Heart Failure: Less Common Symptoms

Topic Overview

While there are certain symptoms that people with heart failure experience more commonly, there are many other symptoms that heart failure can cause. These symptoms are typically less common because they often result from more severe heart failure, when the body can no longer compensate properly for the failing heart.

The first table summarizes congestive symptoms that result from fluid leaking into the lungs and the rest of the body. The second table summarizes symptoms that occur because the heart can no longer pump enough blood to meet the body's needs, which causes poor blood circulation. After the tables is a more detailed explanation of each symptom.

Tell your doctor if you experience any of these less common symptoms.

Symptoms of congestion

Symptom	What happens?	What causes it?
Cough	Most commonly a dry cough (without phlegm) More severe heart failure can cause a wet cough-coughing up pink, frothy fluid. Some people experience wheezing, similar to that caused by asthma.	Backup of blood and fluid into the lungs
Abdominal bloating	Abdominal bloating can result from fluid backup in your: Liver, which makes your abdomen feel swollen or tender. Stomach, which causes decreased appetite, bloating, and nausea. Intestines, which causes decreased appetite and poor absorption of medicines and food. Abdominal cavity ascites, tenderness, or fever can indicate an infection in this fluid buildup.	Backup of blood and fluid into different parts of the gastrointestinal system or abdominal cavity

Symptoms of poor blood circulation

Symptom	What happens? What does it feel like?	Results from poor circulation to the:
Less frequent urination	You may urinate less often than you normally do (because of poor blood flow to the kidneys).	Kidneys
Feeling cold in arms, legs, hands, and feet	May feel cold due to poor circulation	Arms, legs, hands, and feet
Lightheadedness	Sensation of dizziness or mild disorientation	Brain
Mental confusion	Inability to think clearly Problems with memory or ability to understand language	Brain
Fainting or passing out	Losing consciousness suddenly (blacking out)	Brain
Impotence	Inability to achieve an erection	Male genitals

How does heart failure make the arms, legs, hands, and feet feel cold? People with heart failure may find that they often feel cold in their arms, hands, feet, and legs (the extremities). This happens because the body is circulating most of the available blood to the brain and other vital organs to compensate for the failing heart's inability to pump enough blood to the entire body. As a result, the extremities get less blood, and without blood to warm them, these parts of your body feel cold.

These symptoms usually occur only in people with chronic, severe heart failure. If your extremities suddenly become cold and clammy, and other symptoms of heart failure, such as fluid buildup (edema), mental confusion, or decreased urine, are becoming worse, you may be going into shock. Shock develops when the amount of blood your heart is pumping becomes critically low. If you experience signs of shock, you will need immediate medical attention.

What happens when the brain doesn't get enough blood? When the body can no longer compensate adequately for the failing heart, blood circulation to the brain will start to drop. Without enough blood, the brain does not function well, resulting in lightheadedness and/or mental confusion.

Lightheadedness is a sensation of dizziness or mild disorientation. People with heart failure may also experience lightheadedness as a side effect of certain medications.

When blood flow to the brain becomes critically low, people with heart failure may experience an inability to think clearly. Specifically, they may have problems with their memory or with understanding language. This can be particularly dangerous because it can prevent people with severe symptoms from being able to report them to their doctor.

Mental confusion resulting from heart failure means that the amount of blood the heart is pumping is critically low. Typically, this level of impairment occurs in people who are already hospitalized with heart failure. If this is not the case, someone with heart failure who experiences mental confusion needs to see a doctor immediately.

What causes impotence in men who have heart failure? Some men with heart failure cannot achieve an erection (impotence). The specific cause of this impotence can vary. In some cases it results from low blood flow to the genitals caused by the failing heart. In other cases, it can happen as a result of the buildup of plaque (atherosclerosis) in the arteries that supply blood to the genitals. Atherosclerosis in the arteries that supply blood to the heart (coronary artery disease) is often what causes heart failure in men who experience impotence.

Also, impotence can be the result of depression or other psychological factors related to heart failure. Certain medicines used to treat heart failure may also cause impotence.