Disconnect the heat exchanger from its normal source and drain it.
Connect a pressure gauge at each end of the heat exchanger, then reconnect the source and drain.
Turn on the source and read the difference in pressure between the input and the output. Heat exchangers will be rated at a particular pressure drop (called head loss) depending on the particular internal shape. Pressure drops of 50 percent greater than the rated drop indicate a fouling of about 25 percent of the inside tubes. Anything over 25 percent fouling and performance of the heat exchanger is going to too low to be of any practical use, and the heat exchanger should be cleaned or replaced.