Symptoms and Causes

The most common symptoms of heart failure are:

• Shortness of breath - difficulty in breathing, caused by fluid or congestion in the lungs, either with exertion or when lying flat
• More shortness of breath than before while still ambulatory
• Shortness of breath resulting in difficulty sleeping
• Waking up breathless at night
• Frequent dry hacking cough, particularly upon lying down
• Fatigue, a feeling of weakness
• Becoming tired with very little exertion or feeling run down, even in the morning
• Edema - swollen feet, legs and ankles, abdomen
• Abdominal problems - nausea, vomiting, pain
• Chest pain

Worsening heart failure is often associated with:

• Pain under the ribs in the right side
• Confusion, inability to think clearly
• Difficulty sleeping, or a need to sleep with two or more pillows
• Loss of appetite caused by fluid accumulation in digestive organs
• Rapid weight gain (two pounds in one day or five pounds in one week)

Your heart failure has worsened and you need to call your doctor if:

• You gain two pounds in one day or five pounds in one week
• Have a significant increase in your shortness of breath
• Your cough worsens
• You experience severe fatigue
• You pass out or faint

The most common causes of heart failure are:

• Coronary Artery Disease - a narrowing of the arteries that supply blood to the heart muscle.
• Cardiomyopathy - heart muscle disorder. The muscle cells of the heart are diseased due to many causes such as: viral or bacterial infections, toxins including drugs and alcohol, and other causes that are not well understood. 
• Hypertension - elevated blood pressure. The heart will often weaken and enlarge after years of pumping against a high-pressure system (the arteries).
• Heart Valve Disease - defects of the valves of the heart.  The heart muscle may be damaged from blood backing up in the chambers due to the valves not opening and closing properly. The valves may be damaged from birth defects or from infections.
• Familial Cardiomyopathy - There are many genetic causes of cardiomyopathy.  In fact, most diseases of the heart muscle have some relationship to genetic predisposition.