Heart failure – symptoms and diagnosis

Heart failure - symptoms and diagnosis

The symptoms of heart failure are divided into four stages depending on their severity so that the doctor can determine the severity of the heart failure. Read all about the signs of heart failure, its course and diagnostics here.

Symptoms of heart failure

The reduction in heart muscle strength can often be measured before the patient feels any symptoms. Symptoms such as:

  • poor performance
  • tiredness and lassitude
  • Coughing irritation during physical activity such as climbing stairs, later also at rest and especially when lying down
  • shortness of breath
  • heart palpitations
  • Water retention on ankles and lower legs
  • nocturnal urination


Development of symptoms throughout the disease

Characteristically, symptoms in the early stages of heart failure only appear with greater physical exertion. As the disease progresses, there are also problems at rest.

A patient in the terminal stage becomes increasingly bedridden and frail and is usually only able to get sufficient air in an upright sitting position. The weak heart can no longer fulfil its function as a circulatory pump. As a result, more and more water accumulates in the lungs and legs, and kidney function also suffers increasingly.

Depending on the underlying disease, other symptoms such as chest pain in the case of coronary heart disease, headaches in the case of high blood pressure or fainting in certain forms of cardiomyopathy also occur. If the symptoms are unclear, a doctor should be consulted early since effective therapy should start as early as possible. If the diagnosis is delayed for years, the treatment options are often severely limited.

stages of cardiac insufficiency

Four stages of heart failure are distinguished depending on how severe the symptoms are and when you feel the first symptoms. The American Society for Heart Disease proposed this classification to the New York Heart Association, NYHA. This is why they are also called the NYHA stadiums.


NYHA-Stadium 1 Slight reduction in cardiac output. Symptoms only appear with significant exertion.

NYHA-Stadium 2 Complaints such as tachycardia, weakness or shortness of breath are noticeable even with moderate, regular, everyday exertion such as climbing stairs over one or two floors or gardening.

NYHA-Stadium 3 The symptoms mentioned occur even with light exertion, such as getting up from a chair.

NYHA-Stadium 4 The heart is so limited in its performance that you suffer from shortness of breath and weakness, even when lying down or sitting.


Diagnosis of heart failure

The limited myocardial strength is diagnosed based on the typical symptoms in connection with objective examinations such as chest X-rays, ECG, ultrasound examination of the heart or cardiac catheter.

The contraction force of the heart muscle, which the doctor can objectively measure, and the subjective complaints of the person concerned do not always match. Shortness of breath or reduced physical resilience can occur even with only moderately pronounced myocardial insufficiency. However, cases are also known in which patients, even with severely restricted heart pumping capacity, lead a largely symptom-free life.

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