Heart Failure Symptoms

Quick Glance: Common Heart Failure Symptoms

Heart failure symptoms can develop gradually over time or appear suddenly, as seen in acute cases. Whether onset is slow or sudden, common symptoms include:

• Breathlessness during activity or, in severe cases, at rest

• Feeling tired or having low energy during everyday activities

• Swelling in the ankles, feet, or legs

• Breathlessness at night or needing extra pillows to sleep comfortably

• A persistent cough or wheeze, which may be worse when lying flat

• Rapid or irregular heartbeat (palpitations)

• Reduced ability to exercise compared with previously

• Unexplained weight gain over a few days due to fluid build-up

Heart Failure Symptoms That Should Not Be Ignored

A sudden shift in heart failure symptoms often means the condition is progressing or fluid is building up. It is important to see a doctor or heart specialist right away. Key warning signs of heart failure that should not be ignored include:

Why Do Heart Failure Symptoms Occur?

Heart failure symptoms occur when the heart muscle becomes too weak to pump blood or too stiff to fill properly. As a result, fluid backs up into the body while vital organs receive less oxygen.

Here is how the following internal changes lead to the specific heart failure symptoms:

• Muscles receive less oxygen when the heart pumps insufficient blood, leading to tiredness and breathlessness.

• When kidney blood flow drops, the body retains extra fluid, causing swelling.

• Hormonal systems, such as the renin-angiotensin-aldosterone system (RAAS), activate to maintain blood pressure. But over time, persistent activation can contribute to fluid retention, increased vascular resistance and further strain on the heart.

• As pressure and fluid overload stretch the heart muscle, it releases natriuretic peptides (such as BNP) in response to increased pressure and volume overload.

• Blood can back up in the lungs (because of left-sided failure) or in the body's veins and tissues (because of right-sided failure), leading to breathlessness and swelling.

• Reduced blood flow to the liver and gastrointestinal tract can affect appetite, digestion, and nutrient absorption.

Heart Failure Symptoms That Require Immediate Medical Attention

The following are heart failure symptoms that require urgent medical care to prevent further complications:

• Severe shortness of breath at rest, especially with chest discomfort or pink, frothy sputum

• Sudden or severe breathlessness when lying down, particularly if it does not settle after sitting upright

• New chest pain or pressure, particularly if it spreads to the jaw, neck or arm

• Fainting, near-fainting or sudden loss of consciousness

• Rapid, irregular heartbeat with dizziness or chest pain

• Severe leg or abdominal swelling with a rapid weight increase

• New confusion, extreme agitation, or marked drowsiness in people with a known heart failure history

Symptoms of Heart Failure Based on Type

Heart failure affects the body differently depending on which side of the heart is struggling and how it pumps. These main types of heart failure along with their symptoms include:

Symptoms of Heart Failure in Men

Men are more likely to develop heart failure with reduced ejection fraction (HFrEF). It occurs when the heart's left ventricle does not pump blood effectively.

Common symptoms of heart failure in men may include:

• Shortness of breath during physical activity or at rest

• Persistent tiredness or low energy

• Swelling in the ankles, feet or legs

• Reduced ability to exercise

• Difficulty breathing when lying down

• Waking up at night due to breathlessness

• Persistent cough or wheezing

• Rapid or irregular heartbeat

• Sudden weight gain due to fluid retention

Symptoms of Heart Failure in Women

Women are more likely to develop heart failure with preserved ejection fraction (HFpEF), a type where the heart muscle becomes stiff. As a result, women often report the following symptoms more severely:

• Shortness of breath during normal daily activities

• Severe fatigue or lack of energy

• Reduced ability to exercise

• Ankle or leg swelling

Symptoms of Heart Failure in Children

Heart failure symptoms may develop in children because of congenital heart defects or cardiomyopathy. Some common symptoms of heart failure in children include:

• Rapid breathing

• Difficulty feeding or tiring during feeds (infants)

• Poor weight gain or not thriving

• Excessive sweating, particularly while feeding

• Fast heartbeat

• Swelling around the eyes, feet or abdomen

• Reduced activity or poor exercise tolerance in older children

Can You Have Heart Failure Without Symptoms?

Yes, heart failure can develop without symptoms, especially in the early stages. Some people have reduced left ventricular function without symptoms. These cases may be classified as pre-heart failure rather than symptomatic heart failure, depending on the findings.

Preclinical stages can also exist without symptoms. It may be suspected during a routine medical assessment or identified during tests performed for another reason.

When Can Heart Failure Symptoms Become Life-Threatening?

Here are the conditions when heart failure becomes life-threatening:

How are Heart Failure Symptoms Diagnosed?

The diagnosis of heart failure is based on clinical evaluation and investigations that assess cardiac structure and function, as well as the presence of congestion. The frequently recommended tests to diagnose heart failure symptoms include: