Red Flag Signs for Congestive Heart Failure

Congestive heart failure occurs when the heart fails to efficiently pump a sufficient amount of blood to the body's organs and tissues. As fluid pools in areas such as the lungs, they become congested. Also called CHF, congestive heart failure can come on suddenly or develop gradually. Untreated, CHF can be fatal. There are several red flag signs for congestive heart failure.

Close-up of an elderly woman's ankles which are swollen. Credit: Ocskaymark/iStock/Getty Images

Difficulty Breathing

As heart failure begins, the sufferer may experience difficulty breathing upon exertion. As it worsens, he may become unable to catch his breath even at rest. This is often more noticeable at night, requiring him to sleep upright in a chair or with his head elevated on multiple pillows. An audible wheeze may be present and he may feel as though he cannot take a full, deep breath. This may cause him to breathe rapidly. He may feel anxious and be unable to sleep well due to the breathing difficulty.

Increased Heart Rate

The heart rate may climb over 100 beats per minute, explains the text "Medical-Surgical Nursing." This gives the sufferer the sensation that the heart is racing. The heartbeat may feel strong or weak while the pulse at the wrist feels weak. She may feel dizzy and appear pale. Her hands and feet may be cool or cold to the touch.

Weight Gain

As fluid accumulates in the body, a person with congestive heart failure may gain weight despite eating the same amount of food or less food than usual. A weight gain of 3 lbs. or greater in a day or 5 lbs. or greater in a week is a red flag, according to the Society for Chest Pain Centers.


The ankles and feet may become swollen, making the wearing of shoes uncomfortable. If the ankle is pressed in a fleshy area, the pressed spot may remain indented--a sign called pitting edema. The hands and fingers may swell, causing rings to feel tight. The abdominal girth may increase, causing the sufferer to feel bloated. This, along with decreased blood flow to the stomach, can lead to a loss of appetite. Someone who spends a lot of time lying down may have swelling in the his lower back and buttocks area.

Low Urinary Output

The CHF sufferer may have little or no urinary output during waking hours. She may urinate more readily after lying down or the output may remain extremely low. Urine may appear deep yellow and smell concentrated.


According to the American Heart Association, continual tiredness is a warning sign of heart failure. The sufferer may notice that he cannot perform his usual daily tasks due to fatigue. His arms and legs may feel heavy and he may need to take frequent rest periods. Taking a shower and changing clothes may be impossible or take a long time.

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