Yes. But there are always reasons, some type of heart damage/ defect may not be due to BP, Sugar etc. Sab normal aap kise keh rahein hain us par depend karta hai. Something that looks externally well may not be internally well and reasons may be beyond simple BP and Sugar and the rest you are talking about. But everything is not normal, it is just that more common causes of heart failure may be missing. But a 2D echo establishes if your heart has failed or not if even that is in question along with the cause.
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