Symptoms of heart failure in the elderly

Q: How long does heart failure last in elderly?

Much depends on the stage of your loved ones condition, and their overall health. While advancements have been made, according to a 2008 study, 50% of patients will have an average life expectancy of five years. For those with advanced heart failure, up to 90% will pass away within one year.

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The earliest symptoms of heart failure are often very subtle, but it's dangerous to ignore them.
FACES of heart failure
Further testing
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What is the most common early symptom of heart failure in geriatric patients?
What are worsening signs of heart failure?
How long does heart failure last in elderly?
What are the signs of end stage heart failure?

Heart Health

March 14, 2022

The earliest symptoms of heart failure are often very subtle, but it's dangerous to ignore them.

It's an unfortunate truth that your body slows down in your sixth and seventh decades. Climbing a flight of stairs that you once took two at a time can now feel as daunting as scaling Mount Everest. While some degree of vitality loss can be attributed to natural aging, fatigue and breathlessness may also be signals that your heart is not functioning as well as it should. "There is a general tendency for people to ignore heart failure symptoms and attribute them to just getting older. Therefore, it was very important for us to create an easy way to identify those symptoms," says Dr. Mandeep R. Mehra, medical director of the Heart and Vascular Center at Harvard-affiliated Brigham and Women's Hospital.

FACES of heart failure

Heart failure occurs when something damages the heart muscle or reduces the heart's ability to pump effectively. Most often, the damage stems from coronary artery disease or heart attack. But faulty heart valves, longstanding high blood pressure, or genetic disease may also be to blame. No matter what the cause, the failing heart can no longer pump well enough to keep up with the body's demand for oxygen-rich blood.

To help both doctors and patients quickly spot a possible combination of heart failure symptoms, the Heart Failure Society of America (www.HFSA.org) developed a handy tool that goes by the acronym FACES.

F = Fatigue. When the heart can't pump enough oxygen-rich blood to meet the body's energy needs, a general feeling of tiredness or fatigue sets in.

A = Activity limitation. People with heart failure are often unable to do their normal activities because they become easily tired and short of breath.

C = Congestion. Fluid buildup in the lungs can result in coughing, wheezing, and breathing difficulty.

E = Edema or ankle swelling. When the heart doesn't have enough pumping power to force used blood back up from the lower extremities, fluid can collect in the ankles, legs, thighs, and abdomen. Excess fluid can also cause rapid weight gain.

S = Shortness of breath. Fluid in the lungs makes it more difficult for carbon dioxide in used blood to be exchanged for fresh oxygen. It may also be harder to breathe when lying down because gravity allows fluid from below the lungs to travel up the torso.

By themselves, these five warning signs do not confirm a diagnosis of heart failure, but they do convey a sense of urgency to seek medical advice, says Dr. Mehra.

Further testing

In addition to the physical exam, doctors have two other important tools to spot the presence of heart failure. The first is an echocardiogram (often called an echo), which is a simple, noninvasive test that uses ultrasound to create images of your heart while it beats. If the echo shows a lower-than-normal percentage of blood leaving the heart when the left ventricle contracts, there is a strong possibility of heart muscle damage. Other findings that point to heart failure include abnormal thickening and ballooning of the heart wall and malfunctioning heart valves.

The next step in identifying early-onset heart failure is to look for biomarkers in the blood, such as B-type natriuretic peptide, which is released when the heart is under stress. "I call these compounds 'tears from the heart' because they show that the heart is crying for help," says Dr. Mehra. Once the initial diagnosis is confirmed, further testing may be needed to figure out what's causing the heart's dysfunction and determine the best treatment approach.

Drugs to avoid when you have heart failure

People with heart failure often take multiple medications. However, several commonly used prescription drugs, over-the-counter medicines, and supplements can interact dangerously to intensify heart failure symptoms. To be on the safe side, make sure all of your medical providers have a complete list of all the medicines you take. Particular compounds to watch out for include these:

Nonsteroidal anti-inflammatory drugs (NSAIDs). This class of widely used painkillers, which includes ibuprofen (Advil, Motrin), can worsen heart failure symptoms by causing the body to retain sodium and fluid.
Heartburn medicines and cold remedies. These over-the-counter aids often contain high amounts of sodium, which can trigger fluid overload.
Herbal remedies. Many so-called natural supplements contain substances such as ephedra, St. John's wort, ginseng, hawthorn, black cohosh, and green tea. All can react badly with several common heart medications.

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What is the most common early symptom of heart failure in geriatric patients?

Dyspnea or fatigue on exertion, with or without some degree of lower extremity swelling, is generally the most common early symptom of heart failure (Cases 1 – 3).

What are worsening signs of heart failure?

Signs of Worsening Heart Failure.

Shortness of breath..

Feeling dizzy or lightheaded..

Weight gain of three or more pounds in one day..

Weight gain of five pounds in one week..

Unusual swelling in the legs, feet, hands, or abdomen..

A persistent cough or chest congestion (the cough may be dry or hacking).

How long does heart failure last in elderly?

Much depends on the stage of your loved one's condition, and their overall health. While advancements have been made, according to a 2008 study, 50% of patients will have an average life expectancy of five years. For those with advanced heart failure, up to 90% will pass away within one year.

What are the signs of end stage heart failure?

Patients in the end stages of heart failure want to know what to expect. The symptoms of end-stage congestive heart failure include dyspnea, chronic cough or wheezing, edema, nausea or lack of appetite, a high heart rate, and confusion or impaired thinking.