Heart Failure - Signs, Symptoms and Diagnosis

Learn how to recognise the signs and symptoms of heart failure and get a professional diagnosis.

asian businessman clutching his chest

What are the Signs and Symptoms of Heart Failure?

A person with heart failure often experiences:

  1. Shortness of breath while doing things he/she would previously normally do without any trouble
  2. Shortness of breath and/or cough when lying down
  3. Need to prop head up on several pillows to breathe more easily or having to sleep in a sitting position
  4. Waking up at night with shortness of breath or coughing
  5. Swollen feet, ankles, hands or abdomen
  6. Feeling bloated or discomfort after a meal and/or loss of appetite
  7. Passing urine more often at night
  8. A sudden weight gain (more than 1kg per day for 3 days)

When there is not enough blood going to the brain, muscle and other organs, the following symptoms may be experienced:

  1. Fatigue, weakness and/or activity intolerance (easily tired)
  2. Confusion and poor memory
  3. Decrease in the amount of urine produced

How is Heart Failure Diagnosed?

Anyone with suspected heart failure must consult a doctor.

The doctor will interview the patient and/or caregiver to clarify the symptoms and signs and do a detailed review of the patient’s previous medical history, social habits, family history and medication use.

The doctor will then carry out a detailed physical examination to confirm the signs of heart failure and also uncover any signs of heart disease as well as other medical problems.

Tests for heart failure generally fall into three categories:


Category 1: To check the heart function, the most commonly ordered test for this purpose is an ultrasound scan of the heart, also called an echocardiogram or echo. The echo measures how much the main pumping chambers (ventricles) can contract (also called ejection fraction). The echo can also detect any disease that has affected the heart function, such as a valve disorder.

Category 2: To find out the cause of the heart disease, a coronary angiogram (imaging of the coronary arteries) and other imaging tests may be conducted.

Category 3: To check for other disease conditions such as diabetes, thyroid disease, kidney impairment, anaemia (low red blood cells) and other conditions that may affect the heart function.

The diagnosis of heart failure will be made when the patient presents with the typical signs and symptoms of heart failure, and the abnormal heart function/structure are confirmed with the tests described.


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