Acute Heart Failure Symptoms, Causes, and Treatments

People with acute heart failure may find it difficult to breathe effectively and they may feel short of breath – this can come on over a few hours to days in acute heart failure. It’s often worse when lying flat and can feel uncomfortable or like you’re suffocating. You may also experience a cough with pink frothy sputum or a wheeze, as fluid builds up in the lungs.

Fluid can build up in the ankles and legs, and this can also affect the lower back if someone is bedbound or sitting for long periods, the abdomen and the scrotum in men.

A combination of the above symptoms and the increased work of the heart will cause people with acute heart failure to feel very fatigued and tired. As people may have other chronic diseases which can come with their own symptoms, it can make identifying heart failure quite difficult. 

Heart failure can occur as a result of a number of conditions, mainly ones affecting the heart such as a previous heart attack, or irregularities of the heartbeat such as atrial fibrillation; infections of the heart and coronary artery disease may also contribute.

You may have a problem with one of the valves in your heart – if this is leaking, blood can't effectively build up in one chamber of the heart to be pushed to the next and then around the body, or one of your coronary arteries could be blocked, therefore the supply of blood to the heart is restricted. You may have been diagnosed with chronic heart failure, which is a long term condition that requires medication and frequent reviews to manage it, but symptoms can sometimes suddenly worsen, causing acute-on-chronic heart failure.

Conditions in other organs can put a strain on the heart, such as a blood clot in the lungs, stroke, diabetes and severe kidney disease.

It’s mostly a condition affecting older people, although those born with heart problems – congenital heart disease – may develop heart failure earlier in life.

If you are having difficulty breathing, leg swelling, a wet cough and any reason to suspect you are at risk of acute heart failure, you should seek urgent medical attention – this can be an emergency GP appointment or attending the Emergency Department. The doctor will take a medical history from you and examine your chest and lungs. Blood tests are done immediately to look for any other reason for your symptoms.

One particular blood test may take longer to come back, and this can identify whether there is evidence of heart failure. The doctor will organise tests such as an ECG – to show the electrical activity of your heart, a chest X-ray and an echocardiogram – an ultrasound scan of the heart – to look at the heart structure and how well it’s pumping.