just walking up a set of stairs. Many individuals that suffer heart failure have demonstrated symptoms of blood that’s backing up simultaneously on both sides of the heart. 

On top of shortness of breath and edema/swelling, other symptoms can include the following: 

  • Rapid pulse, heart palpitations 
  • Fatigue, weakness 
  • Less stamina, lower ability to do physical exercise 
  • Wheezing, coughing 
  • Sudden gains of weight 
  • Lost appetite 
  • Nausea 

Laboratory testing can include the following: 

BNP or N-terminal pro-BNP: BNP stands for B-type natriuretic peptide, which is a measurement of concentrations of a specific hormone the left ventricle produces. Given its role as the heart’s primary pumping chamber, the left ventricle’s production of BNP helps doctors both diagnose and grade how serious heart failure is. 

Metabolic Panel: This looks for things like liver disease, electrolyte imbalances, and kidney failure, given how many kidney disease symptoms are very similar to the ones of Congestive Heart Failure. 

CBC: A complete blood count looks for anemia, which not only has symptoms like CHF but can also contribute to CHF. 

Thyroid Testing: Such tests check the thyroid hormone levels in the blood. Heart failure can result from both hyperthyroidism and hypothyroidism, which are respectively too much or too little thyroid hormone. 

Two relatively new tests are now available for those already diagnosed with CHF to predict their prognosis. ST2 and Galectin-3 tests both measure protein levels in the blood. If these biomarkers are elevated, they might indicate someone who has heart failure is at a higher risk of complications and requires more assertive levels of treatment.