Signs of End-Stage Heart Failure

Medically Reviewed by James Beckerman, MD, FACC on September 01, 2023
3 min read

Your heart pumps blood around your body to supply all of your organs with oxygen. When it doesn’t work the way it should anymore, you have what’s known as heart failure. Your ticker may not be strong enough to gather enough oxygen from your lungs, or to pump oxygen-rich blood around your body.

Either way, heart failure causes health problems and must be treated by a doctor. Drugs and lifestyle changes may help you lead a more active life than you’d be able to without treatment.

Over time, if your health gets worse, you may learn that you have advanced heart failure, also known as end-stage heart failure. It means the treatments you’ve used in the past to keep your health stable no longer work.

Some are easy to confuse with normal aging or other diseases. The more advanced your heart failure, the more likely you are to have many symptoms, or the changes that you’ve noticed in yourself will worsen.

These are common ways that heart failure can affect you:

Shortness of breath. Heart failure can make it hard to breathe when you walk up a flight of stairs. With advanced heart failure, you may get winded in a shorter period of time, or you may have trouble even when you’re sitting still.

Sleep problems. Heart failure can make it hard to breathe or catch your breath when you lie in bed. You may have trouble nodding off to sleep, or you might wake up in the middle of the night gasping for air. Try sleeping while propped up on two or more pillows instead of lying flat. Advanced heart failure makes it even more likely you’ll have trouble breathing when you’re at rest. That means your bedtime problems will probably get worse, too.

Coughing. You may already have a dry cough that acts up when you’re lying in bed. You might cough often during the day, and your phlegm could have a slight pink tint to it. That means there’s a bit of blood in the gunk you’re coughing up. Advanced heart failure can make that cough worse, especially when you’re lying down.

Fatigue. Heart failure can make you feel worn out. Things that wouldn’t have tired you out in the past suddenly do. You’re more likely to feel tired all of the time with advanced heart failure.

Swelling. When your heart can’t move blood through your body, it can build up in certain body parts. That can lead to swollen feet, ankles, legs, or a swollen belly. You might also gain weight from fluid in these areas. Advanced heart disease makes swollen body parts and weight gain more likely.

Eating less. You might not feel hungry anymore, so you may eat less. Advanced heart failure can make this more pronounced. You may not lose weight, either. Fluid buildup in your body often leads to weight gain.

More bathroom visits. You may have to go to get up and pee in the middle of the night more when you have heart failure than when you were healthy. That’s one way your body can get rid of that extra fluid. With advanced heart disease, it’s even more likely you’ll make frequent bathroom trips.

Racing heartbeat. You may feel like your heart is beating too fast or pounding too hard. This is called heart palpitations. When your heart isn’t pumping the amount of blood it should, it can try to make up for the loss by going faster. If you have advanced heart disease, you may notice this more often or to a greater degree.

Feeling anxious. This disease can make you worry about your health. You may even have physical symptoms like sweating, shortness of breath, or fatigue. Depression or anxiety may be even more likely with advanced heart failure. Talk to your doctor about ways to get help.