Heart failure occurs when the heart is unable to pump blood normally throughout the body. This occurs for several reasons, including high blood pressure, narrowing or blockages in the blood vessels of the heart, problems with the heart valves, or infection of the heart. Heart failure continues to progress, and in end-stage heart failure medications and other treatments become ineffective. Heart failure is staged on a four-point scale and stage four is considered end-stage heart failure.
Shortness of Breath
A hallmark sign of end-stage heart failure is shortness of breath. This occurs because of the back-up of blood into the lungs. According to the Cleveland Clinic, patients with end-stage heart failure become short of breath even while resting. Shortness of breath increases at night and is called paroxysmal nocturnal dyspnea. In end stages of heart failure, patients become dependent on oxygen and may have to sleep sitting up or on several pillows at night.
Swelling
Due to the back-up of blood, edema or swelling occurs, typically in the feet. The Cleveland Clinic states that swelling results with right-sided heart failure. Swelling can also occur in arms, abdomen, and other parts of the body such as the buttocks when a person sits for long periods of time. Medications given to rid the body of swelling are called diuretics. However, eventually in end-stage heart failure diuretics become ineffective at fluid reduction.
Fatigue and Activity Intolerance
Cedars-Sinai Medical Center lists fatigue as a symptom of heart failure. Because the heart is overloaded and cannot meet the body's demands for blood, the body often fatigues easily. Poor metabolism of food for energy and shortness of breath combine to make daily activities such as walking difficult. End-stage heart failure patients sleep more often and need frequent rest.
Weight Changes
According to the Cleveland Clinic, patients may suffer from a condition of significant weight loss called cachexia. This occurs due to the body's inability to metabolize food properly. Significant weight loss occurs both due to loss of appetite and poor metabolism. Due to the back-up of fluids in the body, weight gain is also possible in end-stage heart failure. It is not uncommon for heart failure patients to gain several pounds in a matter of days. Daily weight taking becomes important to manage fluid overload and prevent cachexia from malnutrition.
Other Symptoms
Several other symptoms occur in end-stage heart failure though they vary among individuals. The Cedars-Sinai Medical Center lists dizziness, cough, confusion, increased urination at night, wheezing, and rapid breathing as symptoms of heart failure. Enlargement of the heart, liver and lungs is also possible.
