Early signs and symptoms of heart failure

Heart Health

by Timothy Gong, MD, FACC

Apr 5, 2022

The symptoms of heart failure, also referred to as congestive heart failure (CHF), can be subtle and easy to dismiss. Feeling tired? Well, you’ve been staying up later than normal this week… Weight gain? It has been a few weeks since you went to the gym…

However, these subtle symptoms can be the first indicator that something not-so-subtle is wrong with your heart.

What is heart failure?

Many people mistakenly view heart failure as a single event, like a heart attack or stroke, that happens suddenly and without warning. The truth is this: heart failure is a chronic condition. and requires ongoing management and healthy lifestyle habits to keep you feeling well.

Heart failure happens when the heart muscle does not pump blood as well as it should. As a result, blood backs up and fluid can build up in the lungs, making it difficult for you to breathe well. For a visual depiction of how heart failure develops, view this animation from the American Heart Association.

So, what causes heart failure to happen? Although all hearts age as we get older, the following conditions increase the “wear and tear” on your heart and can lead to heart failure. If you have more than one of these conditions, your risk of heart failure is greater.

  • Heart disease (coronary artery disease)
  • Past heart attack, which weakens the heart’s ability to pump blood
  • Abnormal heart valve (can be present at birth or happen as a result of disease or infection)
  • Inflammation or damage to the heart muscle from drug/alcohol use, viral infections or other unknown causes
  • Heart defects present at birth
  • Severe lung disease such as chronic obstructive pulmonary disease (COPD)
  • High blood pressure (hypertension)
  • Diabetes
  • Obesity
  • Sleep apnea
  • Abnormal heart rhythm (arrhythmia)

6 common signs of heart failure

Here’s the good news—early diagnosis and intervention can make a big difference in helping you manage heart failure. That’s why it’s critical to know the signs of heart failure, especially if you have any of the conditions mentioned above.

Here are the six most common early signs and symptoms of heart failure to watch out for:

Shortness of breath

You may have difficulty breathing during activity, at rest or while sleeping.


Swelling is especially common in the feet, ankles, legs or abdomen. Your shoes may also feel tight.


Coughing and wheezing, especially coughing that produces white or pink blood-tinged mucus, is also common.

Confusion or memory loss

You may notice feelings of disorientation or unexplained memory loss, or a loved one may notice you’ve been acting “out of it” lately.

Rapid weight gain

Weight gain often happens as a result of excess fluid buildup in the body tissues, also referred to as edema.

Feeling tired

You may feel tired all the time and notice difficulty performing everyday activities such as carrying groceries, going up the stairs, shopping, etc.

If you’ve been experiencing these symptoms and are worried you may be experiencing heart failure, talk to your cardiologist if you have one or your primary care physician (who may refer you to a cardiologist for specialized care).

For a full list of heart failure symptoms and why they happen, refer to the American Heart Association’s heart failure symptoms list.

Healthy habits to prevent or manage heart failure

As with many heart conditions, making healthy choices can help you prevent heart failure from happening or help alleviate symptoms and slow progression of the disease. These healthy lifestyle changes include:

  • Quitting smoking
  • Maintaining a healthy weight
  • Managing stress
  • Tracking daily fluid intake
  • Avoiding or limiting alcohol and caffeine
  • Keeping track of blood pressure and any symptoms
  • Eating a heart-healthy, balanced diet (find inspiration here)
  • Prioritizing healthy sleep
  • Staying physically active
  • Avoiding tight clothing and hot temperatures

Talk to your doctor about what steps you can take today for a more heart healthy future.

Find heart care near you.

About the Author

Timothy Gong, MD, FACC, is a cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas and Baylor Scott & White Medical Center – Irving. 

Dr. Gong specializes in the treatment of patients with advanced heart failure, and he is the section physician leader for the Heart Failure, Transplant and Mechanical Support Cardiology Team. His clinical interests include ventricular assist devices and cardiac transplant.

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