Heart Failure


Heart failure symptoms can vary, depending on age and the type and severity of the heart failure.  

Most Common Symptoms

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

Symptoms in Older Adults

Unusual symptoms of heart failure increases with age. Older adults are more likely to have:

  • Thinking problems
  • Lethargy (lack of energy)
  • Irritability
  • Anorexia (loss of desire to eat)
  • Digestive symptoms, like constipation or diarrhea

Acute Heart Failure Symptoms

This condition comes on suddenly and may be the result of a heart attack.  Symptoms may include:

  • Extreme fatigue
  • Trouble breathing with just a little bit of activity or even at rest
  • Swelling of legs, feet, or ankles
  • Chest pressure or discomfort
  • Sudden anxiety or confusion
  • Cough (sometimes coughing up pink foam)
  • Dizziness
If you have any of the above symptoms, get medical attention immediately.

Chronic heart failure is an ongoing medical condition. A person needs to monitor their breathing pattern, body weights and extent of leg swelling, and let their healthcare provider know if the following symptoms become worse. 

Fluid Retention (Buildup)

When the hearts pumping action becomes weaker, less blood flows through the body with each heartbeat. This results in fluid that builds up in different parts of the body. 


Fluid buildup in the lungs leads to coughing, wheezing, or difficulty breathing:

  • This may start with wheezing during activity.
  • Next comes congestion and coughing at night.
  • Difficulty breathing can happen even when a person is resting or lying down. A person may need to prop up their head or sit up to breathe more comfortably. 

Feet and ankles

Extra fluid makes a person’s feet and ankles swell. Legs can feel heavy. 


When fluid builds up in the liver, it may cause stomach problems. These include:

  • Discomfort in the upper right part of the belly
  • Sense of fullness after eating
  • Loss of appetite
  • Nausea, or vomiting. 

Other Heart Failure Symptoms

  • Decreased alertness and difficulty concentrating
  • Thinking problems and memory loss
  • Difficulty sleeping
  • Low energy
  • Weight gain
  • Rapid or irregular heartbeat (a feeling of pounding or the heart skipping beats”)


Last Updated February 2023

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