Signs and Symptoms of Heart Failure
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Medically reviewed by Christopher Lee, MD
Your heart is responsible for pumping blood to deliver oxygen and nutrients to the other organs in your body. Heart failure occurs when your heart cannot pump enough blood to effectively meet your body's demands, which can cause symptoms like shortness of breath, fatigue, and swelling in your legs.
Symptoms of heart failure occur due to two primary reasons: a backup of blood flow (known as congestion) and poor blood flow to the rest of your body (known as low output). Every person can experience symptoms a little differently. Some people may have very mild symptoms or have no symptoms at all, while others have severe symptoms of heart failure that occur even while resting. Knowing what signs to look for can help you understand when to seek medical care.
Symptoms of Congestion
Congestion is a term to describe fluid overload in your heart—also known as congestive heart failure (CHF). When your heart starts to fail, elevated pressure in your heart chambers causes a backup of blood flow and makes it difficult for your heart to pump blood as effectively as it does when it's functioning normally.
During heart failure, your body accumulates more fluid than it needs and forces your kidneys to retain water. The excess water retention can also cause a backup of fluid in other organs, like your lungs. As a result, you may experience the following congestion symptoms:
Shortness of breath which often worsens when lying down
Weight gain due to fluid retention
Difficulty performing physical activity or feeling more exhausted than usual after exercise
If you are experiencing the above symptoms, it's important to see your healthcare provider for testing. During your appointment, they can perform a physical exam that also looks for other signs of congestive heart failure, such as:
Jugular venous distention (JVD), which causes swelling in the veins on the right side of your neck
Pitting edema, a type of swelling that leaves an indent or "pit" when you press down on the skin
Crackles, a sound your lungs make when you have fluid in them—which can be heard when your provider uses a stethoscope to listen to your chest
Symptoms of Low Output
Low output occurs when your heart isn't providing enough blood flow to the rest of your organs. Your heart tends to fall into a low output state at later stages of heart failure. During this state, you may experience symptoms such as:
Cold, pale skin
Nausea or vomiting
Loss of appetite or feeling full soon after eating
Unintentional weight loss
It's good practice to see your healthcare provider if you're experiencing the above symptoms. During a physical exam, your provider can perform a physical exam and order lab tests that show other signs of low output, which include, but are not limited to:
A weak pulse
Elevated liver enzymes, which can cause inflammation in your liver
High heart rate
Low blood pressure
Additional Signs of Heart Failure
It's possible to experience other symptoms of heart failure that aren't directly related to or caused by congestion or low output. These include:
Fainting
Increased heart rate
Mental confusion, often due to having low sodium in your blood
When to Contact a Healthcare Provider
If you suspect you or a loved one are experiencing heart failure or may be at risk for heart complications, it's vital to see a healthcare provider to determine the cause of your symptoms. An easy way to remember the warning signs of heart failure is by using the acronym FACES, which stands for:
Fatigue
Activity limitation (feeling exhausted during physical activity)
Congestion (due to fluid build-up)
Edema (swelling)
Shortness of breath
Remembering the FACES acronym can help you seek medical care sooner and get started on treatment early. Your healthcare provider can diagnose heart failure and start medications that can help keep your heart as functional as possible, prevent complications, and improve survival. It's important to never ignore heart failure symptoms, as heart failure can cause serious complications like an irregular heartbeat and death.
If you have a pre-existing diagnosis of heart failure and develop worsening symptoms, you should also contact your healthcare provider for another evaluation. Sometimes changing the dose of your medication can help improve symptoms, but it's essential to learn why your heart failure may be worsening and rule out complications like a heart attack.
A Quick Review
Heart failure is a condition that occurs when your heart isn't able to pump enough blood that the other organs in your body need to function properly. Symptoms of heart failure are commonly due to a backup and retention of fluid (congestion) or poor blood flow (low output). As a result, you may experience symptoms like fatigue, swelling, shortness of breath, and coughing. Seeing your healthcare provider if you have these symptoms can help you get started on treatment sooner.
Frequently Asked Questions
What is the life expectancy of someone living with heart failure?
Life expectancy varies greatly depending on the stage of heart failure you're in, your age, and your overall health. In general, with chronic heart failure, the 1-year survival rate is approximately 90% and the 5-year survival is approximately 50-60%, according to research.
How quickly does heart failure progress?
There are four stages of heart failure: A, B, C, and D. How fast your condition progresses varies on a variety of factors like the stage of heart failure you're in, the underlying cause of your condition, and your treatment plan. Progression from one stage to the next can happen in as little as a couple of months to a few years. Following your treatment plan can help slow the progression of the condition.
Can walking improve symptoms of heart failure?
Walking and regular physical exercise are important lifestyle changes you can make to help keep your heart healthy and prevent the progression of heart failure. Walking can help improve your overall cardio (heart-related) fitness and exercise tolerance. Some research also shows that walking and exercising consistently can improve your survival chances with heart failure.
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