Heart failure means that the heart has trouble pumping enough blood to supply muscles and organs with oxygen. The first signs of heart failure are shortness of breath, fatigue and swollen ankles. Heart failure is a life-threatening condition, but early diagnosis can help a person manage it, prolong their life and improve their outlook. Recognizing the early signs of heart failure can help a person get needed treatment.

In the early stages of heart failure, symptoms occur when a person strains beyond their normal activity level. Doctors then classify the stage of the disease based on the severity of the symptoms and the amount of exertion required for them to manifest. For many people, the first symptom is shortness of breath, especially during light or moderate exertion.

This article details the early signs of heart failure and how to spot them. It also explains the causes, treatment, and when to contact a doctor.

Easy to remember early signs of heart failure

To memorize the signs, try memorizing the acronym FACES to look for the following early signs of heart failure:

F for fatigue: People with heart failure may feel tired even with enough rest or lose energy quickly.
A for limited activities: Heart failure can make some activities difficult or impossible. For example, a person may find it very difficult to climb stairs or feel exhausted while taking a walk.
C for chest congestion: A person may develop chest congestion or a chronic cough.
E for edema or swelling of the ankles: When the heart is not working well, fluid can build up in the extremities.
S for shortness of breath: This is the most common symptom of heart failure. In the early stages, a person may be short of breath only during certain activities. For example, a person may experience shortness of breath when walking longer than usual.

Other common symptoms are:

waking up having trouble breathing at night, but noticing that the symptoms get better after sitting up
difficulty breathing when lying down
a chronic cough
All of these symptoms are common and do not necessarily mean that a person has heart failure. It is important that a person sees a medical professional for further advice.

Less common signs of heart failure

As heart disease progresses, symptoms may get worse. A person may be short of breath even if they are not exerting themselves. She may also develop other symptoms. These symptoms are still quite common, but they are less likely to occur in the early stages of heart failure:

unintentional weight gain
loss of appetite or feeling full faster after eating
heart palpitations
coughing up white or pink mucus
cough while lying down
chest pain

When to contact a doctor

It’s easy to be scared when someone has symptoms of heart failure. But treatment can help, and early treatment is best. A person should contact a doctor if they have symptoms of heart failure, such as:

difficulty breathing
unexplained tiredness
chest pain
heart palpitations
leg swelling

People with risk factors for heart disease, such as diabetes, high blood pressure, a history of smoking, or obesity, should see a doctor regularly to make sure they have the risk factors under their best control. This will also allow the doctor to quickly detect complications such as heart failure.

Diagnose heart failure

Doctors diagnose heart failure based on the severity of symptoms and a person’s ejection fraction. The ejection fraction is the proportion of blood that the left ventricle expels with each beat. A doctor may recommend an echocardiogram or electrocardiogram to assess the activity of the heart and see if it is pumping blood well.

A doctor may also recommend other tests, including:

blood tests
chest and heart imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT)
a stress test
heart catheterization


Treatment for heart failure includes medication to improve symptoms and reduce the risk of hospitalization and death. The goal is to ensure that a person can continue to lead a healthy and fulfilling life despite their condition. In most cases, it is a beta-blocker and an angiotensin converting enzyme (ACE) inhibitor, an angiotensin receptor neprilysin inhibitor (INRA ) or an angiotensin II receptor (ARB) blocker. A doctor may also recommend other medications, such as spironolactone and SGLT-2 inhibitors, for people with advanced heart failure or severe symptoms.

In some people with heart failure and low ejection fraction, a cardiologist may recommend an implantable cardioverter-defibrillator (ICD). This is a device that a doctor implants in a person’s chest to monitor and treat abnormal heart rhythms to reduce the risk of sudden cardiac death.

In severe cases, a person may need a heart transplant.

Lifestyle changes to better manage heart failure may include:

become more physically active
adopt a balanced diet
reduce sodium intake
Reduce water consumption
reduce alcohol consumption
stop smoking
Treating underlying conditions such as hypertension and high cholesterol is important for treating heart failure.


The outlook with heart failure depends on many factors, including age, general health, severity of heart failure, access to treatment, and whether a person can make lifestyle changes. A 2019 study looked at survival rates among people living in the UK who were newly diagnosed with heart failure. She made the following findings:

After one year, 80.8% were still alive.
After five years, 48.2% were still alive.
After 10 years, 26.2% were still alive.


Lifestyle changes can reduce the risk of developing heart failure and can prolong survival for people who already have it. A person can try the following:

Stop smoking.
Maintain a healthy body weight.
Treat any chronic disease, especially diabetes.
Manage cholesterol with medication or diet.
Become more physically active.
Reduce sodium intake.


Heart failure can be scary. It can shorten a person’s life and affect their quality of life. It can make certain daily activities difficult. Although there is no cure for heart failure, treatment can slow its progression and even reverse some symptoms. No matter how severe a person’s heart failure is, the right combination of lifestyle changes and treatment can prolong their life and help them feel better physically.

* criptom strives to transmit health knowledge in a language accessible to all. In NO CASE, the information given can not replace the opinion of a health professional.