• Swelling of feet and ankles
• Urinating more frequently at night
• Pronounced neck veins
• Palpitations (sensation of feeling the heart beat)
• Irregular heartbeat or rapid heartbeat
• Fatigue
• Weakness
• Faintness

When an individual is predisposed to heart failure, sudden symptoms may be caused by any factors that impose additional demands on the heart. These factors include the following:

• Increased activity
• Increased intake of fluids or salt
• Fever
• Infections
• Anemia
• Irregular heartbeats (arrhythmias)
• Overactive thyroid gland (hyperthyroidism)
• Kidney disease

Heart function may also worsen if you stop taking medications used to treat heart failure, such as diuretics, digoxin, ACE inhibitors, or vasodilators.

Your health care provider will obtain your medical history and will conduct a physical examination. The examination may reveal the following:

• Irregular or rapid heartbeat
• Weight gain
• Distended neck veins
• Enlarged liver
• Ankle swelling

Examination of the chest with a stethoscope may reveal abnormal lung sounds or abnormal heart sounds.

You may be asked to undergo some diagnostic tests:

• An ECG may show signs of thickened heart muscle or arrhythmias.
• An echocardiogram (heart ultrasound) may show enlargement of the heart, heart abnormalities and decreased function. A Doppler study allows the health care provider to take pressure measurements in your heart and major blood vessels, which can help determine exactly what is wrong.
• A chest X-ray may show enlargement of the heart and lung abnormalities.
• Routine laboratory studies may be performed:
  • CBC,
  • Blood chemistry
  • Urinalysis
  • Thyroid function tests
  • Tests for iron levels
• Cardiac catheterization:
  • During this test, a catheter is inserted through a vein into the right side of the heart and pressures there are measured.
  • Sometimes the right ventricle and the fucntioning of the right-sided valves needs to be visualized, and dye is injected into the ventricle to obtain a ventriculography.
  • Your left ventricle and your coronary arteries may also need to be studied, with a coronary angiography and left ventriculography, respectively.