Many symptoms of heart failure result from the congestion that develops as fluid backs up into the lungs and leaks into the tissues. Other symptoms result from inadequate delivery of oxygen-rich blood to the body's tissues. Since heart failure can progress rapidly, it is essential to consult a doctor immediately if any of the following symptoms are detected:
Fatigue. Patients may feel unusually tired.
Shortness of Breath (Dyspnea).
- Patients typically report that they feel out of breath after exertion. While this may begin only when climbing stairs or taking longer walks, it can eventually be present even when walking around the home. (Those who have chest pain or feel like a heavy weight is pressing on the chest should also be evaluated for possible angina.)
- Orthopnea refers to the shortness of breath patients may have when they lie flat at night. Patients may report that they need to use one or two pillows underneath their head and shoulders in order to be able to sleep. Sitting up with legs hanging over the side of the bed often relieves symptoms.
- Paroxysmal nocturnal dyspnea (PND) refers to sudden episodes that awaken a patient at night. Symptoms include severe shortness of breath and coughing or wheezing, which generally occur 1 - 3 hours after going to sleep. Unlike orthopnea, symptoms are not relieved by sitting up.
Fluid Retention (Edema) and Weight Gain. Patients may complain of foot, ankle, leg or abdominal swelling. In rare cases, swelling can occur in the veins of the neck. Fluid retention can cause sudden weight gain and frequent urination.
Wheezing or Cough. Patients may have asthma-like wheezing, or a dry hacking cough that occurs a few hours after lying down but then stops after sitting up.
Review Date: 05/04/2011
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.