5 unexpected signs of heart failure

Heart failure doesn’t mean what you probably think it means: That your heart suddenly—and catastrophically—stops beating. Rather, it means that the heart is not as efficient as it once was and can’t deliver enough oxygen-rich blood as the body needs. It’s a serious condition, but it sounds like it should be pretty easy to know if you have it. That’s not always the case, however; heart failure can be mild, and shares symptoms with a number of other conditions, including a cold or flu, depression, various cancers and even PMS. Here are the signs you need to watch out for.

Medically reviewed in November 2019.

What does heart failure have to do with the lungs? A lot, actually. Blood can back up in the lung’s blood vessels, causing fluid to leak into the lungs. Additionally, one of the main consequences of heart failure is that the kidneys can’t get rid of sodium and water as well as they used to. This leads to fluid buildup and swelling—known as edema—in various parts of the body, including the lungs. You might also experience coughing and wheezing as a result of this fluid buildup in the lungs. Shortness of breath, wheezing and coughing can all be worse lying down if they’re caused by heart failure. 

If your pants are feeling snugger around the thighs or waist, or you can’t seem to get your shoes on, that’s a possible clue that you may have heart failure. Fluid doesn’t build up only in the lungs. In heart failure, oxygen-poor blood can’t return to the heart as well, which can cause your legs, feet and abdomen to swell. Look for pitting: if you press down on the swollen part and your finger leaves an imprint, that’s a sign that the swelling may be caused by heart failure. 

Is your heart pounding like you’ve just run a marathon when all you’ve done is walk up the stairs? Does your pulse seem irregular? When your heart can’t pump blood efficiently, it tries to make up for it by pumping faster. Heart failure can also cause your heartbeat to go out of whack. According to the Heart Failure Association and European Heart Rhythm Association, between 25 and 50 percent of people with heart failure have atrial fibrillation (Afib), a type of heart arrhythmia that can cause stroke. It can go the other way, too. Afib itself can also cause heart failure, and heart failure and Afib share many risk factors. 

Daily life in the 21st century can be exhausting, but if you’re more tired than usual, especially during everyday activities, that could be a sign that your heart is failing. When the heart starts to lose its pumping efficiency, it can’t get enough blood to meet all the demands of the body. It begins diverting blood to crucial areas like the brain and vital organs, which might not leave enough for muscles, limbs and extremities.  Bear in mind that fatigue is a symptom in a large number of conditions, so fatigue alone shouldn't cause you to worry about heart failure.

Do you find yourself feeling foggy, or unable to remember conversations? Cognitive impairment is a common symptom of heart failure, with between 30 and 80 percent of heart failure patients experiencing some sort of impairment. Researchers suspect that reduced blood flow to the brain may play a part. Memory, attention, problem solving, language skills and facial recognition may all be affected by heart failure.