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Heart failure

Symptoms of heart failure: feeling breathless, tired and lifeless

Heart failure has many symptoms - breathlessness, low levels of energy, congestion in the chest, swollen feet and ankles, bouts of dizziness and fainting, nausea, persistent coughing, feeling bloated, being unable to sleep and palpitations (see also 'Symptoms of heart failure: oedema, palpitations and wakefulness'). Many of these symptoms occur in other illnesses and so should not necessarily be linked to heart failure. People with heart failure may experience one or more of these symptoms and most can be relieved with the appropriate medication.

Breathlessness (or dyspnoea) has been called a 'hallmark' of heart failure and is probably its most common symptom. For some people being short of breath occurred when they tried to do too much in a day, took too much exercise (e.g. walking, hill climbing, gardening, line-dancing and fishing) or tried to lift things. Avoiding certain activities and taking things slowly worked well for some people and medication was also a help. (See also 'Home life and everyday routines'). Those with more severe heart failure could experience breathlessness when they were lying down and resting and one man said that this had worried him and made him go and see his doctor.
 

He becomes aware of his heart beat and gets breathless if he lifts things.

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Age at interview: 75
Sex: Male
Age at diagnosis: 65
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Shortness of breath, you know, wanting to do things more or less like out of the ordinary, such as gardening, you know. Out of my ordinary scope, of course, I can't, because shortness of breath steps in and you can feel your heart sometimes, you know? You can feel it's there, it starts to... you can feel the beat. And when I start to feel the beat then I know it's time to slow down. If I'm making an effort, such as lifting anything, you know, lifting anything I find I've got to quickly get rid of that load, that weight, because it starts the shortness of breath. And you feel as though there's something there in your chest. And all these sort of things happen but, you begin to live with it, and you automatically, you know, stop or slow down whatever you're doing. And that's how' There's a continual thing there to remind you, you know, there's this little' you just can't explain what it is but it tells you that you're not A1, there's something there. 

 

He can feel breathless if he tries to do something too quickly.

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Age at interview: 64
Sex: Male
Age at diagnosis: 63
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Well when you feel breathless its like... walking up hill, and when I feel you know walking up, or running up and downstairs we'll say, and I feel breathless, I don't run up and down stairs but if that's what it feels like I've run up and down stairs you know, up and down a few times you now puffing hard you know. You know you're gasping for air a bit more. But it's a lot better now that I'm on the medication, I don't get so much breathlessness, only if I approach a bank or I do something rather quicker than I should have done like go upstairs faster than I should, then I might feel a little bit breathless you know. But other than that it hasn't affected me too badly now. It did initially before I had the medication I felt I was, I was puffing walking on level ground you know I was out of breath then so that's how it felt. 
 
 

He noticed he was breathless at night and went to see his doctor.

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Age at interview: 74
Sex: Male
Age at diagnosis: 73
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Nobody told me that, well I was told that every time I had a heart attack the muscles in my heart died a little or were damaged, and that they wouldn't recover at that time and up to the present time there is no recovery, although they're working on it!  And...the consultant, no not the consultant, the surgeon that actually did the thing said that he didn't think he would get rid of my breathlessness completely with this but it should do me. It should prevent any more heart attacks coming and should look after me for... I think approximately 10 years. And that was that. I had a triple bypass and I had a nurse come and take out the stitches and see me here, and then she went ill and I never saw anybody again for about 7' years.  

When I started getting very alarmingly puffy, and especially alarming was getting breathless lying down in bed and I thought well this is not right, this is something wrong. And... it was then I went down to the local doctor and it was an emergency appointment so it was a lady doctor, who was very good, and she decided to send me for a scan in the [name of Hospital] the hospital. And there was an Irish lady doctor there, who had a good look at everything and said there hadn't been any great deterioration in my heart, but it might be a good thing to see the consultant. 
 

Several people described breathlessness in the lead up to getting treatment and diagnosis for heart failure. One woman described how her breathlessness got worse in a short space of time and that she had thought at first she had a chest infection. Others who had had heart failure for several years said sometimes they felt very short of breath as well as tired and that this combination of feelings could be triggered by everyday things such as tearing up bread to feed the birds or having a shower.

 

She thought her breathlessness was a chest infection at first.

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Age at interview: 55
Sex: Female
Age at diagnosis: 53
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Well it felt as if I had a chest infection so I had gone to the doctor, but they couldn't hear anything on my chest at all so I was told to go away and see if it got better, really, come back if it didn't. And so it didn't really get better so I went back again but they couldn't hear anything again on my chest at all. I was getting puffed out walking to the car from the supermarket, I was getting puffed out walking up the stairs but not too much at that time. So still couldn't hear anything on my chest so I thought oh well, it's bound to go away. Then one night I started getting really out of breath and sort of gasping for breath and it got worse really. Eventually it went away again, but I went to the doctor's, and it was another doctor I saw and they gave me an ECG, and they found through taking my pulse, that there was a slight irregularity there. So they had something to go on with the ECG if it happened again, if anything happened and they told me to come back in 2 days. I think they were thinking about giving me some tablets but also at the time they thought it might be something to do with stress because I suppose it really sounded a bit like a panic attack. The way that I was describing that I was breathing and then it went away. 

Anyway I didn't get to the 2 days; the next night I started breathing really heavily, I couldn't get my breath at all and I sat down and I tried to breathe easily and I thought well if this a panic attack then I need to keep calm. So I tried to keep calm and I tried to breathe easily and I couldn't. And my husband came in and he didn't think that I should wait any longer and he actually called Q-Doc. 

 

 

Having a shower can make him feel as though he's run a marathon.

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Age at interview: 49
Sex: Male
Age at diagnosis: 44
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I find it's only when I'm exerting myself. If I go for a shower I've got to sit down for an hour after it. I've actually got a shower chair in the shower room to sit in the chair and dry myself because I can't stand after I've had a shower, it's very very tiring..

Can you describe the tired, it's not tired like I'd feel tired is it?

No it's like exhaustion. You'd run a marathon and that's how you feel after, well I feel like that just getting a shower. You'll feel dizzy, sometimes nauseated, basically just really really breathless, and you can feel your heart pumping as well. You can feel it thumping you know, it's weird, it's a weird feeling so it is. It's basically tiredness like when I say running a marathon, well I have that with a shower which is a big big difference.
 

Feelings of weariness, fatigue or tiredness made many people want to slow down or stop what they were doing and rest. Being very tired led some into what they called a 'bad day' when they felt listless and tired on and off all day (see 'Bad days, anxiety and depression'). Others described weariness in relation to losing physical strength, for example noticing they had less strength in their arms and found it difficult to lift or carry as much as before. Energetic gardening was something people often said they missed (see 'Sports, hobbies and activities').

 

Tiredness makes her feel everything is an effort.

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Age at interview: 63
Sex: Female
Age at diagnosis: 61
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It's not a 'tired' tired where you want to go to bed and sleep, it's a weary tired as if everything is an effort. It's a tired where you don't want to go to bed and sleep, you just want to... I don't know... it's like a weary tired, that's the only way I can describe it really. I can't say it's a 'go to sleep' tired. I don't really know, it's just an 'I must sit down' tired, 'I just can't take another step' tired.

And when you do sit down when you feel like that, how long does it take before you feel better again?

Oh I only need a few minutes. It just depends what you're doing, I think. If I'm just in the room, in the kitchen doing something and I come and sit down, just 5 or 10 minutes and then I'm up again. I don't want to sit, especially if I've got something to do, I don't want to sit. I want to get up and do it and then I want to sit.
 

Some described a general loss of interest in things that they had previously been passionate about. One man who had always loved cars and caravanning had not connected his lack of interest in them with heart failure and said he felt much better once his drugs were altered.

 

He lost interest in his hobbies for a time but felt better once his medication was changed.

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Age at interview: 82
Sex: Male
Age at diagnosis: 81
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Well actually it happened last October. I just began to feel that I had something wrong with me, I didn't know what obviously. Very weary, strange for me, I wasn't sleeping very well. Normally I go to bed and you know I'm lucky if I wake up myself in the morning but I just wasn't sleeping at all well. And it just proceeded to get worse and worse and worse. 

I called in the doctor and I'm afraid I didn't, there's something I find very strange, I didn't appreciate that I had heart problems. He didn't seem to spell it out to me although maybe I should have known that I was taking remedies for. My main trouble is that my heart is not pumping fast enough and even, well just a few weeks ago, when I had my iron done at the hospital before they started the operation they checked all those things, and they said, 'Oh it's very low'. And they went so far as to phone up the surgery here to see what they said about it. And then again, about the same time we had our annual health check and the nurse, she commented so I'm a wee bit worried that my heart is still, you know I might want to go a bit faster! But the difference in me now to 6 months ago is just fantastic. Well I lost interest in everything. Normally I'm mad about cars, motor sport, caravans. I've got books come in every month and I just stopped reading them. You know, it sounds strange, although I didn't realise it was happening very much, did I? [looks at wife] .
 
For more information on heart failure see the British Heart Foundations website. It has a number of useful publications which explain heart failure in more detail.

 

Last reviewed April 2016.
Last updated April 2016.

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