Early symptoms of heart failure

heart failureThe early symptoms of heart failure usually start out as fatigue and shortness of breath after being physically active, for instance after climbing stairs. The condition can however progress to the point that this shortness of breath is experienced even when the patient is lying down flat on their backs.

Congestive heart failure symptoms include:

  • Shortness of breath.
  • Tiredness.
  • Weakness.
  • Faintness.
  • Increased frequency of night urination.
  • Swelling in legs, ankles, and feet.
  • Reduced tolerance to exercise.
  • Chronic cough or wheezing accompanied by white or pink, blood-tinged phlegm.
  • Swollen abdomen.
  • Appetite loss.
  • Nausea.
  • Weight gain caused by fluid retention.
  • Concentration or alertness issues.
  • Chest pain.
  • Irregular or fast pulse.
  • Palpitations.
  • Pulmonary edema.
  • Pleural effusion.

These symptoms are caused by conditions that weaken or damage the heart to the extent that it is no longer able to properly pump blood throughout the body. When blood backs into the lungs, the liver, the gastrointestinal tract, the abdomen, and the lower extremities, leading to an accumulation of fluid in these organs and areas of the body, we are talking about congestive heart failure. However, there are other types of heart failure just as there are multiple possible causes for this condition.

Types of heart failure


Fluid backs up into the lungs                 


Fluid backs up into the abdomen, legs, and feet.


Left ventricle cannot pump blood out properly.


Left ventricle becomes stiff and cannot fill with blood properly.

And the causes of heart failure include the following:

  • Coronary artery disease.
  • Heart attack.
  • High blood pressure.
  • Defective heart valves.
  • Cardiomyopathy.
  • Myocarditis.
  • Congenital heart defects.
  • Arrhythmias.
  • Infection weakening the heart muscle.
  • Diabetes.
  • Other
  • Amyloidosis
  • Emphysema
  • Overactive or underactive thyroid
  • Sarcoidosis
  • Severe anemia
  • Excessive iron in the body

Heart failure develops slowly. Therefore, a person can go from experiencing the early symptoms of heart failure only when they are very active to eventually noticing other symptoms even when they are at rest. If enough time passes without treatment, the person may face such complications as kidney and liver damage, and heart valve and rhythm problems. ‘Person’ is a rather general term, though; we can narrow it down a bit more. People who are at risk of heart failure include:

  • Men.
  • African Americans.
  • People aged 65 or older.
  • Overweight people.
  • People who have had a heart attack.

Other risk factors are sleep apnea, viruses, and alcohol and tobacco use. Then again, as far as narrowing it down goes, the number of people who have heart failure in the United States alone is still approximately 5.8 million. So do not hesitate to call your doctor or even 911 if you encounter heart failure symptoms, even if you do not fit the profile. During a physical exam, the doctor can use a stethoscope to pull a Roxette and listen to your heart – and your lungs – for abnormal sounds and signs of congestion. Other means of diagnosing heart failure are:

  • Blood tests.
  • Chest x-ray.
  • Electrocardiogram.
  • Echocardiogram.
  • Stress tests.
  • CT scan.
  • MRI.
  • Coronary angiogram.
  • Myocardial biopsy.
  • Doppler ultrasound.
  • Holter monitor.
  • Nuclear heart scan.
  • Cardiac catheterization.
  • Thyroid function tests.

Heart failure classification

New York Heart Association

Class I

No symptoms.

Class II

Patient can perform daily activities without problem but becomes fatigued when exerting themselves.

Class III

Patient has problems completing daily activities.

Class IV

Shortness of breath even at rest.


American College of Cardiology/American Heart Association

Stage A

Several risk factors but no symptoms.

Stage B

Heart disease but no symptoms.

Stage C

Heart disease and symptoms.

Stage D

Advanced heart failure requiring specialized treatment.

Speaking of treatment for heart failure, this includes lifestyle changes, medications, and surgical procedures and medical devices.

Treatment for heart failure


  • A healthy diet including potassium, vegetables, fruits, whole grains, fat-free or low-fat dairy products, and protein foods, (meats, eggs, poultry without skin, seafood, nuts, seeds, beans, and peas), and low in sodium, solid fats, added sugars, and refined grains.
  • Reduced fluid intake, especially alcohol.
  • Losing weight.
  • Physical activity.
  • Quitting smoking.


  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Angiotensin II receptor blockers.
  • Beta blockers.
  • Diuretics.
  • Aldosterone antagonists.
  • Inotropes.
  • Digoxin.
  • Isosorbide dinitrate/hydralazine hydrochloride


  • Coronary bypass.
  • Heart valve repair/replacement.
  • Implantable cardioverter-defibrillators.
  • Cardiac resynchronization therapy.
  • Heart pumps.
  • Heart transplant.

The lifestyle changes used to treat heart failure are pretty much the same ones used to prevent it. Another preventive measure is to check for swelling in legs, ankles, and feet every day.


Related Read: 

- Caring for someone with congestive heart failure (CHF)