6 Surprising Signs of Congestive Heart Failure to Look Out For

Many people associate heart trouble with sudden, dramatic events like a heart attack, marked by chest pain and shortness of breath. While these are critical signals, your heart can also send more subtle warnings when it is struggling. Understanding these less obvious signs is a key step in proactively managing your health and recognizing conditions like congestive heart failure.

Congestive heart failure is a chronic condition that affects millions of Americans, with approximately 6.2 million adults in the United States living with the diagnosis. It is a serious condition, but with expert management and lifestyle changes, individuals can lead full and active lives. 

What is congestive heart failure?

Heart failure is a medical term that means the heart muscle isn’t pumping blood as well as it should. When your heart’s pumping power is diminished, it cannot keep up with the body’s demand for oxygen-rich blood. Congestive heart failure occurs when this poor circulation causes fluid to build up in the body.

This process starts when the weakened heart cannot pump enough blood to the kidneys. In response, the kidneys are unable to filter out excess fluid and salt from the body effectively. This fluid accumulates in various tissues, leading to congestion. The term "congestive" reflects this fluid buildup, which can occur in the lungs, legs, ankles, and abdomen. Think of it like a traffic jam; when the main highway (your heart) slows down, traffic (blood and fluid) backs up, causing problems in other areas.

What causes heart failure?

A variety of conditions can damage or weaken the heart muscle, leading to heart failure. The most common causes are conditions that either overwork the heart or directly harm it over time. These include:

• Coronary artery disease and heart attack: This is the most common form of heart disease and the most frequent cause of heart failure. The arteries that supply blood to the heart muscle become narrowed, depriving the heart of oxygen and nutrients. A heart attack occurs when an artery is completely blocked, causing parts of the heart muscle to die.
• High blood pressure (hypertension): When your blood pressure is high, your heart has to work harder to circulate blood throughout your body. Over time, this extra exertion can cause the heart muscle to become thicker and stiffer, making it less effective at pumping.
• Diabetes: Uncontrolled diabetes can contribute to high blood pressure and coronary artery disease. High blood sugar levels can damage blood vessels and the nerves that control your heart.
• Faulty heart valves: Heart valves keep blood flowing in the correct direction. If a valve is damaged due to disease, infection or a congenital defect, the heart must work harder to pump blood, which can weaken it over time.
• Cardiomyopathy: This term refers to damage to the heart muscle from causes other than artery or blood flow problems, such as infections, alcohol abuse or drug use.
• Other conditions: Thyroid disease, severe infections and irregular heart rhythms (arrhythmias) can also contribute to the development of heart failure.

Understanding these risk factors is the first step toward prevention and effective management. Our mission is to partner with you to address these underlying issues and protect your heart health.

What are the six less common signs of congestive heart failure?

While chest pain is a well-known alarm bell, the body often signals heart trouble in more subtle ways. Recognizing these symptoms is important for early diagnosis and intervention.

1. Persistent coughing or wheezing: When fluid builds up in the lungs (a condition called pulmonary edema), it can cause a persistent cough or wheezing, similar to asthma or bronchitis. This cough may produce white or pink-tinged mucus. It often worsens when you are lying down, as fluid settles in the lungs. If you have a cough that doesn't go away, it’s important to see a healthcare provider to determine the cause.
2. Swelling in the legs, ankles and feet: One of the hallmark signs of congestive heart failure is fluid retention, known as edema. When the heart cannot pump blood effectively, it backs up in the veins. Gravity pulls this excess fluid down into the lower parts of the body, causing noticeable swelling in the legs, ankles, and feet. You might notice that your shoes feel tighter or see indentations in your skin after pressing on the swollen area.
3. Fatigue and unexplained weakness: Feeling tired is normal, but overwhelming fatigue that interferes with daily activities is not. In heart failure, the heart can’t supply enough oxygen-rich blood to meet the body’s energy needs. As a result, individuals often feel a profound sense of exhaustion and weakness. Simple tasks like climbing stairs, carrying groceries, or walking across a room can feel like a marathon. This isn't just regular tiredness; it’s a debilitating fatigue that should be discussed with a doctor.
4. Nausea or lack of appetite: When the heart struggles to pump, the digestive system can also receive less blood, which can interfere with its normal function. This can lead to feelings of nausea, indigestion or a general lack of appetite. Some people experience stomach pain or feel full even when they have eaten very little. While these symptoms are often attributed to stomach issues, they can be a sign that your heart is in distress.
5. Confusion or impaired thinking: Changes in the levels of certain substances in the blood, such as sodium, can lead to confusion, memory loss or disorientation. This "brain fog" can also be caused by reduced blood flow to the brain. Family members are often the first to notice these cognitive changes. Any sudden shift in mental clarity warrants immediate medical attention.
6. Snoring and sleep apnea: Loud snoring is more than just a nuisance; it can be a sign of obstructive sleep apnea, a condition where breathing repeatedly stops and starts during sleep. These pauses in breathing cause a drop in blood oxygen levels, which puts significant stress on the heart. Over time, sleep apnea can increase the risk of high blood pressure, heart attack and heart failure. If a partner reports that you gasp or choke in your sleep, it’s a signal to get evaluated.

How is congestive heart failure diagnosed and treated?

Diagnosing congestive heart failure involves a comprehensive approach. A physician will start with a physical exam and a thorough review of your medical history and symptoms. Several tests help confirm the diagnosis and determine the severity of the condition:

• Blood tests: Can check for signs of diseases that affect the heart.
• Echocardiogram: This ultrasound of the heart is a key diagnostic tool. It shows how well your heart is pumping and can identify structural abnormalities.
• Electrocardiogram (ECG or EKG): Records the electrical activity of the heart, helping to diagnose rhythm problems and damage to the heart muscle.
• Chest X-ray: Can show if the heart is enlarged or if there is fluid in the lungs.

Treatment for congestive heart failure focuses on managing symptoms, slowing the progression of the disease and addressing the underlying cause. Treatment plans are highly personalized and often involve a combination of lifestyle changes and medications.

• Lifestyle modifications: A heart-healthy diet low in sodium is crucial for managing fluid retention. Regular, moderate exercise, as approved by your doctor, helps strengthen the heart and improve overall fitness.
• Medications: Several classes of drugs are used to treat heart failure. These include diuretics to reduce fluid buildup, ACE inhibitors or beta-blockers to lower blood pressure and reduce the heart's workload, and other medications to improve the heart's pumping ability.
• Devices and surgery: In some cases, implantable devices like pacemakers or defibrillators may be recommended. For severe heart failure, surgical options such as coronary bypass surgery, valve replacement or even a heart transplant may be necessary.

With a dedicated care team and a commitment to your treatment plan, you can manage congestive heart failure and maintain your quality of life. Our integrated teams of cardiologists, surgeons, and wellness experts work together to provide expert management of your health, creating a personalized path forward.

Take the first step towards a healthy heart and schedule an appointment with a cardiologist today!