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Many of the symptoms of heart failure are similar to the symptoms of other illnesses. This can make it difficult to diagnose. Feeling short of breath, for example, can be caused by more than 30 different conditions.

The most common symptoms of heart failure are listed below.¹ You get these symptoms when your heart can no longer do its job properly. If you have these symptoms, talk to your doctor as soon as you can.

• Feeling breathless: It's normal to have to stop to catch your breath if you've been exercising. But if you need to stop more often than other people your age, you should see your doctor.
• Difficulty catching your breath at night: If you wake up suddenly feeling as if you are suffocating, it may be a sign that you have heart failure.
• Having to sleep on extra pillows. It's normal to sleep on a moderate-sized pillow. But if you have to prop your head up high to sleep, and if you feel breathless lying flat, you may have heart failure.
• Coughing up pink frothy phlegm: This is a common symptom of more serious heart failure. If you have this problem, you should contact your doctor or go to the emergency department right away.
• Swelling in your ankles: Fluid may collect in your feet, ankles and legs. The swelling tends to be equal on both sides, rather than one leg being much more swollen than the other. If your feet feel uncomfortable and your shoes feel tight, it's a good idea to see your doctor.
• Feeling tired: Heart failure can make doing even the simplest things feel like a struggle.

Here are some symptoms that aren't as common, but which some people with heart failure get.

• Putting on weight: This is caused by your body holding onto extra fluid.
• Bloating: If excess fluid collects in and around your abdomen, you might feel bloated.
• Losing weight: You may not feel like eating much if you have heart failure. You may also feel sick to the stomach. Both these things can make you lose weight.

Your doctor may use a scoring system to find out how much your symptoms affect your life.¹ To learn more, see How heart failure is classified.

Your symptoms may change from day to day.¹ Sometimes they may be easy to cope with, and sometimes they may make your life very difficult. It's possible to have severe symptoms even when your heart failure isn't very bad.¹

Your doctor will probably want to see you regularly to make sure that treatment is working well for you. If any of your symptoms suddenly get much worse, let your doctor know right away.

Some people feel depressed or anxious when they find out they have heart failure. This is a normal reaction to being told you have a serious illness, but you don't have to feel this way. Sometimes it helps to talk to other people who have heart failure. Your doctor may have information about local support groups.

To learn more, see Feeling depressed.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.