ELECTROCARDIOGRAM
The doctor generally will start by ordering a chest X-ray and an electrocardiogram (EKG or ECG) to measure the electrical impulses in the heart. The next step may be a test that measures how much blood the heart's left ventricle pumps out with each contraction. This reading is called the ejection fraction. With each beat, a normal heart ejects about one half to two thirds of the blood in its left chamber. Based on the medical history and symptoms, the doctor will order one or both of the following tests :
ECHO
Echocardiography (echo). This ultrasound test uses sound waves to examine the heart's structure and motion. During this safe, painless test, the patient lies still while a technician moves a device over the chest. It gives off a silent sound wave that bounces off the heart, creating images of its chambers and valves. The echo can tell the doctor how thick the heart muscle is and how well the heart pumps.
Radionuclide ventriculography or multiple-gated acquisition scanning (MUGA). These tests involve injecting radioactive substances called radionuclides into the bloodstream. Computer-generated pictures can then find them in the heart. These tests show how well the heart muscle is supplied with blood, how well the heart's chambers are working, or identify a part of the heart damaged by heart attack.
These tests also allow the doctor to determine the nature of the problem with the heart's larger lower chambers, the ventricles. These chambers may have lost some of their power to pump blood to the body or relax and fill with blood. The doctor uses this information, along with the ejection fraction reading, to determine what treatments would be most effective.
Someone with a normal ejection fraction reading can still have heart failure. If the heart muscle has become so thick and stiff that the ventricle holds a smaller than usual volume of blood, it might still seem to pump out a normal percentage of the blood that enters it. In reality, though, the total amount of blood pumped isn't enough to meet the body's needs.
The above information thankfully comes from the americanheart.org at the following link.
