Signs and Symptoms

You will notice some of these symptoms when your heart is not pumping enough blood to the rest of your body:

	Swelling in your ankles and legs
	Needing two or more pillows to sleep or needing to sit up in a chair to sleep
	Becoming short of breath during regular activities such as making beds, vacuuming, walking to the end of the block or walking to your car
	Waking up short of breath
	Needing to urinate often at night
	Gaining weight (2-3 pounds in 2 days or 5 pounds in a week)
	Bloating
	Clothes and belts getting tighter around your waist
	Losing your appetite
	Feeling tired or weak

Let’s look at why you get each symptom.
Swelling in your ankles and legs—As blood backs up, fluid moves from your blood vessels into your tissues. Swelling often increases later in the day. How can you tell if your ankles and legs are swelling? Push firmly with your thumb on the top of your foot or front of your leg. You may notice a dent remaining in the tissues. You may also notice that your shoes are fitting tighter.

Becoming short of breath—As blood backs up, fluid collects in your lungs. You may feel that you are not getting enough air. This may occur during activities, when you are at rest, or when you are asleep. You may wake up with shortness of breath and feel the need to sit up. You may need to use several pillows or sit in a recliner chair to sleep.

Gaining weight—If you gain more than two pounds in a day or three to five pounds over several days, there is probably a fluid buildup in the body. The fluid buildup leads to shortness of breath and swelling of feet or legs. You may notice that clothing and belts fit more tightly around your waist. You may gain five pounds of weight before noticing any swelling or shortness of breath. Be sure to weigh yourself every day as an early warning system.

Losing your appetite—Fluid backs up in your digestive track. This backup interferes with the absorption of food and medicine. When this happens, you may lose your appetite, feel “bloated” or even have an upset stomach.

Feeling tired or weak—Your weak heart may not be able to pump enough blood to your muscles. You may find that you get very tired from small actions like walking up stairs or doing your daily chores. You may wake up in the morning feeling as tired as you did when you went to bed. Activities like walking may tire you quickly or cause you to become short of breath.

Needing to urinate often at night—Your diuretic (water pill) may not work well on the fluid that has backed up into your tissues. You may notice less urine output than usual after you take it. At night, gravity helps extra fluid to return to your heart. Your kidney then makes more urine.