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Warning Signs of Heart Failure

If you or someone you love has been diagnosed with heart failure, it can be frightening.

By themselves, any one sign of heart failure may not be cause for alarm. But if you have more than one of these symptoms, even if you haven't been diagnosed with any heart problems, report them to a healthcare professional and ask for an evaluation of your heart. Congestive heart failure is a type of heart failure which requires seeking timely medical attention, although sometimes the two terms are used interchangeably.

If you have been diagnosed with heart failure, it's important for you to manage and keep track of symptoms and report any sudden changes to your healthcare team (View an animation of heart failure).

Download our Self-Check Plan for help with tracking your heart failure symptoms:
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This table lists the most common signs and symptoms, explains why they occur and describes how to recognize them. 

Sign or Symptom --- Shortness of breath (also called dyspnea)
People with Heart Failure May Experience --- breathlessness during activity (most commonly), at rest, or while sleeping, which may come on suddenly and wake you up. You often have difficulty breathing while lying flat and may need to prop up the upper body and head on two pillows. You often complain of waking up tired or feeling anxious and restless.
Why It Happens --- Blood "backs up" in the pulmonary veins (the vessels that return blood from the lungs to the heart) because the heart can't keep up with the supply. This causes fluid to leak into the lungs.

Sign or Symptom --- Persistent coughing or wheezing
People with Heart Failure May Experience --- coughing that produces white or pink blood-tinged mucus.
Why It Happens --- Fluid builds up in the lungs (see above).

Sign or Symptom --- Buildup of excess fluid in body tissues (edema)
People with Heart Failure May Experience --- swelling in the feet, ankles, legs or abdomen or weight gain. You may find that your shoes feel tight.
Why It Happens --- As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing fluid to build up in the tissues. The kidneys are less able to dispose of sodium and water, also causing fluid retention in the tissues.

Sign or Symptom --- Tiredness, fatigue
People with Heart Failure May Experience --- a tired feeling all the time and difficulty with everyday activities, such as shopping, climbing stairs, carrying groceries or walking.
Why It Happens --- The heart can't pump enough blood to meet the needs of body tissues. The body diverts blood away from less vital organs, particularly muscles in the limbs, and sends it to the heart and brain.

Sign or Symptom --- Lack of appetite, nausea
People with Heart Failure May Experience --- a feeling of being full or sick to your stomach.
Why It Happens --- The digestive system receives less blood, causing problems with digestion.

Sign or Symptom --- Confusion, impaired thinking
People with Heart Failure May Experience --- memory loss and feelings of disorientation. A caregiver or relative may notice this first.
Why It Happens --- Changing levels of certain substances in the blood, such as sodium, can cause confusion.

Sign or Symptom --- Increased heart rate
People with Heart Failure May Experience --- heart palpitations, which feel like your heart is racing or throbbing.
Why It Happens --- To "make up for" the loss in pumping capacity, the heart beats faster. 


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This content was last reviewed May 2017.

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