Signs and Symptoms of Congestive Heart Failure
Congestive heart failure (CHF) is a condition that occurs when your heart doesn't pump blood as efficiently as it should. This leads to a slowdown in blood flow out of the heart, causing blood to back up in your veins. This backup results in congestion or swelling in the body's tissues—especially in your legs and ankles. Other symptoms may include shortness of breath and a persistent cough. Your symptoms will also depend on which side of the heart is affected and which stage of CHF you're in.
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Common Symptoms of Heart Failure
One of the most common symptoms of congestive heart failure is getting out of breath easily during routine activities, like climbing stairs. When you have CHF, fluid accumulates in the lungs, making it hard to breathe. This is known as pulmonary edema and can be quite dangerous if not treated, as it may lead to severe breathing troubles. As CHF progresses, shortness of breath could happen during even simpler tasks, such as getting dressed or lying down for bed.
For older adults, symptoms can look a little different. Shortness of breath might not be as noticeable in CHF among older adults who aren't very active. Instead, they could feel unusually tired or find themselves getting confused more easily.
Other common symptoms can include coughing, swelling in the legs and ankles, and an increased need to urinate. Keep in mind: some symptoms of CHF will also vary based on which side of the heart (left or right) is affected.
Warning Signs of Left-Sided Heart Failure
In left-sided heart failure, your heart is unable to effectively pump oxygen-rich blood to the rest of your body. This occurs when the left side of the heart is either too weak to pump the necessary amount of blood or the heart is too thick or stiff to properly relax and fill adequately with blood. Symptoms of left-sided heart failure include:
Difficulty breathing
Feeling extremely tired, even after resting
Body weakness
Bluish-colored fingers and lips
Trouble focusing
Difficult sleeping when lying flat
Warning Signs of Right-Sided Heart Failure
In right-sided heart failure, your heart has difficulty pumping an adequate amount of blood to your lungs to get oxygen. Symptoms of this type of CHF can include:
Loss of appetite
Abdominal pain and swelling
Swelling in the lower extremities including the ankles, feet, legs
Unexplained weight gain
Stages of Heart Failure
The American College of Cardiology (ACC) and the American Heart Association (AHA) have developed a system to classify CHF into different stages. This helps you and your provider better understand your condition and make an appropriate treatment plan.
Stage A: At Risk
Stage A includes people who are at risk of developing heart failure. They don't show any symptoms yet, but they have risk factors like cardiomyopathy (a disease of the heart muscle), high blood pressure, diabetes, metabolic issues, or genetic tendencies for heart muscle diseases.
Stage B: Pre-Heart Failure
People in stage B don't have symptoms of heart failure, but there are some signs of heart disease. Tests might show elevated markers that show that your heart is under stress or evidence of heart strain. Results might also show that there is an issue with your heart's structure.
Stage C: Symptomatic Heart Disease
People in this stage have some type of heart disease and have experienced or are currently experiencing symptoms of heart failure. There are likely also signs of an abnormal heart structure at this stage.
Stage D: Advanced Symptoms
Stage D is the most severe stage and occurs when symptoms are so intense that they disrupt daily activities or lead to frequent hospital visits, despite receiving treatment. People at this stage may show signs of low blood pressure, cold hands and feet, and a reduction in urine output (or, peeing less).
Heart Failure in Children
In most cases, children who have heart failure usually have their condition because of heart defects they are born with—known as congenital heart defects. In some cases, other medical conditions can lead to heart problems or damage a child's heart, which may result in heart failure. There are two main types of heart failure in children: over-circulation failure and pump failure.
In over-circulation failure, congenital heart defects disrupt the normal separation of the heart's chambers, leading to improper blood circulation. As a result, oxygen-rich and oxygen-poor blood mix inside the heart instead of circulating separately through the body.
In pump failure, the heart is unable to pump blood effectively due to developmental issues or damage. This can be triggered by viral or bacterial infections that harm a healthy heart muscle, a reduced blood supply to the heart (which is rare in children), certain medications used to treat other medical conditions like cancer, or irregular heartbeats that occur due to abnormalities or defects at birth.
Signs of heart failure can look different, depending on the age of the child. In infants, symptoms may include:
Difficulty breathing
Trouble feeding
Not growing or gaining weight at a normal rate
Sweating excessively
Swelling in the feet, ankles, lower legs, stomach, neck, or face
Rapid heartbeat, even while sleeping or resting
Children and teenagers experiencing heart failure might exhibit different symptoms, such as:
Extreme fatigue or getting tired easily
Frequently urinating, especially at night
Loss of appetite
Persistent coughing
Irregular heartbeat
Swelling in the feet, ankles, and abdomen
Shortness of breath
Unexpected weight gain
When to Contact a Healthcare Provider
If you're experiencing symptoms of CHF or notice a change in symptoms, such as worsening shortness of breath or gaining unexplained weight, consult with your healthcare provider. Getting treatment early can reduce your risk of complications and prevent your condition from worsening. If you're noticing concerning symptoms in your child, it's also essential to contact their pediatrician as soon as possible for testing.
There may be times when your symptoms abruptly worsen and warrant immediate medical attention. Symptoms that may require seeing medical care urgently include difficulty breathing, fainting, or loss of consciousness. If you have CHF, always keep the following information readily accessible:
Contact details for your healthcare provider and the nearest hospital
Directions to both your doctor’s office and the hospital
A comprehensive list of all medications you are currently taking
Information about your emergency contact or next of kin
Questions to Ask Your Provider
When you go in for your appointment, it can help to ask your provider the following questions to learn more about your condition?
How serious is my heart failure?
Do you recommend that I wear compression socks to help the swelling go down?
What lifestyle changes will help me better manage my symptoms or prevent progression?
Should I be tracking and reporting any symptoms to you?
What treatment options are available for me?
A Quick Review
Congestive heart failure happens when your heart's effort to pump blood through the body is inefficient, causing symptoms like swelling, breathing difficulties, and persistent cough. Your exact symptoms will depend on which side of the heart is mostly affected and what stage of CHF you're in. If you're experiencing symptoms of CHF, it's important to see a healthcare provider as soon as possible for testing and diagnosis, as this can get you started on treatment sooner, if needed.
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