Heart failure isn’t a disease. It’s actually a syndrome, which means a collection of symptoms and physical problems caused by injury to, or weakness of, the heart.
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Heart failure occurs gradually. As the heart gets weaker and weaker, symptoms appear and worsen over time. Because the entire body depends on oxygenated blood supplied by the heart, heart failure affects organs throughout the body.
“It’s good to know the symptoms of heart failure, because they can indicate that your heart is not functioning as well as it should. After you begin treatment, if your symptoms appear less often or become less severe, it tells us that your medications and lifestyle adjustments are working well to keep your heart performing to the best of its ability,” says heart failure specialist David Taylor, MD.
Left vs. right-sided heart failure
Symptoms not only depend on the severity of heart failure, but also which side of the heart it affects.
The left side of the heart receives oxygen-rich blood from the lungs, so when the left side of the heart fails, blood backs up into the lungs. This makes breathing difficult and can cause fluid to leak into the lungs, producing congestion.
In right-sided heart failure, deoxygenated blood returning to the right side of the heart from the body backs up. This generally causes excess fluid to pool in the legs and ankles, abdomen and gastrointestinal tract.
Symptoms of congestion
You might be familiar with the term “congestive heart failure.” Congestion refers to fluid retention. Here are three common symptoms:
- Dyspnea means shortness of breath. It occurs when fluid accumulates in the lungs. When heart failure patients awaken in the night short of breath, they are said to have paroxysmal nocturnal dyspnea.
- Orthopnea means difficulty breathing while lying down. When you lie flat, blood from your lower extremities flows back into your heart. A weakened left ventricle cannot handle the increased volume, and blood backs up in the lungs. Patients with orthopnea must use pillows, a wedge or a recliner chair to elevate their heads or upper body to sleep.
- Bendopnea means shortness of breath when bending over. It happens within 30 seconds of bending over and is usually a sign of worsening heart failure. The heart is not able to compensate for the fluid shifts and extra pressure placed on the abdomen when you bend over. Bendopnea can also occur in individuals with large bellies who don’t have heart failure.
Other symptoms of fluid buildup
Excess fluid also can seep through blood vessel walls into other tissues. This may cause swelling in the legs and ankles or abdomen.
Sometimes fluid accumulates in tissues throughout the body. This may be more difficult to spot. However, patients may experience a rapid weight gain of several pounds in a day or two.
Symptoms of poor blood flow
Other symptoms of heart failure are linked to the weak flow of oxygen-rich blood caused by the heart’s weakened pumping power.
Heart failure patients almost universally experience fatigue and weakness, especially with exertion. This occurs because the muscles are not receiving enough oxygen.
When the oxygen supply is limited, the body shunts blood to the most vital organs to try to keep them functioning. This means less blood flows to the hands, feet and skin. The hands and feet may become pale and cool, and the skin may develop a blue tint.
As heart failure worsens, feelings of lightheadedness and dizziness may appear. They are usually signs of low blood pressure or abnormal heart rhythms. Some arrhythmias may be particularly noticeable when you lie on your left side.
Finally, impaired blood flow can cause drowsiness, confusion and a poor memory. These may be symptoms that heart failure is worsening.
Prevention is the best medicine
Keeping heart-failure patients functioning and out of the hospital is a challenge. That’s why preventing heart failure is wiser.
“Heart attack, high blood pressure and diabetes are major causes of heart failure, and they are largely preventable. That’s why it’s important to do everything you can to control these risk factors and prevent a heart attack,” says Dr. Taylor.
This article originally appeared in Cleveland Clinic Heart Advisor.