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Further tests and investigation are warranted as soon as signs
and symptoms are observed. Listed below are the tests that
can be used to identify and define heart failure.
- The chest X-ray should be part of the initial diagnostic
work-up in heart failure [Remme
and Swedberg, 2001]. This is used to detect the presence
of cardiac enlargement and pulmonary congestion. In the
person with diabetic cardiomyopathy, the heart may appear
normal as the stiffer diabetic myocardium reduces cardiac
enlargement [Shaw, 1996].
- An electrocardiogram will assess left ventricular hypertrophy,
infarction, myocardial ischemia, conduction system disease
and arrhythmias. The diagnostic contribution of ECG anomalies
markedly increases if clinical signs and symptoms of heart
failure co-exist [Remme
and Swedberg, 2001]. However, those patients with diabetic
cardiomyopathy may not show any clear abnormality on the
ECG recording [Shaw, 1996].
- Echocardiography is used to observe cardiac dysfunction
at rest and will show abnormal heart size, shape, and movement
and abnormal ejection fraction. This test may be particularly
useful in detecting poor left ventricular contractility,
reduced end diastolic ejection fraction and the overall
global restriction of the myocardial function in the person
with diabetic cardiomyopathy [Shaw,
1996].
- Laboratory investigations should include complete blood
count, serum electrolytes, assessment of renal and hepatic
function, lipids and glycaemic control [Lavine
and Gellman, 2002].
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