Symptoms of Heart Failure

Heart failure develops when the heart muscle becomes weak or damaged and it cannot pump blood effectively to meet the demands of your body. It can affect one or both sides of the heart.

Symptoms depend on what type of heart failure you have and how serious it is. You may not experience any symptoms at all in the beginning. They usually get worse as your condition progresses.

Frequent Symptoms

One of the first symptoms of heart failure is feeling short of breath after routine activities like climbing stairs. As your heart grows weaker, you may start having shortness of breath while lying down.

You may have additional symptoms depending on which side of the heart is affected. Other common symptoms in people with left-sided heart failure include:

• Trouble breathing 
• Cough 
• Fatigue (extreme tiredness even after rest) 
• General weakness 
• Bluish color of finger and lips  
• Sleepiness and trouble concentrating 
• Inability to sleep lying flat 

Other common symptoms in people with right-sided heart failure include:

• Nausea and loss of appetite 
• Pain in your abdomen 
• Swelling in your ankles, feet, legs, abdomen, and veins in your neck 
• ​​​​​​​Needing to pee often 
• Weight gain 

A weakness and swelling in your limbs occurs when you lose the ability to pump enough blood to the areas of your body farthest from your heart. Without a forceful pump, blood flow decreases, and the amount of oxygen that blood delivers to your organs and limbs drops too.

Your kidneys are one of the most sensitive organs to a weakened heart since the kidneys require a strong blood flow to filter wastes effectively from your blood. When your heart doesn't beat forcefully enough, your kidneys can't filter as well and fluid starts to collect in your body, causing swelling. This fluid can also collect in your lungs, making breathing more difficult.

Rare Symptoms

Rare symptoms of heart failure include:

• Cardiac arrhythmia (irregular heartbeat)
• Fainting
• Pulmonary edema (fluid buildup in your lungs)
• Low blood pressure

Complications

As heart failure progresses, a number of complications could arise. Low cardiac output, which is the amount of blood that is pumped out to the body, can be damaging to many systems in your body. These complications can include:

• Pneumonia
• Stroke
• Kidney disease
• Organ failure
• Sudden death
• Flash pulmonary edema (when fluid suddenly shifts from the blood vessels between the heart and lungs to the tissues within the lungs)

When to See a Doctor

If you notice that you are more tired than usual even with a good night's sleep or you are having trouble completing your normal activities, you should visit your doctor.

Heart failure can be a slow-moving process, or it can develop as a result of an acute event like a heart attack. You should immediately go to the emergency department or call 911 if you have the following:

• New chest pain, or chest pain that lasts longer than 15 minutes and is not improved with medications or rest
• Severe chest pain, especially if it comes with sweating, nausea, weakness, or shortness of breath
• A heart rate over 120 beats per minute
• Sudden weakness or paralysis
• Sudden, severe headaches
• Shortness of breath that doesn't improve with rest
• Fainting or loss of consciousness

Heart Failure Doctor Discussion Guide

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Summary

The most common symptom of heart failure is shortness of breath. Other symptoms depend on which side of your heart is affected and how severe your condition is. In the beginning stages of heart failure, you may have mild or no symptoms at all.

A Word From Verywell

Heart failure is a chronic, progressive condition that can result in a number of dangerous complications. However, with the right treatment and good communication with your healthcare team, you can still maintain a good quality of life. Be sure to discuss your health history and any medications you are taking with your doctor, as well as when to call to discuss changes or seek emergency care.