According to the online medical library Merck Manuals, heart failure is a condition in which the heart does not pump a sufficient amount of blood to meet the body's nutrition and oxygen needs. Merck Manuals also reports that heart failure ultimately develops in one out of every 100 people in the United States. The American College of Cardiology (ACC) and the American Heart Association (AHA) have developed a classification system to define the severity of heart failure from stage A through D, with D being the stage that is most severe.
Lung Symptoms
People with Stage D heart failure have all the signs and symptoms of people with Stage C (Stage A and B heart failure have no associated symptoms), but the symptoms of Stage D are more persistent and severe. Trouble breathing is one Stage C symptom that becomes more persistent and severe in Stage D. The breathing problems are due to the buildup of fluid in the lungs. This buildup is "congestion," which is the reason for the name "congestive heart failure." The ACC and AHA report that people with Stage D heart failure may have persistent and severe coughing, and may cough up phlegm that is foamy and pink; the pink color is due to blood that is retained in the lungs. People with Stage D heart failure have problems with breathing even when at rest and despite receiving medical care. In very advanced heart failure, according to Merck Manuals, patients may develop Cheyne-Stokes respiratory syndrome, which is characterized by periodic quick and deep breathing, followed by a slow rate of breathing, then a halt to breathing completely for many seconds. Cheyne-Stokes develops due to a reduction in blood flow and oxygen to the parts of the brain that control breathing. The Mayo Clinic also lists severe breathing problems as symptoms of severe heart failure, and advises people experiencing these symptoms (or the symptoms below) to seek immediate medical attention.
Activity Level
People with Stage D heart failure have considerable difficulties maintaining a normal level of activity. Because the muscles are not receiving enough blood, for example, they become weak and tire easily. Activity is also inhibited because of problems with the lungs.
Fluid Retention
Because the heart does not pump blood properly and at an adequate rate, fluid buildup extends beyond the lungs and into other sites in the body. According to Merck Manuals, fluid can accumulate in ankles, the feet, the liver or the abdomen. If the fluid accumulates in the abdomen, there can be a reduction in appetite and the person may even feel nauseous.
Heart Symptoms
The ACC and AHA also list symptoms of Stage D congestive heart failure that involve the heart directly. These symptoms include a rapid or irregular heart beat. The person may also feel as if his heart is pounding in his chest. If heart failure has progressed to the point that the heart stops, a person would feel intense chest pain.
