Sometimes people have heart failure and don't realize it. Many signs and symptoms of heart failure are the same as for other conditions. Also, early symptoms may be quite mild. Your primary care doctor may suspect heart failure from your symptoms. Your medical history and a physical exam may provide clues too. Your doctor also may do several tests to make a heart failure diagnosis. He or she may send you to see a cardiologist. That's a heart specialist who can help with your diagnosis and treatment. Doctors usually follow these steps in diagnosing heart failure: 1. A heart failure diagnosis starts with asking about your symptoms. Talking about the problems you are experiencing gives your doctor valuable information. Symptoms are an important piece of the puzzle. Are you much more tired than usual? Have you had shortness of breath? Do you cough a lot, especially when lying down? These are common symptoms of heart failure. 2. The next step is reviewing your health. Your doctor may ask whether anyone in your family has had heart disease. If they have, it might increase your odds of having heart failure. Your own medical history matters too. Do you have known health conditions like high blood pressure, diabetes, or coronary artery disease (heart disease)? Any of these can make a diagnosis of heart failure more likely. 3. A physical exam is necessary. A physical examination could reveal signs that make your doctor suspect heart failure. For instance, the doctor might hear abnormal heart sounds. The doctor could detect sounds of fluid in your lungs. An exam might show that you have swelling in your legs, ankles or belly. Or it could reveal swelling in the veins in your neck. 4. Lab and imaging tests are important in diagnosing heart failure. Your doctor may suspect heart failure after talking with you and examining you. If so, the doctor may want you to have some diagnostic tests. There are many options. These five are the most common tests: EKG (electrocardiogram). This will show whether your heart beats at a normal rhythm. It can also show whether the walls of your heart are thicker than normal. Chest X-ray. This can show whether your heart is enlarged, which is a sign of heart failure. The heart enlarges to compensate for reduced ability to pump blood. The X-ray also will show any fluid that's in your lungs. BNP blood test. This checks the level of a specific hormone—brain natriuretic peptide—in your blood. Despite its name, your heart makes this peptide. The level is greater in people with some types of heart failure. Echocardiogram. (Your doctor might call this an echo.) The test creates a moving picture of your heart. Like a chest X-ray, it shows whether your heart is enlarged. It also will show whether your heart is pumping blood like it should be. Exercise stress test. This checks how your heart works when it's under stress. That means it has to beat fast. You'll probably do some sort of exercise for this test, such as running on a treadmill. People who can't exercise may take a drug to make their heart beat fast during the test. It's important to find out if you have heart failure. There's no cure for heart failure, but treatment can slow down its progression. You can get symptoms under control and lead a healthy, more active life.