Symptoms of Congestive Heart Failure
As the heart's pumping action grows weaker, blood no longer circulates in an adequate flow to the body's
major systems. The result is a series of increasingly debilitating symptoms, many of which seem to have
little to do with heart disease. Some problems originate in the brain, where the body's respiratory centers,
lacking adequate oxygen, begin malfunctioning. The kidneys, too, may no longer effectively filter excess fluid
out of the blood. Or the fault may be with the damaged heart itself, which is unable to move the now increasingly
waterlogged blood at its usual brisk pace through the circulatory system. Consequently, the water begins backing
up into the lungs, liver and tissues of other organs, producing one of the most telltale signs of heart
failure--congestion. This is why physicians often refer to the disorder as congestive heart failure.
Its most common symptoms include:
Shortness of breath. Medically, this symptom is known as dyspnea, and it is often the earliest warning
signal of heart failure. Usually, it appears gradually. In fact, the patient rarely notices it, until the first
time he is left breathless by climbing a flight of stairs or must stop at the end of a short walk to catch his breath.
Rapid heartbeat. At about the same time, he may also notice that his heart occasionally beats very
rapidly. This is called tachycardia; it is another early symptom of heart failure, and it occurs because the
overtaxed cardiac muscle attempts to compensate for its inability to pump the normal amounts of blood per beat
by beating more frequently.
Swelling. Caused by the buildup of fluids, this symptom announces itself by an unexpected and seemingly
unaccountable weight gain of 5, 10 or 15 pounds. Usually, the ankles are the first place the swelling shows up;
typically, they become puffy and bloated during the day, then return to normal with sleep. As the swelling
increases, excess weight may also become noticeable on the arms and legs.
Nocturnal breathlessness. This occurs in two forms, both of which are associated with the later stages
of heart failure. The less serious and less dramatic type is related to sleep position: If a person lies flat
on a bed with only a single pillow, he may awake coughing and choking. Far more terrifying, however, is to be
awakened by a feeling of imminent suffocation. Known as paroxysmal nocturnal dyspnea, this sensation is usually
accompanied by a racing pulse, and it may last anywhere from a few minutes to an hour or more.
