Heart Failure Symptoms

By Dr. Ananya Mandal, MDReviewed by Sally Robertson, B.Sc.

The symptoms of heart failure depend on the type and severity of heart failure. Some of the most common symptoms of heart failure include:

Extreme fatigue or tiredness
Initially, this may occur only on exertion but with progressive heart failure, a person may experience fatigue while simply engaging in day-to-day activities. During the more advanced stages of disease, a person may get tired even when they are resting.

Shortness of breath or dyspnea
In the initial stages, breathlessness may be brought about on exertion such as when walking or climbing stairs. As heart failure progresses, however, a person may become short of breath when carrying out normal daily activities. With more advanced disease, shortness of breath may occur even while a person is resting.

Paroxysmal nocturnal dyspnea
This refers to a sudden shortness of breath that occurs while a person is lying down asleep. The patient may have to sit or stand up to relieve themselves of the sudden breathlessness. Sometimes the person may need to be propped up by pillows while they sleep, to avoid breathlessness.

Breathlessness may be accompanied by a persistent cough.

Swelling of the ankles and feet that slowly extends up to the legs.

A lack of adequate blood circulation to the brain may lead to dizziness and confusion. In addition, the limbs may feel cool to the touch due to a lack of adequate blood supply to the peripheries.

In cases of fatigue, a person may experience a loss of appetite and weight loss. If there is weight gain, it may be due to edema.

There may be palpitations and a rapid heart rate as the heart tries to compensate for the low cardiac output. The beating rhythm may be rapid and shallow.

Chronic heart failure is also associated with psychiatric problems such as depression and anxiety.

Left-sided ventricular failure or forward failure leads to congestion in the lungs that gives rise to shortness of breath on exertion or even at rest.

Backward failure or right sided ventricular failure leads to an excess accumulation of fluid in the body and edema, called anasarca. This initially causes swelling in the feet or legs and a person may start to urinate more frequently during the night. In severe cases, fluid accumulates in the abdomen, a condition called ascites. The liver may also become enlarged and the blood coagulated.

Further Reading

• All Heart Failure Content
• Heart Failure
• Heart Failure Terminology
• Heart Failure Classification
• Heart Failure Causes