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End-Stage Left Heart Failure Symptoms

author image Christy Brogan
Christy Brogan is a nurse specializing in the fields of oncology, hospice and home care who has written educational materials for patients and students locally. She has been a clinical instructor teaching both patients and nursing students about health care issues. She graduated from Grand View College in 2005 with her Bachelor of Science in nursing.
End-Stage Left Heart Failure Symptoms
Senior man talking to a nurse holding his chest Photo Credit: Jovanmandic/iStock/Getty Images

The Centers for Disease Control and Prevention report that 670,000 people are diagnosed with heart failure each year. Left-sided heart failure occurs when the left side of the heart becomes unable to pump blood effectively to the rest of the body. As a result, blood flow backs up into the lungs and other organs, and several symptoms occur. Symptoms typically worsen as heart failure worsens, and eventually multiple organs fail.

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Shortness of Breath

According to the University of California San Fransisco, shortness of breath occurs as fluid backs up into the lungs because the heart cannot pump blood efficiently. Patients with left-sided heart failure find it hard to catch their breath. Shortness of breath often worsens at night, typically requiring patients to sleep upright or propped up by several pillows. Eventually left-sided heart failure causes shortness of breath even at rest. End-stage heart failure patients become dependent on oxygen and walk only short distances because of severe shortness of breath.


"Medical Surgical Nursing" reports that a dry, hacking cough is an early sign of left-sided heart failure. Cough occurs as a result of fluid buildup in the lungs, because the heart cannot pump blood fast enough. The fluid then backs up into the lungs and pools in the bases of the lungs. In end-stage heart failure, the cough becomes productive and patients cough up white, frothy secretions. Secretions sometimes contain blood and may be tinged pink.


Patients with heart failure regularly experience fatigue related to the heart's inability to pump enough blood to meet the body's requirements. The body automatically reserves blood for the vital organs, and as a result, arms and legs become weak. End-stage left-sided heart failure patients find it hard to do normal activities, including walking, getting dressed, or doing household work. End-stage heart failure patients become so fatigued that they sleep longer and require frequent breaks from any kind of activity.

Chest Discomfort

Left-sided heart failure often causes the to beat irregularly. As a result, chest discomfort is a common complaint with heart failure. According to "Medical Surgical Nursing," palpitations and skipped heartbeats cause a fluttering feeling in the chest. Chest pain or pressure also commonly occurs.


Because of left-sided heart failure, the brain receives less oxygenated blood, which causes confusion and altered thinking. The University of California San Francisco states that the buildup of certain substances in the blood also causes confusion in heart failure patients. In end-stage left-sided heart failure, sodium and potassium commonly build up to cause the confusion. Memory loss also accompanies decreased blood flow to the brain.

Poor Circulation

When the heart cannot adequately supply the whole body with blood, the body reserves blood flow for vital organs. This redistribution often leads to poor circulation in the arms and legs. Symptoms of poor circulation include cold hands and feet, bluish discoloration, and weak pulses. Poor circulation also causes end-stage heart failure patients to appear pale or have a grayish tint to their skin.


Eventually left-sided heart failure causes right-sided heart failure. Patients that reach end-stage heart failure are prone to swelling in the hands, feet and abdomen because the right side of the heart cannot push blood out fast enough. Much like the process of fluid backing up in the lungs, fluid backs up into the extremities. End-stage heart failure patients often experience rapid weight gain from the backup of fluid.

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