Signs & Symptoms of Congestive Heart Failure

Here are the most common signs and symptoms of congestive heart failure (also known as CHF):

Fatigue

Fatigue is often the first symptom of CHF. However, it usually goes unreported until it becomes severe.
Congestive heart failure causes the heart to pump less blood to the tissues in the body. This means that people with CHF don’t get enough oxygen and nutrition sent to their muscles. That is what causes them to suffer from fatigue.
When people feel tired, or worn out easily by routine exercises, they will naturally rest more and modify the amount of exercise they do in order to avoid feeling tired. They don’t usually report this right away to a doctor or nurse.
It’s important to report when a client is feeling fatigued by routine activity.

Dyspnea (Shortness of breath):

Dyspnea is another early symptom of heart failure. Depending on the severity of the illness, dyspnea may be seen in different ways:
Dyspnea at Rest— Some people with CHF may get short of breath while just sitting and resting.
Dyspnea on Exertion— Others get short of breath on exertion. These clients will need to alter their routine to include frequent breaks, and will need help doing strenuous activities like housework.
Orthopnea— Some CHF clients will get short of breath when lying down. These clients will often sleep sitting up in a chair.

Sudden Weight Gain

It is not unusual for people with CHF to gain weight in a short period of time due to fluid retention.
Monitor weight daily and report even small changes to the nurse. Weight gain of 3 or more pounds in less than a week may be an emergency.

Edema

Heart failure keeps the kidneys from getting rid of extra fluid that the body doesn’t need. This causes edema (swelling), especially in the legs, feet and abdomen.
Edema can also be caused by blood backing up into veins throughout the body.
Monitor your client for any swelling of the feet, legs, or abdomen.
When you press your thumb on an area of edema, you will notice a “dent” remains after you pull your finger away. Notify the nurse if you observe this.

Some additional signs and symptoms you may see in a client with CHF include: