Are You Experiencing Heart Failure?

If you’ve been feeling unusually tired, short of breath, or noticed swelling in your legs or feet, it could be more than just stress or aging—it might be a sign of heart failure. This condition affects millions of people but often goes unrecognized in its early stages. 

In this article, experienced heart failure nurse practitioner Cheryl Rogers, NP-C, CHFN, of Riverside Healthcare shares expert insights into the symptoms, causes, and when to seek medical attention. Whether you’ve been recently diagnosed or are just starting to wonder if your symptoms might be heart-related, this robust discussion offers clear, compassionate advice to help you take the next steps toward better heart health.

What Causes Heart Failure?

Heart failure can develop from a variety of factors, and it's increasingly affecting younger individuals. The condition is generally linked to declining cardiovascular health, which can result from issues like uncontrolled high blood pressure, obesity, sleep apnea, poor diet, and unmanaged stress.

“Any combination of those things can line up to be very hard on your heart and cause issues. There are two different types of heart failure, actually, but several different causations,” explains Rogers. “So, when a person comes in with a new diagnosis of heart failure, we dive into those elements comprehensively to say, ‘What brought you here? What were the things happening to you? What were your symptoms prior to being diagnosed?’ Oftentimes, the diagnosis comes after hospitalization because all these factors can mimic other considerations on the list.”

While genetic conditions can predispose some younger individuals to heart failure—especially when identified through family diagnoses—these cases are relatively rare. More commonly, conditions like diabetes play a major role in damaging heart function. Uncontrolled diabetes can lead to silent heart attacks, as it may dull pain signals, making symptoms less noticeable. 

When combined with other comorbidities such as sleep apnea, high cholesterol, and cardiovascular disease, the risk of significant heart damage increases substantially. Early detection and management of these conditions are key to preventing serious outcomes.

Why Heart Failure Sometimes Presents with Asthma-Like Symptoms

Shortness of breath is a common symptom that can signal different conditions—most notably asthma or heart failure—but their causes are quite different. Asthma is typically due to airway inflammation or muscle spasms that restrict airflow, often managed with inhalers or nebulizers. In contrast, heart failure results from poor heart pump function, leading to fluid buildup, especially in the lungs, which restricts breathing and can mimic asthma symptoms. 

While asthma is often managed by primary care providers, persistent or worsening symptoms—especially if inhalers aren't helping—may indicate heart failure. Additional symptoms like coughing and wheezing can also overlap, but wheezing in heart failure is due to fluid, not airway obstruction. Proper diagnosis and communication with healthcare providers are essential to ensure the right treatment.

How Is Heart Failure Diagnosed?

A BNP (brain natriuretic peptide) test is a blood test that measures an enzyme released by the heart when it's under stress or strain from poor blood flow. An elevated BNP level indicates that the heart may be struggling, prompting further evaluation. 

Depending on the results, patients may undergo a stress test, echocardiogram, or other diagnostics to assess heart function. Once the type of heart failure is identified, treatment can be tailored to help support and strengthen the heart.

“I'm a big proponent of keeping in touch with your primary care person to look at all the avenues. ‘Have we done all the tests I need? Do you know why I might still be short of breath?’ Every good primary care person knows a good family history. Primary care is very good at their assessment of looking further into one’s concerns,” assures Rogers.

Small Lifestyle Shifts Can Make a Significant Difference

In the case that patients hear their heart is "failing," fear often takes over—they immediately think of transplants or even death. But, per Rogers, the focus is on helping patients understand what heart function impairment really means and identifying the factors that contributed to it. Small, manageable lifestyle changes can make a big difference. 

While medications are important, addressing high blood pressure and stress, and ensuring a healthy diet and exercise is in play, are all key elements of treatment. Many patients feel overwhelmed, but with the right support and guidance, positive change is possible.

“I try to take them on the journey to look at different things in different ways. Not being a hundred percent perfect in everything, but let's look at some ways we can make small changes,” shares Rogers. “It is amazing to me, and that's why I love what I do. Making relationships with people and helping them on that path to recognize, ‘Wow, all I did right now was these two or three pieces and I can't believe how different I feel.’”

For more information on heart care at riverside visit riversidehealthcare.org/heart and click here to view upcoming dates of the Riverside Heart Failure Support Group.