9 signs of heart failure you should know

Heart failure does not mean that the heart has stopped working. It means the heart is no longer able to pump enough blood to meet the body’s needs effectively. The condition can develop slowly over time or become worse within a short period. 

As the heart struggles to keep up, fluid can build up in the lungs and other parts of the body, while reduced blood flow can leave a person tired and weak.

Some symptoms may be mild at first and easily mistaken for normal tiredness or aging. Recognising the warning signs early can help a person get medical attention before the condition becomes more serious.

In this article, Tribune Online highlights 9 signs that may occur with heart failure.

Shortness of breath

One of the most common symptoms is difficulty breathing. At first, a person may become breathless while walking, climbing stairs or doing activities that previously caused no problem. As heart failure progresses, the breathlessness may occur with less activity and, in more severe cases, even while resting.

Fluid accumulating in the lungs can make it harder to breathe normally. Not every case of breathlessness is caused by heart failure. Asthma, lung infections, anaemia and other conditions can also cause it. However, unexplained or worsening breathlessness should be medically assessed.

Swelling of the feet and ankles

When the heart is not pumping effectively, the body may retain more fluid. This can cause swelling , particularly around the feet, ankles and lower legs. The swelling may become more noticeable towards the end of the day. Shoes or socks that normally fit comfortably may suddenly feel tight.

Leg swelling has many possible causes, including problems with the veins, kidneys or liver, so it should not automatically be assumed to be heart failure. However, swelling accompanied by breathlessness, rapid weight gain or increasing tiredness deserves medical attention.

Getting unusually tired or weak

A person with heart failure may find that ordinary activities require much more effort than before. Walking to a nearby place, climbing stairs, shopping or doing household chores may leave the person unusually exhausted .

This can happen because the heart is not delivering enough blood and oxygen to the muscles and other tissues during activity. Fatigue is a common symptom of many health conditions, so it does not confirm heart failure on its own. Persistent or worsening tiredness should be discussed with a healthcare professional, particularly when it occurs alongside other symptoms.

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Difficulty breathing when lying down

Some people with heart failure find it harder to breathe when they lie flat. They may need to sleep with several pillows or sit more upright before they can breathe comfortably. This symptom is known as orthopnoea.

It can happen because lying down changes the way blood and fluid are distributed in the body, which may increase pressure and congestion in the lungs. A new need to sleep sitting up or with significantly more pillows than usual should not be ignored.

Waking up suddenly at night because of breathlessness

Another warning sign is waking suddenly from sleep struggling to breathe. A person may feel the need to sit up, stand or move towards a window to catch their breath. This is known as paroxysmal nocturnal dyspnoea.

It can occur when fluid shifts towards the chest after a person has been lying down for some time. Repeated episodes of waking at night with severe breathlessness require medical assessment, especially if they are becoming more frequent.

Rapid or irregular heartbeat

The heart may beat faster as it tries to compensate for reduced pumping ability.

Some people may notice a racing, pounding or irregular heartbeat. Heart failure can also occur alongside abnormal heart rhythms such as atrial fibrillation.

Palpitations do not necessarily mean that a person has heart failure. They can also occur because of anxiety, certain medicines, anaemia, thyroid disorders and other conditions. However, a fast or irregular heartbeat accompanied by chest pain, fainting, severe weakness or serious breathlessness requires urgent medical attention.

Persistent cough or wheezing

A cough  that does not go away can sometimes be linked to fluid congestion in the lungs.

Some people with heart failure may also experience wheezing. The symptoms may become worse when lying down or at night.

A persistent cough can have many causes, including infections, asthma and allergies. But when it occurs together with breathlessness, swelling or other signs of fluid retention, heart failure should be considered. Severe breathing difficulty or coughing up pink, frothy sputum is an emergency and requires immediate medical care.

Sudden increase in body weight

A quick increase in weight over a few days may sometimes be caused by fluid retention rather than an increase in body fat. For people already diagnosed with heart failure, regular weight monitoring can detect changes in fluid levels early.

A sudden increase in weight should be reported according to the instructions given by the person’s healthcare team. People who have not been diagnosed with heart failure but experience rapid unexplained weight gain, particularly together with swollen legs or breathlessness, should also seek medical advice.

Prominent veins in the neck

Heart failure can increase pressure in the veins returning blood to the heart. As a result, the veins in the neck may become more prominent. Doctors refer to this as jugular venous distension.

This is usually detected during a physical examination rather than something a person needs to diagnose at home. When present alongside other signs of fluid congestion, prominent neck veins can provide an important clue that the heart is struggling to handle blood returning to it.