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According to data provided by the World Heart Federation, heart failure is one of the most common cardiovascular conditions and its risk increases steadily with age, affecting more than 64 million people worldwide.
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To gain a deeper understanding of this deadly condition and its subtle signs, such as swelling in the ankles, which may indicate a weakening of the heart, HT Lifestyle spoke to Dr. Pradeep Haranahalli, Consultant Interventional Cardiologist, Manipal Hospital, Whitefield, Bengaluru.
Early symptoms that are easy to miss
According to Dr. Pradeep, this cardiac condition is broadly classified into two categories: heart failure with preserved ejection fraction and heart failure with reduced ejection fraction. “Although these categories guide treatment, the symptoms experienced by patients are often similar. Recognizing these signs early is the key to effective management,” he emphasized.
According to Dr. Pradeep, one of the earliest and most common symptoms of heart failure is “decreased effort tolerance, a gradual decline in the ability to perform physical activity.”Many people dismiss it as a normal part of aging.
However, Dr. Pradeep said that in fact, it could be a subtle warning sign of underlying heart failure. “This is particularly relevant in older individuals with back or knee problems, who reduce activity due to pain and may never test their stamina. In such cases, heart failure may remain hidden until it is advanced,” he said.
fluid buildup and breathing problems
Next, Dr. Pradeep said that as physical activity decreases, weight gain can occur, often due to accumulation of fluid rather than fat. “This fluid accumulation can affect the intestines, leading to loss of appetite and early feeling of fullness after meals,” he stressed.
Swelling in the legs is another important sign, the cardiologist said. “Initially, it appears in the evening and disappears by morning. As heart failure progresses, the swelling persists throughout the day and should never be ignored,” he explains.
Additionally, fluid may also accumulate in the lungs, causing shortness of breath, cough and difficulty lying down. Dr. Pradeep elaborated, “Many patients require extra pillows at night or feel more comfortable sitting up. Some people wake up suddenly from sleep with severe shortness of breath and coughing, known as paroxysmal nocturnal dyspnea. These symptoms clearly indicate fluid in the lungs.”
Risk Factors, Test Leads and Advanced Signs
Other warning signs according to Dr. Pradeep include:
- shoes seem tight
- Abdominal distension
- facial flushing upon waking up
“Heart failure also triggers the secretion of natriuretic peptides, which can cause increased urination at night. Routine health checkups may provide clues, such as an enlarged heart in a chest X-ray or increased levels of creatinine and NT-proBNP in blood tests,” the cardiologist said.
Finally, the doctor said heart failure is more common in people with obesity, diabetes, high blood pressure, prior heart attacks or known heart disease.
Additionally, in advanced stages, patients may experience shortness of breath even at rest, making simple activities like bathing or walking around the room become tiresome. He cautioned, “These symptoms should never be attributed to aging alone. Heart failure can be largely controlled if recognized early, and timely medical care can significantly improve quality of life and outcomes.”
Note to readers: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor with any questions you may have about a medical condition.
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