Symptoms of Heart Failure

Symptoms of heart failure develop gradually and are often put down to age or being unfit. Noticing them early allows treatment before a crisis.

Common symptoms

• Breathlessness: at first on climbing stairs or walking, later at rest. It may be worse when lying flat (orthopnoea) and may wake you at night (paroxysmal nocturnal dyspnoea).
• Swelling: of feet, ankles, legs and sometimes the abdomen.
• Rapid weight gain: more than 2 kg in 3 days can mean fluid build-up.
• Tiredness and weakness, with less ability to do usual tasks.
• Persistent cough or wheeze, sometimes with frothy sputum.
• Poor appetite, nausea or a bloated feeling from fluid in the gut.
• Fast or irregular heartbeat, or palpitations.
• Confusion or poor concentration in more advanced cases, particularly in older adults.
• Needing to pass urine at night.

Call 112 or 102 immediately for

• Severe breathlessness at rest or inability to speak in full sentences
• Pink or frothy sputum
• Chest pain or pressure
• Fainting
• Very fast or irregular heartbeat with dizziness
• Blue lips

See a doctor soon for

Increasing breathlessness, new swelling, sudden weight gain, needing more pillows to sleep, or a new cough that does not settle.

Key point

A daily morning weight and attention to breathlessness can catch worsening early.

Before your appointment

Bring your list of medicines and supplements, recent test reports such as echocardiogram, ECG and kidney tests, and your daily weight and blood pressure log. Note any breathlessness, swelling, night-time symptoms or reduced activity, and how much salt and fluid you take. Ask about warning signs and when to call 112 or 102.