Congestive heart failure (CHF) occurs when the heart is unable to properly pump needed blood throughout the body. The tissues and organs of the body will have unmet metabolic needs and fluid begins to pool in various areas, including the feet, ankles and lungs. Heart failure is staged according to its severity. One classification is the New York Heart Association Heart Failure Symptom Classification System. According to this classification, people with end-stage congestive heart failure are in Stage IV. This indicates that they are short of breath with the slightest effort or even while resting. A different classification system has been created by the American College of Cardiology and the American Heart Association. According to this classification, end stage patients are at Stage D, meaning that they have noticeable symptoms during rest even with the best medical care.
Severe Fatigue
According to the guidelines found in the "ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults," severe fatigue is one of the predominant symptoms of end stage congestive heart failure. The patient may communicate less and seem to lose interest in anything beyond his basic needs. This fatigue must be dealt with by planning activities to incorporate scheduled rest periods.
Difficulty Breathing
Breathing difficulties are a part of daily life for those with end stage heart failure. This occurs even at rest, but worsens with activity or lying flat. It may also worsen with emotional upset. Many patients develop anxiety as a result of difficulty breathing. This symptom is managed with medication, sodium-intake reduction and lying with the head elevated.
Body Wasting
Wasting of the body is often noted in patients with CHF. This syndrome is evidenced by loss of muscle, fat and bone. The body becomes weak and weight is lost, despite the overload of fluid in the body. This symptom, combined with severe fatigue, leaves many patients requiring help to manage their daily care. To reduce the effect of this symptom, the patient should follow a healthy diet and physician recommendations for light exercise.
Severe Swelling
According to Mayo Clinic, patients with heart failure experience swelling in their feet, ankles and legs. This becomes severe for those in the end stage. The feet may become quite painful as fluid expands the lower extremities beyond normal size. To alleviate this symptom, the feet should be kept elevated whenever possible, sodium intake reduced and medications taken as prescribed.
Loss of Appetite
Fluid in the abdominal area can lead to nausea and loss of appetite. This symptom can be managed through the introduction of small, appetizing meals.
Irregular Heartbeat
End stage congestive heart failure is usually marked by abnormalities in heart rhythm. The heart may race or seem to change rhythm from time to time. This symptom is managed by medication.
