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Congestive Heart Failure
|What Are The Symptoms Of Heart Failure?
As congestive heart failure (CHF) decreases the pumping strength of the heart, the body tries to compensate by diverting blood from less vital organs to the brain and heart. These compensating mechanisms can slow down the onset of symptoms for a long time. Eventually though, as the heart continues to fail the burden becomes harder and symptoms of heart failure will eventually develop. In fact by the time many people receive a diagnosis of heart failure their heart has been failing for some time - although it may feel like the signs have just suddenly occurred. As early symptoms of CHF are similar to many other conditions, they do not necessarily mean you have heart failure. For example, breathing problems, one of the most common signs, can be caused by anything from CHF to asthma and bronchitis or a simple cold or flu.
The 3 Most Common Signs
The three most common signs of heart failure are:
1. Shortness of Breath
Fluid buildup in the lungs (pulmonary edema) can cause breathing difficulties (dyspnea) which is usually notable when the person lies down or exercises. Some people wake up at night gasping for air and need to stand up to get relief. This is known as paroxysmal nocturnal dyspnea. As the condition worsens the person may cough up a pink-tinged liquid (phlegm).
2. Exercise Intolerance
All physical activity increases the workload on the heart requiring it to pump more blood and oxygen around the body. As the heart begins to fail, the person will find that they cannot tolerate as much exercise as they used to. They may find they cannot even walk at a mild pace without suddenly becoming tired and fatigued. Even everyday household chores cause severe breathlessness. Rest usually restores the person. To compensate, many people unconsciously reduce their physical activity to lower levels.
As blood backs up in the arteries fluid can leak through the veins into surrounding tissues or organs. This causes a puffy swelling (edema). Which part of the body is affected depends on where the leakage occurs. Usually it starts in the legs, feet and ankles which can become puffy, particularly after a long day spent standing. Eventually it may reach the hips and abdominal wall (ascites). If you press down on the swollen skin, your finger mark will remain visible for a few minutes. This is called pitting edema and is associated with CHF. If the mark disappears within a few seconds it is called nonpitting edema which is NOT associated with CHF.
When To Call A Doctor
If you experience any of these symptoms, report them to your doctor:
• Unusual fatigue and weakness.
• Cardiac palpitations or rapid heartbeat.
• Shortness of breath especially when you lie down or with daily household chores.
• Waking from sleep short of breath.
• Blueness in the skin (called cyanosis), usually detected in the toes or finger nails which indicates low levels of oxygen in the blood.
• Persistent dry cough, either with exercise or when lying down.
• Coughing up a white or pink-tinged phlegm.
• Swelling in the feet, ankles or legs.
• Sudden bloating or fluid-related weight gain.
• Abdominal swelling (ascites).
• Persistently pale skin.
• Loss of appetite or feeling of persistent indigestion.
• Difficulty concentrating or decreased alertness.
• Chest pain, although CHF does not usually cause chest pain it can coexist with other causes of chest pain such as angina pectoris attacks and heart attacks in women.
If you have already been diagnosed with CHF then if any of your symptoms become worse, or a new one occurs it may mean that you are not responding to your heart failure treatment. Do be sure to contact your doctor immediately. People who do not respond to medications may need to undergo heart failure surgery.
How Bad Are My Symptoms?
The symptoms of CHF can vary from mild to severe. They are considered mild if they occur only during physical activity, but more serious when that start occurring at rest. Heart failure is classified according to a common scale created by the New York Heart Association. When you seek help from your doctor, he may ask you to classify your symptoms according to this scale:
You experience shortness of breath or fatigue after an unusual amount of physical activity.
You experience symptoms carrying out everyday tasks such as vacuuming the house or climbing the stairs.
Symptoms occur with any activity.
Fatigue and shortness of breath occur at rest. CHF at this stage may be fatal and a heart transplant may be the only hope, although if the patient is particularly elderly this may not be an option. Fortunately, despite the millions of Americans with CHF, relatively few progress to this stage.
Have more questions about the heart? Womens Health Questions. Also, see living with heart failure, the survival guide.
Left Sided And Right Sided Heart Failure
What symptoms a patient experiences can be determined by which side of the heart muscle is diseased. In most cases heart failure starts on the left side but eventually goes on to weaken the right side. It can however start in either side or both at the same time. The following is a list of symptoms according to left-side and right-side heart failure:
|Left-Side Heart Failure
||Right-Side Heart Failure
|Shortness of breath
||Edema (swelling) of feet, ankles, legs
|Shortness of breath when lying down
||Swelling in the veins in the neck
|Fatigue and weakness
||Liver enlargement or swelling (hepatomegaly)
|Paroxysmal nocturnal dyspnea (waking up gasping for air)
||Swelling in the abdominal cavity (ascites) which includes the intestines. This can cause you to feel full or nauseous.
|Fluid in the lungs causing the person to cough up blood-tinged phlegm
||Need to urinate frequently at night, caused by fluid redistribution when you lie down
Next see: Causes of heart failure or what is the prognosis for heart failure?