Symptoms of congestive heart failure include:
- Swollen legs or ankles
- Difficulty breathing
- Weight gain
- Hacking cough
- Fatigue, palpitations, or pain during normal activities
- In some cases, no symptoms are present
When the left side of the heart fails, blood and fluid builds up in the lungs. The main symptom is extreme shortness of breath, sometimes accompanied by wheezing, which causes some patients to mistake the condition for asthma. The shortness of breath will be more severe when the patient is tired, and breathing will be more difficult lying down. Lying down may also cause a dry, hacking cough. All of these difficulties may cause the patient to wake up in the middle of the night desperately needing air. The attacks of shortness of breath can last up to an hour. When the amount of fluid in the lungs becomes immediately life-threatening, symptoms may include: coughing up a pink frothy substance, the sound and sensation of bubbling in the lungs, a drowning feeling, and skin taking on a pink or bluish tinge. If any of these symptoms occur, go to an emergency room immediately. Left side failure can also cause pneumonia, because fluid decreases resistance to infections.
When the right side of the heart fails, fluid accumulates in the rest of the body. The first symptom usually experienced by the patient is fatigue. Fluid accumulates first in the feet, then the legs, and then the abdominal area, including the liver. If the patient is bedridden, fluid will accumulate in the lower back.
With both types of heart failure, the blood pumped by the heart is not sufficient enough to supply the body with enough nutrients and oxygen. The body interprets this as a lack of blood; to compensate, the kidneys retain salt and water to increase the blood volume. The patient will thus gain weight, despite a probably decrease in appetite. In addition, the patient will lose muscle mass, because of the lack of oxygen and nutrients in the tissues.