Signs of early heart failure: When you should visit your doctor

February 20, 2017
Heartdisease

It’s an inevitable truth that we are all aging. Barring a real-life Indiana Jones finding an ancient fountain of youth, there’s little chance any of us will escape Father Time. And while it’s quite normal to lose some verve due to natural aging, it’s important to understand that fatigue and general tiredness may also be caused by a malfunctioning heart.


In fact, most people aren’t aware of the subtle signs and symptoms of heart failure, and too often attribute them to age.  I once had a 78-year-old patient who was excessively fatigued and short of breath from daily activities. She was initially treated for a cold and later bronchitis. Fast forward two months and she was still experiencing these symptoms with no relief. 

Watching for horses, not zebras

Now, if it looks like a duck, swims like a duck and quacks like a duck, then it’s probably a duck, right? Alternatively, all new doctors hear the saying: “When you hear hoof beats, think of horses, not zebras!”  After all, horses are a lot more common than zebras. 

In medicine, a zebra is a very unlikely diagnosis, and the saying is a teaching tool to help doctors think logically when treating patients.

Many symptoms to consider

People can experience many possible symptoms when they have heart failure. The symptoms go far beyond the classic excruciating chest pain dramatized in movies. On top of that, women are much likelier to have unusual warning symptoms and be those zebras we are trained to keep in the back of our minds instead of in the front.

Coming back to my patient, it turns out she was a zebra of sorts and was experiencing congestive heart failure. She received the appropriate treatment after she was hospitalized and examined more closely. 

A symptom checklist

Her story highlights how important it is for all of us to be able to easily identify those not-so-obvious signs of early heart failure. And we all need to know our own risk factors. These include smoking, diabetes, obesity, high blood pressure and coronary artery disease.

When risk factors and symptoms are taken into consideration, doctors and patients can quickly identify heart failure symptoms using a checklist that goes by the acronym FACES, developed by the Heart Failure Society of America:

F = Fatigue.  Are you experiencing unusual bouts of fatigue?

A = Activity limitations. Do you tire easily and have shortness of breath when doing normal activities?

C = Congestion. Are you coughing, wheezing or having difficulty breathing? These symptoms can be caused by fluid buildup in the lungs.

E = Edema or ankle swelling. When the heart doesn't have enough pumping power to force blood back up from the lower extremities, fluid can collect in the ankles, legs, thighs and abdomen. Excess fluid can also cause rapid weight gain.

S = Shortness of breath.  It may be harder to breathe when lying down because gravity allows fluid below the lungs to travel up the torso.

If you are experiencing any or a combination of these symptoms,  you should see your doctor immediately and get tested. 

The Swedish Heart & Vascular Institute has one of the most comprehensive congestive heart failure programs in the Northwest and specialists in advanced heart failure to treat this condition. Call 206-320-4100 to schedule a consultation.