Early Symptoms of Heart Failure

The early symptoms of heart failure often trigger women to seek help from healthcare providers. Getting tired quickly or easily, lacking energy, shortness of breath, difficulty sleeping when laying flat, weight gain or fluid retention, and an inability to do usual daily activities were signs and symptoms that something was not right. Some women described experiencing a sudden event, such as a heart attack, that might have preceded symptoms of heart failure. Others lived with these persistent symptoms for many months and even years prior to finally receiving a diagnosis, despite efforts to seek answers. Some women had experienced no symptoms at all and then heart failure was discovered when undergoing routine tests for other conditions. Some had a previous cardiac diagnosis or were health care providers themselves, yet they didn’t recognize these early symptoms. How the symptoms presented was often linked to the underlying cause of the heart failure and how women ultimately discovered their condition [see our Backstories page].

 

Fatigue/Tiredness

Exhaustion, fatigue, or extreme tiredness was reported by most of the women that we spoke to. For women who live with other serious health conditions, such as stroke, cancer, chronic obstructive pulmonary disease (COPD), or lupus, it was often a challenge to pinpoint the cause of symptoms such as fatigue or shortness of breath. Several women talked about getting used to living with low level symptoms or having their attention focused on more pressing medical problems, until the fatigue became extreme.

Some women reported having to sleep for more than twelve hours a day. Others reported that their fatigue impacted their ability to complete normal tasks – such as falling asleep while working and the inability to get out of bed. Lise talks about feeling so fatigued that she would fall asleep while working, “And it was really bad. I was falling asleep at my desk. I couldn’t stay awake. I couldn’t breathe. I was gasping the whole time.”

 

Shortness of Breath

Shortness of breath or becoming ‘winded’ easily (not being able to catch your breath), often when climbing hills or stairs, was a common early symptom. Some women reported their shortness of breath occurring so slowly that they didn’t really notice it at first, while others felt these symptoms severely. One woman who had cardiomyopathy diagnosed as a child describes recognizing as a teenager that she was “not in the same physical shape as other people”. She initially blamed it on her lack of fitness.

Shortness of breath is also a symptom of other conditions such as asthma or COPD, making it hard to determine the cause. Women described how they monitored their own symptoms to help diagnose the cause or worked with their healthcare providers to diagnose heart failure.

Lillian’s request for a puffer for her coughing or asthma, alerted to GP to send her for cardiac work up to investigate potential heart failure.

 

Difficulty Sleeping

Many of the women that we interviewed spoke about breathing problems or pain preventing them from lying flat when sleeping and sitting up to relieve those symptoms. Several women spoke about their physicians sending them to the ER for diagnostic tests, once they were aware of this symptom, in combination with the other symptoms.

 

Weight Gain/Fluid Retention

Gaining weight and retaining fluid often occurs in individuals experiencing heart failure due to the heart’s inability to pump correctly. Several women spoke about experiencing weight gain, which was not normal for them. Others described feeling bloated or having swollen ankles and legs and extended abdomens. For many of the women, fluid retention occurred for several months, while others did not experience this symptom at all during their heart failure journey.

 

Impact on Daily Activities

Some women noticed that regular activities were becoming more difficult. Walking, especially going up hills or stairs became increasingly difficult for some of the women. For others, the inability to keep up with friends, or having to stop for breaks when walking was one of the signs that something was not right.

 

Nausea & Vomiting

While many of the women spoke about breathing issues, fluid retention and fatigue, others reported symptoms such as throwing up and indigestion. These symptoms seemed to be more common in women who experienced a sudden onset of heart issues such as those who were having a heart attack versus those who experienced symptoms for many months. Chest pain was also noted by those who experienced heart attacks but also by those who had more sudden onset of heart failure. Other women reported dizzy spells or passing out prior to having a cardiac event while another woman reported feeling as if she had flu like symptoms. Rhonda reported that “the only symptom I had was two dizzy spells a month prior. I had been very tired”, whereas Debbie felt intense dizziness.

 

No early symptoms

Some women that we spoke with reported that they didn’t have any early symptoms. Instead, they had their heart failure discovered as a result of the process of testing for some other health condition such as stroke or cancer.