FACES of Heart Failure

Written by Dr. Veena Madhankumar and medically reviewed by iCliniq medical review team

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Contrary to what most people think, heart failure does not mean that your heart has completely stopped working. What it means is that your heart is working less efficiently than it normally would. This reduced efficiency of your heart to pump blood results in the blood moving slower from your heart to the other parts of the body. As the heart cannot pump enough blood to meet the body’s requirements, its oxygen and nutrient needs are also not met. This increased pressure on the heart to pump blood makes the walls of the heart chambers weak. As your kidneys do not get enough blood to function, they respond by retaining fluid and salt, which results in fluid build-up in the ankles, legs, arms, lungs, and other organs.

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The common causes of damage to the heart muscle are coronary artery disease, heart attack, defective heart valves, chronic hypertension, inflammation of the heart muscle (myocarditis), diabetes, viral infection, obesity, tobacco use, or genetic conditions. No matter the cause, the warning signs of heart failure will remain the same, and early diagnosis is the key to manage this condition. For this, the Heart Failure Society of America developed an acronym called FACES, which stands for –

F –> Fatigue

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Fatigue, or lack of energy or motivation, occurs when your heart is unable to pump sufficient oxygen-rich blood to your major organs and muscles. This makes you tired, and your legs start to feel weak. Even though fatigue is a common symptom associated with various other mental and physical conditions, make sure you rule out cardiac conditions if you feel tired most of the time and have a heart disease history.

A –> Activity Limitation

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Heart failure patients are often unable to perform their normal day-to-day activities, as they get tired easily. As the heart muscle does not pump with enough force, the heart beats faster, resulting in irregular heartbeat and shortness of breath. Such patients also experience dizziness, confusion, fainting, and difficulty concentrating. All these symptoms interfere with everyday activities.

C –> Congestion

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Pulmonary edema (collection of fluid in the lungs) is often seen in heart failure. With the reduced heart’s efficiency to pump, blood can back up in the veins that carry blood through the lungs. The pressure in these blood vessels increases, pushing fluid into the air spaces (alveoli) of the lungs and causing lung congestion. This build-up of fluid in the lungs can result in wheezing, coughing, and difficulty in breathing.

E –> Edema

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As blood reaching the heart from the lower extremities slows down, blood in these veins backs up. This forces the fluid out of the blood vessels to the surrounding tissues. Also, the kidneys get affected by less blood supply, and they retain more water and salt, again resulting in edema. Edema can cause swelling of the ankles, legs, feet, and abdomen. This can also result in sudden weight gain.

S –> Shortness of Breath

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Heart failure patients have trouble breathing even when they rest or lie flat in bed. This difficulty in breathing occurs due to congestion (fluid build-up in lungs) or when the body is not getting enough oxygen-rich blood. You have to consult a doctor right away if you wake up at night to catch your breath. Lying down makes it harder to breathe as gravity allows fluid from below the lungs to travel up.

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Content published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek information from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.


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