The main symptom of heart failure is choking or dyspnea, especially when shortness of breath increases with the performance of daily activities. If this symptom appears, and especially if it is associated with any of the following, you should consult your physician as soon as possible (Figure 3):
- Waking up during the night due to shortness of breath and with the need to sit up in order to breathe, or needing to put on several pillows to sleep comfortably, without choking (Figure 3A).
- Weight gain of 3-5 kg in one week.
- Increased difficulty sleeping with dry cough.
- Decreased urination or getting up frequently at night to urinate. During the night, when lying down, the fluid in the legs and ankles accumulated during the day, returns to the bloodstream and the kidneys are responsible for eliminating them through urine.
- Dizziness or fainting on exertion.
- Palpitations (rapid and/or irregular heartbeat).
- More exhaustion than usual, with lack of appetite and swelling of the stomach, (Figure 3B).
- Swelling in the ankles (due to fluid retention), (Figure 3C).
How is heart failure diagnosed?
If you have any of the symptoms listed above, see your doctor promptly. He or she will measure your blood pressure and heart rate, your weight and height, explore your abdomen, listen to your heart and lungs, etc.
Of special interest in the clinical history will be the presence of cardiovascular risk factors (smoking, hypertension, diabetes, obesity…) and personal or family history of heart-related diseases.
The medical tests of most interest for the diagnosis of heart failure are (Figure 4):
- Chest X-ray: assesses the size of the heart and the amount of fluid in the lungs.
- Electrocardiogram: records the rhythm and electrical activity of the heart.
- Echocardiography: this is one of the most interesting tests. It allows to know the state of the heart muscle, the dimensions and functioning of the heart chambers, the heart valves, etc.
- Ergometry or stress test: allows to see the functional capacity in terms of physical capacity of the patient.
- Cardiac catheterization: cardiac catheterization is sometimes necessary to determine the state of the valves, the possible presence of coronary artery disease, etc., with a view to considering definitive treatment of the disease (spring implantation or assessment of the need for surgical intervention of the valves).