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Signs & Symptoms Of Heart Failure Getting Worse

symptoms of heart failure getting worse

In a 2020 report, the CDC and the American Heart Association found that at least 6.2 million people in the US alone are affected by heart failure, and with the aging population, this number continues to rise. Heart failure is a serious long-term medical condition where the heart struggles to pump blood effectively throughout the body. There are four common stages of heart failure, ranging from mild to severe, and the goal of treatment is to slow down the progression of the stages. Doctors usually determine how serious heart failure is by looking at what symptoms the patient is experiencing and how much those symptoms are impacting or limiting their activity. Certain risk factors and inherited diseases, as well as injuries like heart attacks, can lead to heart failure. 

Map created using the Center for Disease Control and Prevention’s Interactive Mapping Tool

It is important to manage the signs and symptoms of heart failure to prevent it from getting worse and to maintain a high quality of life. Many people think heart failure can only impact adults and the elderly, although children and adolescents who are born with a congenital heart defect or other medical conditions can also develop heart failure early on. Lifestyle changes, medications, and sometimes surgeries can be recommended to help control symptoms and slow down the progression of the disease. 

Warning Signs & Symptoms of Heart Failure Getting Worse

Heart failure ranges from mild to severe, so its symptoms may begin slowly, or a patient may initially not recognize the signs at all. Because heart failure prevents blood from flowing properly throughout the body, a person’s symptoms are often caused by fluid buildup in the body and lack of cardiac output. Monitoring the signs and symptoms of heart failure is a crucial part of preventing complications and improving the overall management of the condition. 

Here are some common warning signs that heart failure may be getting worse:

Shortness of Breath

Shortness of breath is a classic symptom of heart failure, and as the disease progresses, this shortness of breath may worsen and begin to limit activities. Dyspnea, or shortness of breath, occurs because as the heart’s ability to pump blood worsens, fluid can build up in the lungs, making it difficult to breathe. Initially, shortness of breath may only happen during physical activity, but as heart failure worses, it can also occur during periods of rest or even during sleep. This can lead to interrupted or disturbed sleep patterns and anxiety

Constant Coughing

Heart failure can cause fluid buildup in the lungs, which may lead to frequent coughing. Excess fluid can irritate the airways, so the body will start to cough and try to clear the air passages.  Patients experiencing a progression of heart failure may describe their cough as “persistent,” and it is typically worse at night or when lying down. 


Swelling, especially in the legs, ankles, and feet, is a common sign of worsening heart failure. Since the heart’s pumping function weakens, blood flow can slow down and may accumulate in the veins of the legs and feet, resulting in swelling. 

Rapid Weight Gain

Sudden and significant weight gain over days or weeks can be a sign that heart failure may be worsening. A person may experience rapid weight gain due to fluid retention caused by sluggish blood flow. To monitor their symptoms, patients are typically advised to weigh themselves regularly. 


Increasing fatigue and overall body weakness are other common signs of worsening heart failure. As the heart struggles to meet the body’s demands by supplying the cells with enough blood, individuals may feel tired and exhausted, even with minimal physical activity. This persistent fatigue can significantly impact their quality of life. 

When to Seek Medical Attention

If heart failure symptoms worsen, it is critical to contact a primary care physician, cardiologist, or seek emergency medical help right away. Heart failure symptoms may be worsening if daily activities begin to cause an increase in shortness of breath, difficulty breathing to breath while lying flat in bed, or chest pain develops.

If someone is experiencing chest pain, extreme shortness of breath, or signs of a heart attack, call 911 immediately. 

Patient resources provided by the American Heart Association.

Healthcare providers assess heart failure through physical examination, reviewing medical history, conducting diagnostic tests –such as electrocardiograms, echocardiograms, or blood tests–, and evaluating symptoms like shortness of breath, fatigue, and swelling. Bringing a professional into the conversation sooner rather than later allows for medication adjustments and lifestyle recommendations to optimize heart function and enhance the patient’s quality of life. The American Heart Association provides several free resources to help heart failure patients, like symptom trackers, self-check guidelines, and discussion topics to address with a doctor or cardiologist. 

How to Prevent Heart Failure Symptoms

While there is no cure for heart failure, the goal of treatment is to prevent the disease from progressing. Reducing symptoms often starts with adopting healthy lifestyle habits, like eating well, staying active (without stressing the heart muscle too much), limiting alcohol and caffeine intake, losing weight (if overweight), making sure to get enough rest, managing stress and quitting smoking. 

For those already diagnosed with heart failure, self-care at home plays a pivotal role in symptom management. Following prescribed medications, such as ACE inhibitors, beta-blockers, and diuretics, can help prevent heart failure from getting worse. More than 80% of people who experience heart failure are prescribed medication to help. These medications can help to lower a patient’s blood pressure and reduce the strain placed on the heart or remove excess fluid from the body and prevent a loss of potassium.

In some cases, surgical interventions like heart valve repair or a heart transplant may be the best course of treatment. Because heart failure can increase a person’s chance of experiencing abnormal heart rhythms, cardiac resynchronization therapy (CRT) or implantable cardioverter defibrillator placement (ICD) may be recommended. 


symptoms of heart failure getting worse

Detecting and treating heart failure in its early stages reduces the risk for hospitalization and helps to provide better patient outcomes. A patient’s treatment approach depends on the cause and severity of the heart failure, so each person’s healthcare program is likely to be different. By combining a healthy lifestyle, proactive self-care, and adhering to medical advice, individuals can reduce their risk of heart failure and effectively manage the condition to enhance their quality of life. When it comes to any matter concerning the heart, prompt and consistent communication with a healthcare provider is vital to ensure the most effective treatment.

What are the symptoms of the last stages of heart failure?

In the final stages of heart failure, patients may experience heightened, more intense versions of all the symptoms mentioned above- including while at rest. They may also experience chest pain, thinking difficulties, increased heart rate, and lack of appetite. The biggest distinction between Stage IV and Stages I, II, and III is that in the final stage of heart failure, the physical symptoms are constant and experienced even while at rest.

What is advanced heart failure?

Advanced heart failure is usually considered Stage IV, the final stage of heart failure progression. According to the American Heart Association, about 10% of the 6.2 million Americans with heart failure have advanced heart failure.

What symptoms should I track if I have heart failure?

If you suffer from heart failure, your provider will likely ask you to keep track of your symptoms to help monitor the progression of the disease. Some of these symptoms to watch for include: new/worsening shortness of breath; new/worsening swelling of the feet, ankles, or legs; weight gain; dry coughing; or discomfort/swelling of the abdomen.

Can you have heart failure with no symptoms?

In the earliest stage of heart failure, Stage I, the patient may have cardiac disease but present no symptoms. In this early stage, their ordinary levels of physical activity are unlikely to be impacted. Mild symptoms are likely to occur during Stage II.

Is diarrhea a symptom of congestive heart failure?

Diarrhea is not typically considered a direct symptom of congestive heart failure (CHF). However, some people with CHF might experience gastrointestinal symptoms, including nausea, loss of appetite, and abdominal discomfort. One study found that patients with later stages of heart failure experienced vomiting and diarrhea at the lowest rates compared to other symptoms.f

What are the stages of heart failure?

Like other serious, chronic diseases, heart failure is characterized in stages that describe the progression and severity of the condition. Heart failure has four stages that range from mild to severe. Stage IV usually indicates that a patient is experiencing severe limitations due to their heart failure, whereas Stage I patients may not experience any symptoms at all.

Medical advice: 

All information on the website is provided in good faith. However, Avive makes no representation or warranty of any kind, express or implied, regarding the accuracy, validity, or completeness of any information on the Site. Any medical/health information on the Site is for general informational and educational purposes only and is not a substitute for professional medical/health advice.


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