Heart failure

  • Alternative Names

    CHF; Congestive heart failure; Left-sided heart failure; Right-sided heart failure - Cor pulmonale


    Symptoms of heart failure most often begin slowly. At first, they may only occur when you are very active. Over time, breathing problems and other symptoms may be noticed even when you are resting.

    However, heart failure symptoms may begin suddenly after a heart attack or other heart problem.

    Common symptoms are:

    • Shortness of breath with activity, or after lying down for a while
    • Cough
    • Swelling of feet and ankles
    • Swelling of the abdomen
    • Weight gain
    • Irregular or rapid pulse
    • Sensation of feeling the heart beat (palpitations)
    • Difficulty sleeping
    • Fatigue, weakness, faintness
    • Loss of appetite, indigestion

    Other symptoms may include:

    • Decreased alertness or concentration
    • Decreased urine production
    • Nausea and vomiting
    • Need to urinate at night

    Infants may sweat during feeding (or other activity).

    Some patients with heart failure have no symptoms. In these people, the symptoms may develop only with these conditions:

    • Abnormal heart rhythm (arrhythmias)
    • Anemia
    • Hyperthyroidism
    • Infections with high fever
    • Kidney disease

    Signs and tests

    A physical examination may reveal the following:

    • Fluid around the lungs (pleural effusion)
    • Irregular heartbeat
    • Leg swelling (edema)
    • Neck veins that stick out (are distended)
    • Swelling of the liver

    Listening to the chest with a stethoscope may reveal lung crackles or abnormal heart sounds.

    The following tests may be used to diagnose or monitor heart failure:

    • Chest x-ray
    • ECG
    • Echocardiogram
    • Cardiac stress tests
    • Heart CT scan
    • Heart catheterization
    • MRI of the heart
    • Nuclear heart scans

    This disease may also alter the following test results:

    • Blood chemistry
    • BUN
    • Complete blood count
    • Creatinine
    • Creatinine clearance
    • Liver function tests
    • Uric acid -blood test
    • Sodium - blood test
    • Urinalysis
    • Sodium - urine test