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8 Heart Failure Symptoms and Warning Signs

Medically reviewed by Steven Kang, M.D.
Posted on March 6, 2023

If you’ve been diagnosed with heart failure, it means that your heart can’t pump blood as well as it should. This can happen when your heart muscle is injured or weakened by heart conditions like high blood pressure or a heart attack.

The symptoms of heart failure, sometimes called congestive heart failure, are different for everyone. You may not even notice any symptoms. If you’ve been diagnosed with heart failure, familiarize yourself with the symptoms so you can look out for early signs that you may need medical help. If you notice new or worsening symptoms, always tell your doctor.

How Does Heart Failure Cause the Symptoms You Feel?

Your blood delivers oxygen and nutrients to essential organs around your body, such as your brain, kidneys, and intestines. If you have heart failure, these organs may not be able to do their jobs as well because they are not getting enough oxygen.

The left side of your heart is responsible for delivering fresh, oxygen-rich blood from your lungs to the rest of your body. Left-sided heart failure is the most common type of heart failure. The symptoms of left-sided heart failure are typically due to the heart’s inability to deliver oxygen-rich blood to the body or from blood backing up in the lungs.

The right side of your heart is primarily responsible for receiving the oxygen-poor blood coming back to the heart from the rest of your body. The right side of the heart then delivers this blood to the lungs, where it can pick up more oxygen. Right-sided heart failure is less common than left-sided heart failure, and it is sometimes caused by a worsening of left-sided heart failure. When the right side of your heart fails, it can cause your blood to back up in the rest of your body as it returns to your heart.

8 Symptoms of Heart Failure

The symptoms of heart failure are caused by complications of your heart not pumping blood efficiently enough to meet your body’s needs. As your heart failure progresses, you may experience more of these symptoms or they may become more severe. If your heart problems are well controlled, you may not experience any of these symptoms. People with advanced heart failure may feel these symptoms even when they are resting.

The symptoms of heart failure can be felt throughout the body. (Adobe Stock)

1. Shortness of Breath

You can experience a feeling of breathlessness at any stage of heart failure. Shortness of breath is also referred to as dyspnea.

Shortness of breath can happen when your heart isn’t efficiently receiving blood coming back from your lungs. The blood buildup in the lungs causes fluid to leak into the surrounding tissue. This is common in left-sided heart failure.

If you notice you feel more breathless than usual while doing normal activities or while you are resting, you should talk to your doctor as soon as possible.

2. Coughing

Excess fluid in the lungs can cause a wet, hacking, persistent cough. You may also notice mucus that has a white or pink hue. If your heart failure is worsening, you may notice you’re coughing more often.

3. Trouble Sleeping

When heart failure causes increased fluid in your lungs, lying down flat can make breathing more difficult. This is called orthopnea and happens because the force of gravity can’t help you drain some of the fluid from your lungs. This condition is more common in people with left-sided heart failure.

If you can’t comfortably lie down flat, or if you need to prop yourself up with more pillows, check in with your doctor right away.

4. Swelling

People with heart failure can experience swelling — also known as edema — all over their bodies. Fluid buildup is especially common in the abdomen, legs, ankles, and feet. You may notice visible swelling or your shoes may feel tight.

When the blood flow out of your heart is slower, it also slows the blood returning to your heart. This can cause excess fluid to leak out of your veins into the surrounding tissue. Swelling is more common and often more severe for people with right-sided heart failure.

If you are living with heart failure, it’s a good idea to record your weight every day to note changes. A sudden weight gain of 2 to 3 pounds in less than a day or 5 pounds in a week is a sign you should talk to your doctor right away.

5. Tiredness

Feeling tired or fatigued, even when you get enough rest, is a possible symptom of heart failure. You may also notice it’s harder to do physical activities, like climbing stairs, going shopping, or walking the dog. You may feel more tired because your heart can’t pump enough blood to meet the needs of your muscles and your brain. You may also feel tired if your symptoms make it hard for you to sleep.

If you feel tired although you are getting enough rest, or if your usual activities feel more difficult, seek medical advice from your doctor.

6. Upset Stomach

Heart failure can affect your digestion if your stomach and intestines aren’t getting enough oxygen. These organs can also be swollen with fluid. You may notice you don’t eat as much as you used to, or you feel nauseated or have an upset stomach. You may also feel like you’re full even when you haven’t eaten. A complete loss of appetite may signal that your heart failure is worsening. If that happens, contact your doctor right away.

7. Confusion

If your heart cannot pump enough blood to your brain, it can cause lightheadedness, confusion, or memory problems. These symptoms are difficult to notice in yourself. Family and caregivers should watch for new or worsening confusion or trouble with thinking and report any changes to the doctor.

8. Increased Heart Rate

As your heart tries to keep up with your body’s needs, it may begin pumping faster. This may also cause an irregular heartbeat, which can feel like your heart is racing or skipping a beat (palpitations).

It’s a good idea to record your heart rate daily, and take note of any changes. A normal resting heart rate is between 60 and 100 beats per minute (BPM). A heart rate over 100 BPM is called tachycardia.

Warning Signs of a Heart Failure Emergency

Pay attention to your symptoms. The American Heart Association recommends you call your doctor or 911 (or other emergency services) right away if you notice any of the following:

  • Frequent cough
  • Shortness of breath while resting
  • Loss of appetite
  • Increased trouble sleeping
  • Inability to lie down flat
  • Increased swelling in your lower body
  • A sudden weight gain of more than 2 to 3 pounds in 24 hours or more than 5 pounds in a week
  • New or worsening confusion

Talk to your doctor about what to look for if you are living with heart failure. If you notice new or worsening signs of heart failure, you may need changes in your medication or treatment plan.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 56,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Are you living with heart failure? How do you manage your symptoms? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on March 6, 2023
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Steven Kang, M.D. is the Director of Cardiac Electrophysiology at Alta Bates Summit Medical Center and Alameda Health Systems in Oakland, California. Learn more about him here.
Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here.

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