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Symptoms

By Mayo Clinic staff

Heart failure typically develops slowly and is a chronic, long-term condition, although you may experience a sudden onset of symptoms, known as acute heart failure. The term "congestive heart failure" comes from blood backing up into — or congesting — the liver, abdomen, lower extremities and lungs.

Some of the signs and symptoms for chronic and acute heart failure are:

Type of heart failure Signs and symptoms

Chronic heart failure
(A long-term condition with signs and symptoms that persist.)

  • Fatigue and weakness
  • Rapid or irregular heartbeat
  • Shortness of breath (dyspnea) when you exert yourself or when you lie down
  • Reduced ability to exercise
  • Persistent cough or wheezing with white or pink blood-tinged phlegm
  • Swelling (edema) in your legs, ankles and feet
  • Swelling of your abdomen (ascites)
  • Sudden weight gain from fluid retention
  • Lack of appetite and nausea
  • Difficulty concentrating or decreased alertness

Acute heart failure
(An emergency situation that occurs when something suddenly affects your heart's ability to function.)

  • Signs and symptoms similar to those of chronic heart failure but more severe, and start or worsen suddenly
  • Sudden fluid buildup
  • Rapid or irregular heartbeat with palpitations that may cause the heart to stop beating
  • Sudden, severe shortness of breath and coughing up pink, foamy mucus
  • Chest pain if caused by a heart attack

In addition to characterizing whether your condition is chronic or acute, your doctor will need to know whether your heart fails to pump, or fills with blood, or a combination of both. Heart failure can involve the left side, right side or both sides of your heart. Typically, heart failure begins with the left side — specifically the left ventricle, your heart's main pumping chamber.

Part of your heart affected by heart failure Description
Left-sided heart failure
  • Most common form of heart failure.
  • Fluid and blood may back up in your lungs, causing shortness of breath.
Right-sided heart failure
  • Often occurs with left-sided heart failure.
  • Fluid and blood may back up into your abdomen, legs and feet, causing swelling.
Systolic heart failure
  • The left ventricle can't contract vigorously, indicating a pumping problem.

Diastolic heart failure
(also called heart failure with normal ejection fraction)

  • The left ventricle can't relax or fill fully, indicating a filling problem.

While systolic heart failure was once thought to be more common and less serious, recent studies have shown this to be incorrect. Isolated diastolic heart failure, now also termed "heart failure with normal ejection fraction," is just as common as systolic heart failure and has a similar prognosis. Identifying the type of heart failure, whether systolic, diastolic, or a combination, is important because the drug treatments for each type may differ.

Causes Definition

DS00061

Jan. 3, 2008

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