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The heart is one of the most vital organs within the body. From about three weeks following conception (when you are still only a bunch of cells inside your mother's womb) until death, the heart tirelessly beats onwards. In fact, according to Sherwood's Human Physiology, the heart beats about three billion times within the normal human lifespan. This muscular pump delivers nutrients and oxygen to all the cells within the body and retrieves waste products and carbon dioxide for disposal. Thus, it seems rather obvious that in the case of heart failure, the whole body will be affected and the patient will experience systemic signs and symptoms. So what exactly are the symptoms of heart failure?

Unlike common misconceptions, heart failure (also referred to as cardiac failure) is not pathologic condition in which the heart stops working as in "fails". Instead, it is a functional conception where the heart is not pumping adequate amounts of blood to satisfy the body's needs. As a result of this, the patient's cardiac output (i.e. the amount of blood pumped by the heart per minute) will fall, causing a fall in blood pressure as well. The underlying cause of the heart failure will determine the form of heart failure that the patient has and subsequently, the clinical signs and symptoms that the patient presents with. But in simple terms, most of the signs and symptoms can be divided according to whether the patient has left-sided heart failure or right-sided heart failure.

In the case of left-sided heart failure, the left ventricle is the one that fails to pump enough blood. The left ventricle is responsible for receiving freshly oxygenated blood from the lungs via the pulmonary veins and delivering the oxygen and nutrients to all the major organs in the body via the systemic arteries. Thus, as you can imagine, when the left ventricle fails to pump all the blood it receives out to the systemic vascular beds, there would be a build-up of blood in the pulmonary veins in the lungs. This fluid accumulation increases the hydrostatic pressure within the bloodstream, causing fluid to leak into the interstitial space (pulmonary congestion) and consequently flooding the lung alveoli (pulmonary edema). A normally dry, sterile environment, the lungs are unable to efficiently perform gas exchange in the presence of fluid. Thus, the patient is likely to have shortness of breath (dyspnea) during light exertion and in severe cases, even at rest. This can be heard by the doctor with

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