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Heart Failure Symptoms - Topic Overview

Shortness of breath continued...

Shortness of breath while sleeping. Some people with heart failure wake up in the middle of the night with severe shortness of breath. The medical term for this symptom is paroxysmal nocturnal dyspnea (PND). This may occur with waking up coughing and/or wheezing, having a rapid heart rate, and a feeling of being suffocated.

In general, people who experience PND don't feel increased shortness of breath when they first lie down. But after several hours of lying down, they awake with shortness of breath, which often occurs suddenly. People who experience PND often have to sit up on the side of the bed, and they may feel a need to open a window to get more air. The shortness of breath generally goes away after a few minutes of sitting up.

Being very tired (fatigue)

You might feel that:

  • You have less energy and feel more tired than usual.
  • You can't exert yourself like you could before.

You might also have low exercise capacity. This can be harder to describe. It is a symptom that people with heart failure often don't even notice because they have gradually reduced the level at which they exert themselves.

For example, they may stop walking up the stairs, or they may drive to the store instead of walking. Some people at first deny that they have been experiencing this symptom. It is only after doctors ask them about changes in their activities that they realize they have been avoiding physical exertion. This decrease in your ability to exert yourself physically is what doctors call low exercise capacity.

Swelling in ankles or feet

People with heart failure often experience swelling in their ankles or feet. You might notice that:

  • It gets worse at the end of the day or after you stand for long periods.
  • It hurts.
  • Pressure leaves impressions in your skin.
  • Shoes no longer fit.

The degree of swelling you experience depends on how well your body is compensating for heart failure and how much sodium and water your body retains. In some cases the swelling is mild and merely bothersome, while in other cases it can be severe and painful if the skin becomes taut and sensitive.

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