A number of symptoms are associated with
heart failure, but none is specific for the condition.
Perhaps the best known symptom is
shortness of breath ("dyspnea"). In heart failure, this may
result from excess fluid in the lungs. The breathing difficulties may
occur at rest or during exercise. In some cases, congestion may be
severe enough to prevent or interrupt sleep.
Fatigue or easy tiring is
another common symptom. As the heart's pumping capacity decreases,
muscles and other tissues receive less oxygen and nutrition, which are
carried in the blood. Without proper "fuel," the body cannot perform
as much work, which translates into fatigue.
Fluid accumulation, or edema,
may cause swelling of the feet, ankles, legs, and occasionally, the
abdomen. Excess fluid retained by the body may result in weight gain,
which sometimes occurs fairly quickly.
Persistent coughing is another
common sign, especially coughing that regularly produces mucus or
pink, blood-tinged sputum. Some people develop raspy breathing or
Because heart failure usually develops
slowly, the symptoms may not appear until the condition has progressed
over years. The heart hides the underlying problem by making
adjustments that delay--but do not prevent--the eventual loss in
pumping capacity. The heart adjusts, or compensates, in three ways to
cope with and hide the effects of heart failure:
- Enlargement ("dilatation"), which
allows more blood into the heart;
- Thickening of muscle fibers
("hypertrophy") to strengthen the heart muscle, which allows the
heart to contract more forcefully and pump more blood; and
- More frequent contraction, which
By making these adjustments, or
compensating, the heart can temporarily make up for losses in pumping
ability, sometimes for years. However, compensation has its limits.
Eventually, the heart cannot offset the lost ability to pump blood,
and the signs of heart failure appear.
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