Congestive heart failure is a common condition. What would be an initial investigation which points to the possibility of congestive heart failure, and which then may lead to blood tests, and further diagnostic measures? Solution Shortness of breath is observed with left side myocardial pain (left hand side) due to shortage of oxygen (hypoxia mediated iscahemia, myocardial infarction) supply to the heart muscles result in increased rate of breathing. This can be initially observed with \"leg swelling (because cardiac output decreases during myocardial infarction, congestive heart failure)\" due to peripheral edema followed by \"rales or crackles\" primarily can be heard in the lung bases. These are the events followed by examining patient for blood tests and ECG etc performed. Congestive heart failure (CHF) is the inability of heart to pump adequate blood according to body demands. Hypertension and coronary heart disease are the most common reasons of heart failure..