What Are the Signs and Symptoms of Heart Failure?

The most common signs and symptoms are:

• Shortness of breath or difficulty breathing
• Feeling tired
• Swelling in the ankles, feet, legs, and sometimes the abdomen

Shortness of breath and feeling tired are caused by the buildup of fluid in the lungs and around the lungs (pleural effusions). When symptoms start, you may feel tired and short of breath after routine physical exertion. Climbing two flights of stairs makes you feel winded. As heart failure progresses, the symptoms get worse. You may begin to feel tired and short of breath after simple activities, like getting dressed or walking across the room. Some people have shortness of breath when lying flat.

Fluid buildup in the lungs can also cause a cough. The cough is worse at night and when you are lying down. Excessive fluid in the lungs can cause a life-threatening condition called acute pulmonary edema. This condition requires emergency treatment.

The swelling is from the buildup of fluid in your body (edema). Other signs of fluid buildup are:

• Weight gain
• Frequent urination

Limitation on Physical Activity

Doctors also classify your symptoms based on how much they limit your daily activity. By class of symptom, your doctor means:

• Class 1: No limits—ordinary physical activity does not cause undue tiredness or shortness of breath.
• Class 2: Slight or mild limits—comfortable at rest, but ordinary physical activity results in tiredness or shortness of breath.
• Class 3: Marked or noticeable limits—comfortable at rest, but less than ordinary physical activity causes tiredness or shortness of breath.
• Class 4: Severe limits—unable to carry on any physical activity without discomfort. Symptoms are also present at rest. If any physical activity is undertaken, discomfort increases.