First symptoms of heart failure

Heart failure means the heart is not pumping blood as effectively as the body needs. Fluid can build up, causing swollen ankles, breathlessness when walking, or a cough that is worse when lying down. Reduced blood flow can leave you tired and less able to do usual activities. Symptoms may develop gradually, so a change in stamina can be easier to notice than a dramatic new symptom.

These symptoms have several possible causes and do not by themselves confirm heart failure. A clinician may consider heart rhythm problems such as atrial fibrillation, high blood pressure, lung conditions, anaemia, or medication effects.

Arrange a medical assessment if breathlessness, swelling, fatigue, cough, or reduced exercise tolerance is new, persistent, or getting worse. Note when symptoms began, what activity brings them on, whether they disturb sleep, and whether your weight or ankle swelling has changed. Bring a list of medicines and describe any history of hypertension, heart disease, or an irregular heartbeat.

Assessment may include listening to your heart and lungs, checking blood pressure and oxygen level, reviewing your rhythm, and arranging blood tests or heart imaging when appropriate. Do not stop prescribed medicines or change salt and fluid intake without clinical advice.

Seek emergency help for severe or sudden breathlessness, breathing difficulty at rest, chest pressure or pain, fainting, blue or grey lips, confusion, or a new rapid heartbeat with weakness or dizziness. Sit upright while waiting for help and avoid driving yourself.

A rapidly worsening cough or swelling also needs prompt assessment, especially when it comes with breathlessness. If symptoms are milder but recurring, contact a healthcare professional soon so the cause can be checked.

Ask what might explain your symptoms, which tests are suitable, and what changes should prompt urgent help. You can also ask how to monitor swelling or breathlessness at home and whether a chronic disease review would help coordinate follow-up.