• Heart failure happens when the heart can't pump enough blood and oxygen to other organs.
  • Early, subtle symptoms of heart failure can be "harbingers" of "impending death," according to a report.
  • Symptoms include an upset stomach and insomnia, the American Heart Association said.

Heart failure can cause early, subtle symptoms that can be "harbingers" of the disease worsening and "impending death," according to a report from the American Heart Association (AHA).

The report published on Thursday in the medical journal Circulation outlines the most recent knowledge on the symptoms of heart failure, as well as other cardiovascular diseases including stroke.

Heart failure happens when the heart can't pump enough blood and oxygen to other organs, and can be fatal. Heart failure can't usually be cured, but early treatment can help people live longer and with a better quality of life, according to the Centers for Disease Control and Prevention. Treatment involves drugs, physical activity, and cutting down salt in the diet.

Around 6.2 million US adults have heart failure, according to the CDC. 

Smoking cigarettes, drinking excessive amounts of alcohol, insufficient physical activity, and a poor diet — that's too high in salt, fat, or cholesterol — all increase the risk of heart failure. Medical conditions, like heart disease, previous heart attacks, high blood pressure, obesity, and diabetes also increase the risk of getting it.

Heart failure most often causes breathlessness 

Breathlessness is a "hallmark" feature of heart failure, the report said. Severe breathing problems are linked with an increased risk of death, the AHA said.

The report said other health conditions that cause breathing problems, like chronic obstructive pulmonary disorder (COPD), can co-occur with heart failure.

Other common symptoms of heart failure include: generally feeling tired, and swollen feet, legs or ankles, according to the CDC.

The AHA report said fatigue was the most "bothersome" hallmark feature of heart failure. 

Early heart failure symptoms include nausea

Early symptoms of heart failure can include: an upset stomach, nausea, vomiting, and appetite loss, the report said. 

Muscle wasting as a consequence of heart failure can indicate that the disease is progressing to more advanced stages, it said.

The AHA said: "Early and subtle symptoms also can be harbingers of worsening HF and impending hospitalization or death."

Other heart failure symptoms include insomnia, depression, and anxiety

The review found 25% to 30% of adults with heart failure report mood disturbances — mostly depression and anxiety — as well as insomnia.

Heart failure causes insomnia for a number of reasons. Firstly, people with heart failure often get breathless when lying flat. Secondly, a side effect of heart failure drugs that off-load fluid that accumulates in the lungs, causing breathlessness, and lower extremities, causing swollen feet, can make people pee more during the night.

Women with heart failure are more likely to get an upset stomach 

The report said women with heart failure are more likely than men to report: nausea, heart palpitations, an upset stomach, sweating, swelling, pain, depression, anxiety, and a lower quality of life. 

Heart failure is diagnosed at a later age in women, and women can have more concurrent illnesses, which may partly explain these differences, the AHA said.

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