Heart failure - Symptoms 

Symptoms of heart failure 

The symptoms of heart failure can vary from person to person. The main symptoms are breathlessness, extreme tiredness, and ankle swelling, which may extend up the legs.

These symptoms may be caused by conditions other than heart failure, and sometimes there may be more than one cause for them.

For example, it is possible for someone to have both emphysema and heart failure, and for both to cause breathlessness. Tiredness and ankle swelling are not usually caused by serious problems.

If you have symptoms such as tiredness and breathlessness, your GP may suggest that you have some tests to see whether you have heart failure, or to rule it out as a cause of your symptoms.

If you have heart failure, you may also get breathless if you lie flat, or you may wake up in the middle of the night with such severe breathlessness that you have to sit or stand up to catch your breath. If you have severe heart failure, you may need to sleep propped up by several pillows.

Ankle swelling related to heart failure is usually better in the morning and gets worse later in the day, although this is the case for most causes of ankle swelling.

If you have ankle swelling in the morning, it may be useful to raise the foot end of your mattress by 15-30cm (about 6-12 inches) because this will help gravity to drain the fluid back into your body.

Other symptoms that are sometimes associated with heart failure include: 

  • a persistent cough
  • lack of appetite
  • weight loss
  • tachycardia (rapid heart rate)

Some people diagnosed with heart failure may find the diagnosis difficult to cope with and develop depression and anxiety.

Monitoring your health

If you have been diagnosed with heart failure, you should monitor your symptoms closely. Weigh yourself daily (after getting up in the morning, before getting dressed) using a reliable set of scales.

If your weight increases by more than 2kg (4-5lb) over a few days, it may be a sign of fluid retention. This could be an indication that you need to watch the amount of salt in your diet, or check with your care team about whether you need to take some more diuretics (water pills).

You should also inform your GP or care team if you develop any new symptoms, or if an existing symptom suddenly gets worse.


Page last reviewed: 03/09/2012

Next review due: 03/09/2014

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