The symptoms of heart failure are divided into four stages, depending on their severity, so that the doctor can determine the severity of the heart failure. Read all about the signs of heart failure, its progression and diagnosis here.
Symptoms of heart failure
Often, the restriction of cardiac muscle strength can be measured before the patient experiences any discomfort. Only when a critical point – which varies greatly from individual to individual – has been exceeded do symptoms such as:
- Weakness in performance
- Fatigue and tiredness
- Irritation to cough during physical activity such as climbing stairs, later also at rest and especially when lying down
- Shortness of breath
- Heart palpitations
- Water retention on ankles and lower legs
- Nocturnal urination
Development of symptoms during the course of the disease
Characteristically, symptoms in the early stages of heart failure occur only during greater physical exertion. As the disease progresses, resting symptoms then occur.
A patient in the final stage becomes increasingly bedridden, lazy and is usually only able to breathe adequately in an upright sitting position. The weak heart no longer fulfills its function as a circulatory pump. As a result, water increasingly accumulates in the lungs and legs, and kidney function also suffers increasingly.
Depending on the underlying disease, other symptoms may also occur, such as chest pain in coronary heart disease, headaches in hypertension, or fainting spells in certain forms of cardiomyopathy. If symptoms are unclear, a physician should be consulted early, as effective therapy should begin as soon as possible. If the diagnosis is delayed for years, treatment options are often severely limited.
Stages of heart failure
Depending on how severe the symptoms are and when the first symptoms are felt, four stages of heart failure are distinguished. This classification was proposed by the American heart disease society, the New York Heart Association, NYHA. Therefore, it is also referred to as the NYHA stages.
| NYHA stage | Description |
|---|---|
| NYHA stage 1 | Mild limitation of cardiac output. Symptoms appear only with marked exertion. |
| NYHA stage 2 | Complaints such as palpitations, feelings of weakness, or shortness of breath are noticeable with even moderate normal, everyday exertion, such as climbing one to two flights of stairs or doing yard work. |
| NYHA stage 3 | The above symptoms occur with very light exertion, such as getting up from a chair. |
| NYHA stage 4 | The heart’s efficiency is so severely reduced that one suffers from shortness of breath and weakness even when lying down or sitting. |
Diagnosis of heart failure
Limited cardiac muscle strength is diagnosed essentially on the basis of the typical symptoms in conjunction with objective examinations such as chest X-ray, ECG, ultrasound examination of the heart or cardiac catheterization.
The contraction force of the heart muscle that can be objectively measured by the physician and the subjective complaints of the affected person do not always coincide. Shortness of breath or reduced exercise tolerance can occur even with only moderately pronounced cardiac muscle weakness. However, there are also known cases in which patients lead a largely symptom-free life even with highly restricted pumping capacity of the heart.
