If you’ve been diagnosed with stage one of congestive heart failure, it is because a doctor has noticed a weakness in your heart. This news may be surprising, as stage one of CHF does not exhibit any symptoms. Although CHF cannot be cured, you can make healthy lifestyle changes and take certain medication to manage this condition.
Stage 2 of Congestive Heart Failure
Stage two of congestive heart failure will produce symptoms such as fatigue, shortness of breath, or heart palpitations after you participate in physical activity. As with stage one, lifestyle changes and certain medication can help improve your quality of life. Your doctor will discuss treatment with you and help you on your healthcare journey while living with CHF.
Stage 3 of Congestive Heart Failure
It’s not uncommon for congestive heart failure to be accompanied by other heart conditions. If you are diagnosed with stage three CHF, along with another heart condition, it’s likely that you’ll have difficulty performing regular tasks. Small bouts of exercise or minimal doses of physical activity will cause the same symptoms mentioned in stage two – fatigue, shortness of breath, and heart palpitations. In stage three, lifestyle changes are not as effective, and a surgical procedure may be necessary. However, it’s never too late to talk to a doctor about your heart condition and what the future may look like.
Stage 4 of Congestive Heart Failure
Stage four of congestive heart failure produces severe symptoms such as rapid breathing, chest pain, skin that appears blue, or fainting. These symptoms may occur whether you are exercising or at rest. In this stage, your doctor will discuss if surgery is beneficial. Although there is no cure for CHF, you can avoid this condition by eating right, exercising, avoiding alcohol and illegal drugs, and maintaining a healthy weight.
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Heart Failure Warning Signs and Symptoms
By themselves, any one sign of heart failure may not be cause for alarm. But if you have more than one of these symptoms, even if you haven't been diagnosed with any heart problems, report them to a healthcare professional and ask for an evaluation of your heart. Congestive heart failure is a type of heart failure which requires seeking timely medical attention, although sometimes the two terms are used interchangeably.
View an animation of heart failure.
This table lists the most common signs and symptoms, explains why they occur and describes how to recognize them.
| Shortness of breath (also called dyspnea) | ...breathlessness during activity (most commonly), at rest, or while sleeping, which may come on suddenly and wake you up. You often have difficulty breathing while lying flat and may need to prop up the upper body and head on two pillows. You often complain of waking up tired or feeling anxious and restless. | Blood "backs up" in the pulmonary veins (the vessels that return blood from the lungs to the heart) because the heart can't keep up with the supply. This causes fluid to leak into the lungs. |
| Persistent coughing or wheezing | ...coughing that produces white or pink blood-tinged mucus. | Fluid builds up in the lungs (see above). |
| Buildup of excess fluid in body tissues (edema) | ...swelling in the feet, ankles, legs or abdomen or weight gain. You may find that your shoes feel tight. | As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing fluid to build up in the tissues. The kidneys are less able to dispose of sodium and water, also causing fluid retention in the tissues. |
| Tiredness, fatigue | ...a tired feeling all the time and difficulty with everyday activities, such as shopping, climbing stairs, carrying groceries or walking. | The heart can't pump enough blood to meet the needs of body tissues. The body diverts blood away from less vital organs, particularly muscles in the limbs, and sends it to the heart and brain. |
| Lack of appetite, nausea | ...a feeling of being full or sick to your stomach. | The digestive system receives less blood, causing problems with digestion. |
| Confusion, impaired thinking | ...memory loss and feelings of disorientation. A caregiver or relative may notice this first. | Changing levels of certain substances in the blood, such as sodium, can cause confusion. |
| Increased heart rate | ...heart palpitations, which feel like your heart is racing or throbbing. | To "make up for" the loss in pumping capacity, the heart beats faster. |
If you have been diagnosed with heart failure, it's important for you to manage and keep track of symptoms and report any sudden changes to your healthcare team.
Download our Self-Check Plan for help with tracking your heart failure symptoms:
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Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.