Heart failure means the heart struggles to pump enough blood to provide the muscles and organs with sufficient oxygen. The early signs of heart failure include breathlessness, fatigue, and swollen ankles.

Heart failure is a life threatening condition, but an early diagnosis can help a person to manage it, prolong a person’s life, and improve their outlook. Recognizing the early signs of heart failure can help a person get the necessary treatment.

In the earliest stages of heart failure, symptoms appear when a person significantly exerts themselves by doing more than their ordinary activity level. Doctors then classify the stage of disease according to the severity of symptoms and the amount of exertion it takes for them to show up.

For many people, the first symptom is breathlessness, especially with mild or moderate exertion.

This article will detail the early signs of heart failure and how to spot them. It will also explain causes, treatment, and when to contact a doctor.

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The Heart Failure Society of America recommends using the FACES acronym to look for the following early signs of heart failure:

  • F for fatigue: People with heart failure may feel tired even with enough rest or quickly lose energy.
  • A for activities limited: Heart failure may make certain activities difficult or impossible. For example, a person may find climbing steps very difficult or feel exhausted going for a walk.
  • C for chest congestion: A person may develop congestion in their chest or a chronic cough.
  • E for edema or ankle swelling: When the heart does not work well, fluid can accumulate in the extremities.
  • S for shortness of breath: This is the most common symptom of heart failure. In the early stages, a person may experience shortness of breath only when doing certain activities. For example, a person may feel shortness of breath when they walk longer than usual.

Some other common symptoms include:

  • waking up struggling to breathe at night, but noticing that symptoms get better after sitting up
  • struggling to breathe when lying down
  • a chronic cough

All of these symptoms are common and do not necessarily mean that a person has heart failure. It is important for a person to see a healthcare professional for further advice.

As heart disease progresses, symptoms may get worse. A person may experience breathlessness even when not exerting themselves.

They may also develop other symptoms. These symptoms are still fairly common but are less likely to occur in the early stages of heart failure:

  • unintentional weight gain
  • loss of appetite or feeling full more quickly after eating
  • heart palpitations
  • coughing up white or pink mucus
  • coughing when lying down
  • chest pain

Read more about heart failure here.

It is easy to feel scared if a person has symptoms of heart failure. But treatment can help, and early treatment is best. A person should contact a doctor if they have any symptoms of heart failure, such as:

  • trouble breathing
  • unexplained fatigue
  • chest pain
  • heart palpitations
  • leg swelling

People with heart disease risk factors, such as diabetes, hypertension, a smoking history, or obesity, should see a doctor regularly to ensure they control risk factors as best as possible. This will also mean a doctor can detect complications such as heart failure early.

Doctors diagnose heart failure based on a person’s symptom severity and ejection fraction. The ejection fraction is the proportion of blood the left ventricle pumps out with each beat.

A doctor may recommend an echocardiogram or electrocardiogram to assess activity in the heart and see how well it is pumping blood.

A doctor may also recommend other tests, including:

Treatment for heart failure includes medications to improve symptoms and lower the risk of hospitalization and death. The goal is to ensure a person can still lead a healthy, fulfilling life with the condition.

In most cases, this means a beta-blocker and an angiotensin-converting enzyme (ACE) inhibitor, angiotensin receptor neprilysin inhibitor (ARNI), or angiotensin II receptor blocker (ARB).

A doctor may also recommend other drugs, such as spironolactone and SGLT-2 inhibitors, to people with advanced heart failure or severe symptoms.

For some people with heart failure and a low ejection fraction, a cardiologist may recommend the placement of an implantable cardioverter-defibrillator (ICD). This is a device that a doctor implants in a person’s chest to monitor and treat abnormal heart rhythms in order to lower the risk of sudden cardiac death.

In severe cases, a person may need a heart transplant.

Lifestyle changes can include:

  • becoming more physically active
  • eating a balanced diet
  • reducing sodium intake
  • reducing water intake
  • reducing alcohol intake
  • quitting smoking

Treatment of underlying conditions such as hypertension and high cholesterol is important in treating heart failure.

Read more about how to improve heart health here.

The outlook with heart failure depends on many factors, including age, overall health, how severe the heart failure is, access to treatment, and whether a person can make lifestyle changes.

A 2019 study looked at survival rates in people living in the United Kingdom who had a new diagnosis of heart failure. It found the following:

  • After one year, 80.8% were still alive.
  • After five years, 48.2% were still alive.
  • After 10 years, 26.2% were still alive.

Read more about the survival rates of heart failure here.

Lifestyle changes can reduce the risk of developing heart failure and may prolong survival in people who already have heart failure. A person can try the following:

  • Quitting smoking.
  • Maintaining a healthy body weight.
  • Treating any chronic medical conditions, especially diabetes.
  • Managing cholesterol with medication or diet.
  • Becoming more physically active.
  • Reducing sodium intake.

Heart failure can be scary. It may shorten a person’s life and affect their quality of life. It can make some daily activities difficult.

While there is no cure for heart failure, treatment can slow its progression and even reverse some symptoms. No matter how severe a person’s heart failure is, the right combination of lifestyle changes and treatment can prolong their life and may help them feel physically better.