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Please seek a proper consultation with a General Physician. I want to find out what you mean to say when you mention "Heart' failure". Unfortunately the Medical definition of Heart failure is different from what the non medico person says.

Yes. It can be.

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Yes. HFpEF is a clinical diagnosis.

Need detailed history.  Yes heart failure can occur with preserved EF, depending on multiple factors.

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As such  no. Go for trop. I test blood.

Yes

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Yes, it is possible for a **2D echocardiogram** to appear **normal** even if a person has **heart failure with preserved ejection fraction (HFpEF)**. HFpEF is a complex condition where the heart's **ejection fraction remains normal**, but there are **functional abnormalities**, such as **diastolic dysfunction**, **increased filling pressures**, or **vascular stiffness**, which may not be fully captured by a standard **2D echo**. A **2D echo primarily assesses cardiac structure and systolic function**, but HFpEF is often characterized by **subtle diastolic dysfunction**, which may require **advanced echocardiographic techniques** like: - **Tissue Doppler Imaging (TDI)** to assess myocardial relaxation. - **Speckle-tracking echocardiography** for strain analysis. - **Left atrial volume index and E/e' ratio** to estimate filling pressures. In some cases, **clinical symptoms**, **biomarkers (like NT-proBNP)**, and **stress echocardiography** may be needed to confirm HFpEF, especially if the **2D echo appears normal**

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Can help you, kindly consult and provide detailed history for proper diagnosis and further management

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