When your car is experiencing engine failure, it doesn’t mean it’s going to just stop working out of the blue. It’s something that typically happens gradually. There may be drops in performance that get worse over time.
Turns out, heart failure occurs in much the same way. It may sound like a medical emergency, as if someone’s heart is about to just stop beating. But heart failure actually means the heart isn’t pumping as well as it should be.
This lack of pumping power can be brought on by other heart conditions that leave the heart too weak or stiff to work properly. These include high blood pressure and coronary artery disease, which is the narrowing of arteries that supply blood flow to the heart.
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The American Heart Association (AHA) estimates that 1 in 5 people will develop heart failure. But more than half of Americans don’t know what symptoms to look for.
Your job: Know the signs. There are more treatment options than ever to help people with heart failure live better for longer. And the sooner you and your health care team catch it, the sooner you can prevent it from getting worse.
The warning signs of heart failure
Here is a list of some of the most common — and surprising — symptoms of heart failure. If you do have any of them, however, it’s important not to jump to conclusions.
The best thing to do is call your health care provider, says Mariell Jessup, MD. Based in Boston, Dr. Jessup is the chief science and medical officer of the American Heart Association. “It may be appropriate to begin testing for heart failure,” she says. This way, your doctor can rule out other causes and help you get the treatment you need.
When should you raise the alarm? It’s time to call 911 if you feel light-headed or as though you may pass out, if you have a fluttering or racing heart, or if you feel sudden chest pain or sudden chest heaviness, Dr. Jessup says.
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Heart failure sign #1: Swelling in the legs, ankles and feet
“If you have heart failure, your heart doesn’t pump with enough force,” says Dr. Jessup. “Not enough blood is pumped out of the heart with each heartbeat, and blood returning from the body can’t enter the heart, backing up the veins.” Fluid from the blood vessels is forced into other body tissues. This can cause swelling.
Your kidneys normally help dispose of extra fluid, Dr. Jessup says. But when they’re not getting the blood they need, they’re not able to do their job as well. And gravity can naturally pull the fluid down into your legs, ankles and feet. (Learn more about leg swelling here.)
Heart failure sign #2: Shortness of breath when you’re lying down
Having shortness of breath during activities that normally wouldn’t faze you is a common sign of heart failure. Examples include walking to your car or climbing the steps to your front door.
But you can also feel breathless while resting or even sleeping.
It has to do with that fluid buildup. “A person lies down, fluid fills the lungs, and it gets hard to breathe fully,” says Maya Guglin, MD. Dr. Guglin is the chair of the American College of Cardiology’s Heart Failure and Transplant Section and Leadership Council in Indianapolis. “Then they sit up and gravity pulls the fluid down and the breathing gets better,” she says.
