By Maya Guglin, MD, told to Mary Jo DiLonardo
Your heart’s job is to pump blood throughout your body to supply all of your organs with the oxygen they need to function properly. When your heart doesn’t pump as hard and as efficiently as it’s supposed to, you have heart failure.
When your heart struggles to pump blood, fluid levels build up in your body. This excess fluid causes almost all the symptoms of heart failure.
Typically, people with heart failure complain of shortness of breath and fatigue. They might also gain weight.
Shortness of breath
There are two pumping chambers in the heart: the left and right ventricles. The left side of the heart collects oxygen-rich blood from the lungs. So, if the left ventricle is more affected by heart failure, fluid accumulates in the lungs and the main symptom is shortness of breath.
At first, it only happens when you try to do something really physically difficult, like running. But as the disease progresses, it becomes difficult to climb the stairs. It then becomes harder to walk fast, then harder to walk at all. You have to stop often and catch your breath.
Eventually, you start waking up at night because your lungs are filling with “unpumped” fluid. You have to sit down, then gravity pulls the fluid down and your lungs can breathe again.
At this point you may even wheeze like in asthma and you may even start coughing. Cough follows the same pattern as shortness of breath: it’s worse when you lie down and better when you sit up.
But if it goes that far, it’s time to go to the emergency room or call an ambulance. It is serious.
Fluid and swelling
The right side of your heart collects blood from all over your body. If your right ventricle fails, excess fluid builds up in your liver, kidneys, intestines, and legs.
At first, you may notice your ankles and feet swell at the end of the day. It is not at all unusual for this to occur in people who spend a lot of time on their feet, so this symptom is easily overlooked.
Then the swelling may continue to move up your body and move into your shins, thighs, and pelvis. If you put your finger on your leg and press lightly, the hollow where your finger was will remain and slowly disappear over the next minute. The medical term for this is “prickly edema”.
Eventually, blisters may form, the skin may break, and the clear fluid inside may begin to seep out. When the tissues are in this state, it is easy to get an infection called cellulitis, and the legs turn purple and angry.
Don’t let that happen! Consult a doctor before it gets so serious.
It is more common to have left ventricular failure first. For example, a major heart attack almost always involves the left ventricle. But if you let the fluid build up in the lungs persist, it will spread to the rest of the body.
It is important to know that heart failure is not the only condition that causes swelling in the feet and legs. Dilated veins called varicose veins can cause very similar symptoms. This is why you should always tell your doctor about any symptoms you experience. Let the specialists sort it out.
stomach pain and weight gain
Sometimes you can eat just a little, but suddenly feel very full. But even if you barely eat, you notice that you are gaining weight. It also comes from all the fluid you collect in your body.
When the liver swells (your doctor may call it “distended”), it can cause stomach pain in the upper right corner. Some people think they might have an inflamed gallbladder. It’s actually an enlarged liver.
Fatigue and changes in activity
The easiest way to tell when heart failure is getting worse is to be able to do less and less of it.
People are starting to pace themselves. They stop doing hobbies that involve physical activity. They used to go fishing, but not anymore. Before, they played 18 holes, now they only have nine. They avoid the stairs whenever they can.
They choose to walk only short distances, and they do so very slowly. They don’t use the upstairs bedroom and sleep on the couch in the living room. They then decide to sleep in a reclining chair. Then they can’t sleep at all.
If you notice that the disease is causing you to change your habits, it’s time to see a doctor. They will almost always be able to help you.
There are medications that can treat heart failure, including diuretics – or diuretics – which work the fastest. There are also many other treatments that can help.
Heart failure is a chronic condition and does not go away. But you can still work with your doctor to treat symptoms and, in some cases, even improve the course of your disease.