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Is It Heart Failure?

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Learn five common warning signs

Posted by Val Rakita, MD

As a cardiologist who specializes in treating advanced heart failure, I'm acutely attuned to the signs that a person may have the disease. For many individuals, though, the symptoms can be less than obvious. However, knowing what to watch for can help protect your health or even save your life, especially if you're at high risk for heart failure.

Heart failure is a serious condition that occurs when the heart isn't strong enough to pump properly or isn't able to fill with enough blood. It can come on quickly or slowly, and despite the name, it doesn't actually mean that your heart has stopped working. Instead, heart failure means that your heart isn't able to pump the amount of blood needed for your body to function properly.

Having heart failure can make everyday activities like walking or climbing stairs difficult for a lot of my patients. Over time, the disease can also lead to complications like liver or kidney damage or an irregular heartbeat. While there's no cure for heart failure, treatment is crucial for managing the condition and helping someone maintain the best possible quality of life.

The condition can affect your body in some unexpected ways. Here are five of the most common heart failure symptoms I see in patients, plus how to tell if you're at an increased risk for developing the disease.

1. Swollen feet.

When your heart has trouble pumping blood, fluid can start to build up in your body. This can lead to swelling, particularly in your legs, ankles, and feet. The swelling might cause your feet to look unusually large or puffy or cause your shoes to not fit as well. It can lead to leg or foot pain and make it harder for you to walk. Sometimes the swelling can also be seen in your abdomen — you might look like you’ve gained weight or your clothes may feel too tight.

It's important to note that many other conditions can cause swelling. And in some of those conditions, the swelling may ease up on its own. That's not the case if you have heart failure. While the swelling might get a little better or a little worse at times, it lasts for long periods and will not go away on its own.

2. Shortness of breath.

Many of my patients with heart failure experience frequent feelings of breathlessness, especially when they're active. This shortness of breath is the result of fluid retention in the lungs, which happens when blood backs up into the vessels that return blood from the lungs back to the heart.

People with heart failure may start to feel breathless even while they're at rest. They might also have trouble breathing when they're lying down or sleeping — or they may even wake up breathless. This can cause them to feel tired during the day.

3. Frequent coughing or wheezing.

Persistent coughing or wheezing can have a number of possible causes, of course. But when a patient's frequent cough is accompanied by white or pink blood-tinged mucus, that suggests to me they may have heart failure. As with trouble breathing, coughing and mucus are caused by excessive fluid buildup in the lungs.

4. Upset stomach.

As your heart struggles to pump effectively, your digestive tract can start to receive less blood. This can lead to digestion trouble that may make you feel bloated or nauseous, or you may lose your appetite or feel full prematurely.

5. Heart palpitations.

To help compensate for its inability to pump as efficiently as it should, your heart works harder. This can cause palpitations, which can make it feel like your heart is skipping a beat, fluttering, or beating too hard or too fast.

How do I know if I’m at risk for heart failure?

That’s an important question that people often ask me. It’s easy to either overlook some of the symptoms of heart failure or chalk them up to something else. But if you have symptoms and you know you’re at risk for developing the disease, you can see a cardiologist and get the help you need.

You may be more likely to develop heart failure if you:

  • Are 65 or older. Aging can cause the heart to become weaker and stiffer. Older adults are also more likely to have other chronic health conditions that can raise heart failure risk.
  • Have a family history of heart failure. If others in your family had or currently have heart failure, you're more likely to be diagnosed as well.
  • Are African American. African Americans are more prone to heart failure compared to people of other races. They're more likely to be diagnosed with heart failure at a younger age, too.
  • Were born male. Men are often diagnosed with heart disease at a younger age than people who were born female.
  • Have another chronic health condition. High blood pressure, diabetes, sleep apnea, chronic kidney disease, anemia, thyroid disease, or iron overload can all increase a person's chances for heart failure. So too can having excess weight.
  • Have or had certain infections. Both HIV and SARS-CoV-2 (the virus that causes COVID-19) may make a person more prone to heart failure.
  • Engage in certain lifestyle habits. Heart failure is more likely to affect people who eat an unhealthy diet or don’t get enough exercise. Smoking, heavy drinking, and using cocaine or other illegal drugs can also increase heart failure risk.

Get help for your heart

As with so many other diseases, the sooner you get help for heart failure, the better. Treatment can help slow progression of the disease and help you live the fullest and most active life possible.

At Temple Heart & Vascular Institute, our experts in heart failure can discuss your risks with you, go over your symptoms and order any necessary tests. If you are diagnosed with heart failure, they will develop a treatment plan that’s right for you.

Schedule an appointment online or call 800-TEMPLE-MED.

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Val Rakita, MD

Dr. Rakita is a cardiologist who specializes in advanced heart failure. With clinical interests in mechanical circulatory support and heart transplantation, he is also Assistant Professor of Medicine at the Lewis Katz School of Medicine at Temple University. Dr. Rakita is a member of the Heart Failure Society of America and the American College of Cardiology.

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