TCM diagnosis Based on Syndrome Differentiation:
In Chinese medicine, chest pain and heart failure have many different causes. The basic cause of chest pain is obstruction of the circulation of Qi and blood.  Chest pain may be caused by either deficiency or excess patterns. Deficient patterns include weak circulation of blood with pooling of blood causing stickiness or increased viscosity of the blood (yin deficiency) which causes stagnation of both Qi and blood. Excess patterns include pathogenic substances which block the circulation of Qi and blood. Generally heart failure is a complex disorder which combines both excess patterns with underlying deficiency patterns (root and branch).

Diagnosis in Western Medicine:
To diagnose heart failure, your doctor will ask you questions about your medical history, talk about your symptom and do a physical examination. In most cases you will also have further tests to confirm the diagnosis and guide how your symptoms are controlled. These include:

blood tests
electrocardiogram (ECG)
chest x-ray
chocardiogram
coronary angiogram

You may hear your doctor talk about the ‘ejection fraction’ of your heart. This refers to the amount of blood that is pushed out of your left ventricle every time your heart beats. It’s usually expressed as a percentage. A normal ejection fraction is around 50-65 per cent, as there is always some blood left in the heart after each heartbeat. Some people with heart failure have a normal ejection fraction, so ejection fraction is used alongside other tests to help diagnose heart failure.

After a diagnosis, your doctor may discuss your 'stage' or 'class' of heart failure. There are four classes, which are based on your symptoms and how they affect you. The higher the number of the class you are in, the more serious your heart failure has become. It is also possible to move between stages as you may have episodes where your heart failure is worse because of other events, such as a further heart attack.