Heart Failure

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Symptoms

Heart failure symptoms vary, depending on age and the type and severity of the heart failure.  The most common symptoms of heart failure are:

  • Shortness of breath during activity
  • Fatigue
  • Orthopnea (shortness of breath or difficulty breathing when laying down)
  • Leg edema (swelling)


Symptoms in Older Adults

As people age, they may have less typical symptoms. Older adults are more likely to have:

  • Problems with thinking
  • Low energy
  • Irritability
  • Loss of appetite
  • Digestive problems, such as constipation or diarrhea  


Acute Heart Failure 

Acute heart failure happens suddenly. It may be caused by a heart attack or another serious illness. Symptoms can include:

  • Sudden extreme fatigue
  • Trouble breathing with little activity or even at rest
  • Swelling of the legs, feet, or ankles
  • Chest pressure or discomfort
  • Sudden anxiety or confusion
  • Coughing (sometimes coughing up pink, foamy mucus)
  • Dizziness
If you have any of the symptoms listed above, get medical care right away.

Chronic heart failure is a long-term condition. People with chronic heart failure should watch their breathing, check their body weight, and look for swelling in their legs. Tell your healthcare provider if these symptoms get worse.



 
Fluid Retention (Buildup)

When the heart becomes weaker, it cannot pump blood as well. This can cause fluid to build up in different parts of the body.

Lungs

Fluid in the lungs can cause coughing, wheezing (a whistling sound when breathing), or trouble breathing.

  • Wheezing may first happen during exercise or activity.
  • Coughing and chest congestion may happen at night when lying down.
  • Trouble breathing can happen during activity or even at rest.

Some people may need to sleep with their head raised on pillows or sit upright to breathe more comfortably.

Feet and ankles

Extra fluid can cause swelling in the feet and ankles. The legs may feel heavy or tight.

Liver

Fluid can also build up in the liver. This may cause stomach problems, such as:

  • Pain or discomfort in the upper right side of the belly
  • Feeling full after eating a small amount
  • Loss of appetite
  • Nausea or vomiting


Other Heart Failure Symptoms

  • Less alertness and trouble concentrating

  • Thinking problems or memory loss

  • Trouble sleeping

  • Low energy

  • Sudden weight gain (from fluid buildup)

  • Fast or irregular heartbeat (feeling like your heart is pounding or skipping beats)

 

Last Updated April 2026

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