Symptoms
Many symptoms of heart failure result from the congestion that develops as fluid backs up into the lungs and leaks into the tissues. Other symptoms result from inadequate delivery of oxygen-rich blood to the bodys tissues. Since heart failure can progress rapidly, it is essential to consult a physician immediately if any of the following symptoms are detected.
Symptoms of Left-Side Heart Failure
In left-side (left-ventricular) heart failure, the more common condition, symptoms might develop initially as follows:
- The first symptoms are usually fatigue and shortness of breath (dyspnea) caused by fluid in the lungs. Patients typically report that they feel out of breath after mild exertion. (This is unlike the breathlessness of angina, which feels like a heavy weight pressing on the chest.)
- Patients may also complain of asthma-like wheezing or a dry hacking cough that occurs a few hours after lying down, but then stops after the patient sits up.
- Over time, patients lose muscle weight due to low cardiac output.
- Central sleep apnea, in which the brain fails to signal the muscles to breathe during sleep, occurs in up to half of people with heart failure. Sleep apnea causes disordered breathing at night. If heart failure progresses, the apnea may be so acute that the sufferer, unable to breathe, may awaken from sleep in panic.
Ultimately, fluid in the lungs (pulmonary edema) may build up. When this happens, symptoms become more severe:
- In addition to shortness of breath, patients sometimes have a cough that produces a pinkish froth.
- Patients may experience a bubbling sensation in the lungs and feel as if they are drowning.
- Typically, the skin is clammy and pale, sometimes nearly blue. This is a life-threatening situation and the patient must go immediately to an emergency room.
Symptoms of Right-Side Heart Failure
Symptoms of right-side heart failure may occur as follows:
- As with left-side heart failure, an early symptom of right-side (right-ventricular) failure is fatigue.
- Right-side failure leads to the accumulation of fluid, first in the feet, next in the ankles and legs, and finally in the abdomen. The liver may also be enlarged.
- Although appetites are often depressed, patients with congestive heart failure gain weight because they retain salt and water.
- At the same time, these patients gradually lose muscle mass as the tissues become oxygen-depleted.
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