Aging & Health A to Z
Causes & Symptoms
The causes and symptoms of diastolic and systolic heart failure are usually different, and you may have symptoms of both types. Heart failure can be caused by more than one condition.
In diastolic heart failure, the walls of the heart have thickened, which makes it difficult for the heart to relax and fill with blood. The most common cause is chronic high blood pressure.
In systolic heart failure, the heart is usually enlarged and has thinner walls. This results in weaker heartbeats, which reduce the amount of blood the heart pumps out to the rest of your body. Systolic heart failure often develops after you’ve had one or more heart attacks, or have a history of coronary artery disease.
Other common causes include:
- Heart valve problems. Heart valves keep the blood flowing through your heart in the right direction. Stenosis (narrowing) of the heart valves can lead to a backup in the blood flow. Leaky heart valves may lead to fluid buildup that makes it harder for your heart to pump efficiently. Both conditions can weaken your heart over time.
- Arrhythmias (abnormal heart beats). When your heartbeat is irregular (too fast or too slow) it affects your heart’s ability to pump enough blood throughout your body.
- Myocarditis is inflammation of the heart muscle. Myocarditis due to an infection can cause heart failure.
- Sleep apnea occurs when tissues in your throat block your airway and cause pauses in your breathing. Sleep apnea is a risk factor for heart failure as well as other circulatory conditions, such as high blood pressure and stroke. Loud snoring can be a symptom of sleep apnea. Central sleep apnea associated with heart failure is treated by managing the heart failure.
Common Heart Failure Symptoms
Heart failure symptoms can vary, depending on the type and severity of the heart failure.
Acute heart failure comes on suddenly, and may be the result of a heart attack. Symptoms may include:
- Extreme fatigue
- Worsening shortness of breath. This happens when your activity level is low or even when you are at rest.
- Swelling of your legs, feet, or ankles
- Chest pressure or discomfort
- Sudden anxiety or confusion
- Cough (sometimes coughing up pink foam)
If you have any of these symptoms, get medical attention immediately.
Chronic heart failure is an ongoing medical condition. If you have been diagnosed with heart failure, watch for these symptoms of chronic heart failure, and let your healthcare provider know if they become worse.
Fluid Retention (Buildup)
When the heart’s pumping action becomes weaker, less blood flows through the body with each heartbeat. This results in fluid that builds up in various parts of the body.
- Lungs: Fluid buildup in the lungs leads to coughing, wheezing, or difficulty breathing. This may start with wheezing during activity. It may then lead to congestion and coughing at night, and even to having difficulty breathing even when you’re resting or lying down. You may notice that you have to prop your head up in bed in order to breathe more comfortably, or that you may need to sit up at night to catch your breath.
- Feet and ankles: Extra fluid here makes your feet and ankles swell and your legs feel heavy.
- Liver: When fluid accumulates in the liver, it may cause abdominal problems. These include discomfort in the upper right part of your abdomen, a sense of fullness after eating, loss of appetite, nausea, or vomiting.
Other Heart Failure Symptoms
- Decreased alertness and difficulty concentrating
- Memory loss
- Difficulty sleeping
- Low energy
- Gaining weight
- Rapid or irregular heartbeat (a feeling of pounding or your heart “skipping beats”).
Updated: November 2017
Posted: March 2012