Ulta Lab Tests

Congestive Heart Failure (CHF)

Congestive heart failure (CHF) happens when the heart cannot pump enough blood to meet the body’s needs. Lab tests help confirm or rule in heart-failure physiology, identify causes or triggers, and monitor safety while you and your clinician manage care.

A practical plan usually combines a natriuretic peptide (NT-proBNP or BNP) with electrolytes and kidney function, adds tests that uncover contributors (anemia, thyroid imbalance, iron deficiency), and uses troponin when symptoms suggest acute heart strain. These labs support screening in symptomatic people, diagnostic work-ups, and ongoing monitoring, but they do not replace a physical exam, blood-pressure control, ECGs, imaging (echocardiogram), or emergency care for severe symptoms.

Signs, Symptoms & Related Situations

  • Fluid & breathing: shortness of breath with activity or lying flat, waking at night breathless, persistent cough, swelling in legs/ankles, rapid weight gain from fluid

  • Fatigue & exercise: low stamina, lightheadedness, reduced exercise tolerance

  • Heart sensations: palpitations, irregular heartbeat

  • Contributors/contexts: recent viral illness, high blood pressure, heart attack, alcohol excess, high-salt intake, medication changes (diuretics, ACEi/ARB/ARNI, MRAs), arrhythmias

  • Urgent care now: new or crushing chest pain, severe breathlessness at rest, fainting, confusion, pink frothy sputum, or one-sided weakness

Why These Tests Matter

What testing can do

  • Signal cardiac wall stress (NT-proBNP/BNP) to help differentiate heart vs. non-cardiac shortness of breath

  • Guide treatment safety by tracking kidney function and electrolytes during diuretics and other heart-failure medications

  • Reveal contributors such as anemia, thyroid disease, or iron deficiency, and track overall risk (glucose/A1c, lipids)

What testing cannot do

  • Diagnose blocked arteries or measure ejection fraction—imaging and ECGs are still needed

  • Replace a clinician’s judgment when symptoms are severe or rapidly changing

  • Predict exact outcomes from a single value; trends matter most

What These Tests Measure (at a glance)

  • NT-proBNP or BNP (blood): peptides released with heart-wall stretch; higher values support heart-failure physiology and help track response. Caveats: levels can be lower in obesity and higher in kidney disease or atrial fibrillation—interpret in context.

  • High-sensitivity Troponin (hs-cTn): detects heart-muscle injury; used when symptoms suggest acute coronary syndrome or decompensation.

  • Comprehensive Metabolic Panel (CMP) & Electrolytes: sodium, potassium, chloride, CO2 (bicarbonate), creatinine/eGFR, BUN, AST/ALT, albumin—essential for medication safety and fluid status.

  • Magnesium & Phosphorus: rhythm stability and diuretic effects.

  • CBC (Complete Blood Count): screens for anemia or infection that can worsen symptoms.

  • Iron Studies (Ferritin, Iron, TIBC/Transferrin, % Saturation): detect iron deficiency, common in heart failure.

  • TSH (± Free T4): checks for thyroid dysfunction that can mimic or worsen heart failure.

  • Urinalysis & Urine Albumin-to-Creatinine Ratio (ACR): kidney health and vascular risk context.

  • Glucose/A1c & Lipids (± ApoB, Lp[a]): cardiometabolic risk that influences long-term outcomes.

  • Medication-specific labs (as directed):

    • Diuretics: electrolytes (Na/K/Mg), creatinine/eGFR

    • ACEi/ARB/ARNI & MRAs (spironolactone/eplerenone): potassium, creatinine/eGFR

    • Digoxin (if used): serum digoxin level with renal function and potassium

    • Anticoagulants (if used): PT/INR or drug-specific assays per clinician

Quick Build Guide

Situation Start with Add if needed
New/worsening shortness of breath NT-proBNP/BNP, CMP/electrolytes, CBC hs-Troponin (symptom-driven), TSH, iron studies
Known CHF, routine monitoring CMP/electrolytes, NT-proBNP/BNP trend Magnesium, ACR/urinalysis, A1c, lipids
Medication check-in (diuretics, ACEi/ARB/ARNI, MRA) CMP/electrolytes (K/Na/Cr/eGFR), magnesium Digoxin level (if on digoxin)
Fatigue/low exercise capacity CBC, iron studies, TSH Vitamin B12/folate (contextual)

How the Testing Process Works

  1. Select the right panel: choose a natriuretic peptide (NT-proBNP or BNP) plus CMP/electrolytes; add tests based on symptoms and medications.

  2. Prepare for collection: fasting is usually not required; follow any instructions on your order and list current medications/supplements.

  3. Get your draw: visit a nearby patient service center; most results post within a few days.

  4. Review with your clinician: combine labs with symptoms, exam, blood pressure, ECG, and imaging (echo) to confirm next steps.

  5. Set a cadence: recheck markers on a schedule aligned with medication changes and clinical status.

Interpreting Results (General Guidance)

  • Natriuretic peptides: rising values often reflect worsening congestion; falling values may signal improvement. Interpret with body size, rhythm (AF), and kidney function.

  • Electrolytes & kidney function: watch for low sodium, high/low potassium, or rising creatinine—especially after medication changes.

  • Troponin: even small elevations merit clinical review; acute patterns require urgent evaluation.

  • Anemia/iron/thyroid: correcting contributors can improve stamina; decisions belong with your clinician.
    Always interpret results with a qualified healthcare professional; do not start or stop medications based on labs alone.

Choosing Panels vs. Individual Tests

  • Symptom triage: NT-proBNP/BNP + CMP/electrolytes + CBC (± hs-Troponin)

  • Stable CHF follow-up: CMP/electrolytes + NT-proBNP/BNP trend (± magnesium, ACR)

  • Contributor check: CBC + Iron Studies + TSH

  • Risk context: A1c/Glucose + Lipid Panel (± ApoB, Lp[a])

  • Medication safety: targeted electrolytes/renal function (and digoxin level if applicable)

FAQs

Do I need to fast for CHF labs?
Usually no. Follow the instructions on your order.

Which is better—BNP or NT-proBNP?
Both reflect heart-wall stress. Your clinician will choose based on local practice and your kidney function/age.

Can kidney disease change results?
Yes. Kidney dysfunction can raise natriuretic peptide levels and affect electrolytes; interpretation adjusts for this.

My BNP fell—does that mean I’m cured?
Lower numbers often track improvement, but symptoms and exams still guide care. Continue regular follow-up.

Why check iron and thyroid?
Iron deficiency, anemia, and thyroid disorders can worsen fatigue and shortness of breath in CHF.

How often should I test?
It depends on symptoms and treatment changes. Many people test more often during medication adjustments, then less once stable.

Related Categories & Key Tests

  • Heart & Cardiovascular Tests Hub

  • Cardiovascular Disease (CVD) Tests • Cholesterol Tests • Diabetes & Insulin Resistance • Kidney Health • Electrolytes & Hydration • Thyroid Testing

  • Key Tests: NT-proBNP/BNP • CMP/Electrolytes (Na/K/Cl/CO2, BUN/Creatinine/eGFR, AST/ALT, Albumin) • hs-Troponin • Magnesium • CBC • Iron Studies (Ferritin/Iron/TIBC/Transferrin, %Sat) • TSH (± Free T4) • Urinalysis & ACR • A1c/Glucose • Lipid Panel • Digoxin level (if used)

References

  • American College of Cardiology/American Heart Association — Heart failure evaluation and monitoring guidance.
  • Heart Failure Society of America — Biomarker use in heart failure.
  • KDIGO — Kidney disease and albumin-creatinine testing recommendations.
  • AHA/CDC — Cardiometabolic risk and inflammation resources.
  • Clinical reviews on natriuretic peptides, troponin in acute and chronic heart failure, and medication-related electrolyte monitoring.

Available Tests & Panels

Your Congestive Heart Failure (CHF) Tests menu is pre-populated in the Ulta Lab Tests system. Start with NT-proBNP/BNP and CMP/electrolytes, add CBC, troponin (when symptoms warrant), and contributor tests (iron studies, TSH). Include kidney markers for medication safety and consider A1c/lipids for long-term risk. Review results with your clinician to personalize follow-up.

 

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The Metanephrines Fractionated Random Urine Test measures metanephrine and normetanephrine levels, metabolites of catecholamines that reflect adrenal gland activity. Elevated values may indicate pheochromocytoma or paraganglioma, rare tumors producing excess catecholamines. This test aids in evaluating unexplained hypertension, palpitations, or episodes of sweating, offering clinical insight into adrenal function and neuroendocrine health.

Urine
Urine Collection
Also Known As: Random Urine Metanephrines Fractionated Test
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The Norepinephrine Plasma Test measures plasma norepinephrine, a catecholamine that regulates blood pressure, stress response, and cardiovascular function. Elevated levels may indicate pheochromocytoma, paraganglioma, or autonomic dysfunction, while low levels can reflect neuropathy or adrenal insufficiency. This test helps evaluate unexplained hypertension, tachycardia, or other symptoms tied to catecholamine imbalance.

Blood
Blood Draw
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The N-terminal proBNP (NT-proBNP) Test measures levels of NT-proBNP, a marker released when the heart muscle is under stress. Elevated levels may indicate heart failure, left ventricular dysfunction, or other cardiac conditions. Doctors use this blood test to diagnose, monitor severity, and guide treatment of heart disease, while also helping distinguish cardiac from non-cardiac causes of shortness of breath and related symptoms.

Blood
Blood Draw
Also Known As: Brain Natriuretic Peptide Test, proBNP Test, N-Terminal proBNP Test
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The T3 Reverse (rT3) Test measures reverse triiodothyronine, an inactive thyroid hormone, to assess thyroid and metabolic function. High rT3 may occur in hypothyroidism, chronic illness, stress, or during certain treatments, while low levels may reflect hormone imbalance. Doctors use this test along with TSH, Free T4, and Free T3 to evaluate fatigue, weight changes, or slow metabolism. The rT3 Test provides insight into thyroid regulation, energy balance, and endocrine health.

Blood
Blood Draw
Also Known As: Reverse T3 Test, RT3 Test, T3R Test
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The T3 Total Test measures total triiodothyronine (T3), a combination of both bound and unbound (free) T3, to assess thyroid function. Abnormal levels may indicate hyperthyroidism, hypothyroidism, goiter, or pituitary disorders. Doctors use this test to evaluate symptoms like fatigue, weight changes, anxiety, or irregular heartbeat and to monitor thyroid treatment. The T3 Total Test provides essential insight into metabolism, energy regulation, and overall endocrine health.

Also Known As: Total T3 Test, Total Triiodothyronine Test, T3 Test, Bound and Unbound T3
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The T3 Free Test measures free triiodothyronine (T3), the active thyroid hormone not bound to proteins, to assess thyroid function. It helps diagnose hyperthyroidism, hypothyroidism, goiter, and pituitary disorders. Doctors order this test to evaluate symptoms like fatigue, weight changes, anxiety, or irregular heartbeat and to monitor thyroid replacement or antithyroid therapy. The Free T3 Test provides key insight into metabolism, energy regulation, and overall endocrine health.

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Blood Draw
Also Known As: Free T3 Test, Free Triiodothyronine Test, FT3 Test, T3F Test, Unbound T3 Test
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The T4 Total Test measures total thyroxine (T4) in blood, a combination of both bound and unbound (free) T4, to assess thyroid function. Abnormal levels may indicate hypothyroidism, hyperthyroidism, goiter, or pituitary disorders. Doctors use this test to evaluate symptoms like fatigue, weight changes, hair loss, or irregular heart rate and to monitor thyroid replacement or antithyroid therapy. The T4 Total Test provides key insight into metabolic, hormonal, and endocrine health.

Also Known As: Total T4 Test, Total Thyroxine Test, T4 Test, Bound and Unbound T4 Test
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The T4 Free Test measures the level of free thyroxine (T4) in blood, the active thyroid hormone not bound to proteins. It helps diagnose thyroid disorders such as hypothyroidism, hyperthyroidism, and goiter, as well as pituitary conditions affecting hormone regulation. Doctors use this test to evaluate symptoms like fatigue, weight changes, hair loss, or irregular heartbeat and to monitor thyroid replacement or antithyroid therapy, providing insight into metabolic and endocrine health.

Blood
Blood Draw
Also Known As: Free T4 Test, Free Thyroxine Test, FT4 Test, T4F Test, Unbound T4 Test
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The Thyroid Peroxidase and Thyroglobulin Antibodies Test measures TPO and TgAb antibodies that target thyroid enzymes and proteins essential for hormone production. High levels are linked to autoimmune thyroid disorders such as Hashimoto’s thyroiditis and Graves’ disease. Doctors order this test to evaluate fatigue, weight changes, neck swelling, or irregular heartbeat and to confirm thyroid autoimmunity. It provides vital insight into thyroid function and endocrine health.

Also Known As: Thyroid Antibodies Test, TPO and TgAb Test
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The Transferrin Test measures transferrin, a blood protein that transports iron, to evaluate iron status and nutritional health. High levels may suggest iron deficiency anemia, while low levels may indicate liver disease, malnutrition, or chronic illness. Doctors use this test alongside iron and TIBC to investigate fatigue, weakness, or anemia symptoms. Results provide vital insight into iron balance, red blood cell production, and overall metabolic function.

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The Triglycerides Test measures triglyceride levels in blood to evaluate heart health and metabolic function. High levels may increase risk for cardiovascular disease, atherosclerosis, or pancreatitis, while low levels may reflect nutritional issues. Doctors use this test as part of lipid screening to assess patients with obesity, diabetes, or high cholesterol. Results provide vital insight into fat metabolism, cardiovascular risk, and overall wellness management.

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Also Known As: TG Test, TRIG Test
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The Thyroid Stimulating Hormone (TSH) Test measures TSH levels in blood to assess thyroid function and diagnose hypothyroidism or hyperthyroidism. It evaluates how the thyroid controls metabolism, energy, weight, and heart rate. Doctors use the TSH test to investigate symptoms such as fatigue, hair loss, or mood changes. Frequently included in routine health exams, it is also key for monitoring thyroid disease treatment and overall endocrine balance.

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Blood Draw
Also Known As: Thyroid Stimulating Hormone Test, Thyrotropin Test
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The Thyroid Stimulating Immunoglobulin (TSI) Test detects antibodies that stimulate the thyroid gland, often causing hyperthyroidism and Graves’ disease. High TSI levels may lead to symptoms such as weight loss, rapid heartbeat, or eye problems. Doctors order this test to confirm Graves’ disease, monitor treatment, or assess relapse risk. Results provide essential insight into autoimmune thyroid disorders and guide personalized management strategies.

Blood
Blood Draw
Also Known As: Thyroid Stimulating Immunoglobulin Test
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The Blood Urea Nitrogen (BUN) Test measures urea nitrogen levels in blood to assess kidney function and how well the body removes waste. Elevated BUN may indicate kidney disease, dehydration, heart failure, or high protein intake, while low levels may suggest liver disease or malnutrition. Doctors order this test to evaluate fatigue, swelling, or abnormal lab results. Results help diagnose kidney and liver conditions and guide treatment decisions.

Blood
Blood Draw
Also Known As: BUN Test, Blood Urea Nitrogen Test
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The Urinalysis Complete Test evaluates urine for physical, chemical, and microscopic properties to assess kidney health, urinary tract infections, diabetes, and metabolic disorders. It measures appearance, concentration, pH, protein, glucose, ketones, blood, bilirubin, nitrites, leukocyte esterase, and microscopic cells or crystals. Doctors use this test in routine exams, to diagnose urinary symptoms, and to monitor chronic kidney or metabolic disease.

Urine
Urine Collection
Also Known As: Urine Analysis Test, UA Test, Complete Urinalysis Test
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Blood
Blood Draw, Phlebotomist
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Blood
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Congestive Heart Failure Symptoms & Laboratory Testing

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.