Feeling breathless in Heart Failure


If you are suffering with heart failure, feeling short of breath is one of the most common symptoms1. As the condition advances, the breathlessness can become more common even during routine activities like climbing a flight of stairs or taking a shower and even resting2. Lying flat can also suddenly bring on shortness of breath for many people, interrupting their sleep and sometimes leaving them feeling anxious and tired3.

As with most symptoms experienced by heart failure patients, feeling short of breath is because of the heart becoming less efficient at pumping blood around the body, over time. As the heart muscles weaken or stiffen, their ability to keep up with the supply of blood coming into and leaving the heart, lessens4.

This can cause blood to "back up" or accumulate in the tubes traveling from the lungs to the heart5. If this happens fluid can leak into and accumulate in the lungs5. Our lungs are complex organs that remove carbon dioxide and exchange it for oxygen, but they can’t do this easily when fluid builds up inside them. It is this that can leave you feeling short of breath5.

This is why heart failure patients may feel more breathless when lying down. When they do, the fluid spreads across the surface of the lungs (imagine liquid in a bottle when it is upright and how it spreads out when you lie it on its side)6.

What can you do about this breathlessness?

1. Listen to your body. If you only become breathless when exercising, then learn to recognise when the symptoms start. Make sure you talk to your Cardiologist about finding a level of activity that does not put too much strain on your heart too quickly7.

2. Talk to your Cardiologist about finding an activity or exercise that is right for you. While ‘movement exercises’ may be recommended more than ‘strength building’ exercises4, make sure you talk to your doctor before you take up a specific activity like walking, swimming or gentle cycling.

3. If you become breathless even during everyday tasks like climbing the stairs, talk to your Cardiologist about exercises that may help your breathing or lifestyle adjustments you can make. It may also be a good idea to seek help of your caregiver and family where required.

4. If you become breathless when resting, talk to your Cardiologist about how to manage this.

5. If you feel breathless when lying down, you may consider supporting yourself with several pillows so that you are lying in a more upright position7. Talk to your Cardiologist about it.



1: Heart Failure Matters. Warning Signs. Shortness of Breath. Available at: http://www.heartfailurematters.org/en_GB/Warning-signs/Shortness-of-breath

2: Bozkurt, B. and Mann, D.L. (2003) ‘Shortness of breath’, Cardiology Patient Page, 108(2), pp. 11–13. doi: 10.1161/01.CIR.0000075956.36340.78.

3: http://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure . Accessed on 7th November 2016.

4: Royal Berkshire Department of Cardiology. Heart Failure: Information for patients. Available here: http://www.royalberkshire.nhs.uk/Downloads/GPs/GP%20protocols%20and%20guidelines/Cardiology/Heart_Failure.pdf

5: Medline Plus. Pulmonary edema. Available here: https://medlineplus.gov/ency/article/000140.htm

6: Heart Failure Matters. Warning Signs. Awakening short of breath/ needing more pillows. Available at: http://www.heartfailurematters.org/en_GB/Warning-signs/Awakening-short-of-breath-needing-more-pillows

7: https://www.heartfailurematters.org/en_GB/What-can-you-do/Activity-and-exercise . Reference Last Accessed: 23rd April 2019


Recommended tags:

Congestive heart failure, cardiovascular disease, heart failure, heart disease, heart failure symptoms, heart failure treatment, heart failure diagnosis, heart failure cardiologist, heart failure & heart attack, breathless, exercise