If the heart is not working as effectively as it should, patients notice a lack of energy, reduced exercise levels and increased fatigue. Ankle swelling or oedema, may also be an associated feature due to excess fluid in the tissues not being circulated properly. The skin is left feeling spongy so if pressure is applied with a finger, a small indentation can be felt that resolves in a few seconds. Shortness of breath can also occur, especially when lying down, due to the fluid causing lung congestion, preventing adequate oxygenation of the blood.
As heart failure progresses, so can the extent of the oedema caused by fluid swelling. Lower limbs can be affected first, with the fluid spreading upwards towards the thighs, scrotal area in males, and even the lower back and abdomen.
Symptoms of heart failure usually occur over a prolonged period of time and may initially be unnoticed. However, they become a problem when one's daily activities begin to be affected. The condition is usually stable but can be interspersed with episodes of acute symptoms.