Symptoms of heart failure
In the early stages of heart failure, you may not have any symptoms. When symptoms do occur, it is because the body is not getting enough oxygen and nutrients, blood backs up into the lungs and body, and the body's efforts to compensate for heart failure begin to fail.
The earliest and most common symptoms of heart failure develop when blood backs up in the lungs and body. These symptoms may include:
- Shortness of breath.
- Swelling (edema) in the feet and ankles.
- Dizziness, fainting, fatigue, or weakness.
- A dry, hacking cough, especially when lying down.
- Weight gain (because of fluid buildup).
- Severe weight loss and decrease in appetite (cardiac cachexia).
- Abdominal swelling, tenderness, or pain (may result from the buildup of fluid in the abdominal cavity and the backup of blood in the liver).
Classic symptoms of heart failure Symptom
What does it feel like?
Medical term
Shortness of breath from exertion
- Unable to catch your breath
- Tightness in your chest
- Being winded
- Feeling tired while walking
- The need to stop frequently when walking
Dyspnea Shortness of breath while lying down
- Shortness of breath that gets worse when you lie flat
Orthopnea Shortness of breath while sleeping
- Sudden shortness of breath that wakes you up at night but is relieved by sitting upright.
Paroxysmal nocturnal dyspnea Weight gain
- Fluid retention that leads to some degree of weight gain
N/A Swelling in the feet or ankles
- Swelling that gets worse at the end of day or with standing for long periods
- Can be painful
- Pressure may leave indentations in skin.
- Shoes may no longer fit.
Pedal edema Fatigue or inability to exercise well
- Having less energy, feeling more tired than usual, or generally feeling fatigued
- Unable to exert yourself physically as much as you could in the past
Low exercise tolerance The following describes a classification for heart failure based on symptoms. It was devised by the New York Heart Association (NYHA). It is important to be familiar with this classification, as it may be referred to during the course of your care.
NYHA classification of heart failure Class I
Class I refers to people with heart disease that does not limit their physical activity. Ordinary physical activity does not cause undue fatigue, heart palpitations, trouble breathing, or chest pain.
Class II
Class II refers to people with heart disease that causes some limitation on physical activity. They are comfortable at rest; however, ordinary physical activity causes fatigue, heart palpitations, trouble breathing, or chest pain.
Class III
Class III refers to people with heart disease that causes a marked limitation on physical activity. They are comfortable at rest; however, less-than-ordinary physical activity causes fatigue, heart palpitations, trouble breathing, or chest pain.
Class IV
Class IV refers to people with heart disease who are unable to carry on any physical activity without discomfort. Symptoms of heart failure or impaired blood flow to heart muscle may be present even at rest. If any physical activity is undertaken, discomfort is increased.
Sudden heart failure
Sudden heart failure causes rapid fluid buildup in the lungs (congestion, pulmonary edema). Symptoms develop suddenly and include:
- Severe shortness of breath.
- An irregular or rapid heartbeat.
- Coughing up foamy, pink mucus.
Sudden heart failure is an emergency medical situation and requires immediate care.
| Author: | Kathe Gallagher, MSW Cynthia Tank | Last Updated: April 3, 2006 |
| Medical Review: | Caroline S. Rhoads, MD - Internal Medicine Kathleen Romito, MD - Family Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology | |
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