4 major symptoms of heart failure - Could a certain sleeping position be a sign?

Heart disease is the third leading cause of death in Hong Kong. How can one detect heart problems early? A cardiologist has pointed out that there are 4 symptoms of heart failure that are easily overlooked, and one specific sleeping position may be a warning sign.

According to the Daily Mail, heart failure is an incurable chronic condition. However, if diagnosed and treated early in the course of the disease, the risk of death from severe complications can be reduced. Renowned British cardiologist Dr. Rosie Godeseth, in an interview, highlighted 4 major atypical warning signs of heart failure:

4 Easily Overlooked Warning Signs of Heart Failure

1. Inability to Sleep Flat on Your Back
   • Reason: Heart failure can lead to pulmonary edema (fluid in the lungs). This symptom causes shortness of breath when lying flat. If you find that you must prop yourself up with pillows to sleep, or if you wake up short of breath, it could be a warning sign of heart failure.
   • Advice: Seek medical attention as soon as possible. A doctor may recommend wearing a health monitor at night or undergoing cardiac testing.
2. Persistent Cough
   • Reason: Pulmonary edema can cause a persistent cough or wheezing.
   • Advice: If a cough lasts more than three weeks, especially if the mucus is pink-tinged or bloody, it is essential to see a doctor immediately.
3. Weakness, Fatigue, and Swelling in the Limbs
   • Reason: When the heart struggles to pump blood effectively, fluid can build up in the body, leading to swelling (edema), particularly in the legs, ankles, and feet.
4. Unexplained Weight Gain
   • Reason: Poor heart pumping efficiency reduces blood flow to the kidneys. In response, the body retains more fluid and sodium to compensate, leading to fluid accumulation in the legs, abdomen, and even lungs, which results in rapid weight gain.

Godeseth advises that adopting daily habits like regular exercise, a balanced diet, and avoiding smoking can help. Exercise alone can reduce the risk of cardiovascular disease by 35%. It's also crucial to regularly check indicators such as blood pressure, blood sugar, and cholesterol levels to help detect symptoms early. She emphasizes that 80% of heart disease and stroke cases are preventable.

What Is Heart Failure? Are Swollen Feet a Warning Sign?

According to information from the Hong Kong Hospital Authority, the heart can be seen as a pump in the body. Through regular contraction and relaxation, it sends blood throughout the body to provide the necessary nutrients and oxygen. When the heart's pumping function is impaired, leading to insufficient output, it is called heart failure.

Common symptoms of heart failure include:

• Frequent urination at night
• Swollen feet/ankles
• Shortness of breath
• Difficulty breathing
• Coughing

The Hospital Authority notes that in the early stages of heart failure, shortness of breath may only occur during physical exertion. As the condition worsens, this can happen when lying flat or after falling asleep. Patients may need to sit up or prop their heads up with pillows to relieve the symptom, and in severe cases, pulmonary edema may even occur.

3 Major Complications of Heart Failure

According to information from the Hong Kong Society of Heart Failure, insufficient blood supply due to heart failure can lead to various complications in different organs:

1. Decline in Lung Function:
   • Patients may develop "restrictive ventilatory impairment," meaning the lungs cannot expand to their necessary volume, leading to a gradual decline in lung function.
2. Decline in Liver Function:
   • Patients may develop congestive hepatopathy (liver dysfunction due to blood backing up). If left untreated for a long time, liver congestion may occur, potentially leading to cirrhosis.
3. Decline in Kidney Function:
   • Due to insufficient blood flow to the kidneys, they cannot efficiently remove waste products. Toxins in the body, such as blood urea nitrogen and creatinine, may consequently rise.

What Causes Heart Failure? Does High Blood Pressure Increase the Risk?

Regarding the causes of heart failure, the Hospital Authority states that most are related to cardiovascular issues, including:

• Coronary artery disease, high blood pressure
• Myocardial infarction, myocardial ischemia/hypoxia
• Heart valve diseases, congenital heart disease, and various types of myocarditis

The above conditions can damage heart muscle tissue, weakening its contraction and relaxation functions, or increase resistance during the heart's contraction or relaxation, impairing its pumping ability. Patients must strictly control the underlying causes (such as high blood pressure, coronary artery disease) to prevent the onset or worsening of heart failure.

While diabetes does not directly cause heart failure, prolonged high blood sugar levels increase the risk of cardiovascular complications like coronary artery disease and high blood pressure, and therefore should not be overlooked.