The symptoms of congestive heart failure are variable and depend upon the condition of the individual, the organ system affected due to the heart’s disability.

• Fatigue is one of the earliest symptoms of congestive heart failure. It is a non specific feature and can signify a number of other conditions.
• Swelling (oedema) of the ankles and legs or abdomen: Congestive heart failure leads to fluid overload in the body. This is actually due to failure of the right heart. Right heart failure may be due to a long standing left heart failure or severe lung diseases (such as cor pulmonale). Less commonly intrinsic disease of the right heart can also cause this.
• An increase in body weight is one of the earliest signs of fluid accumulation
• Shortness of breath: Fluid accumulation in the lung lead to shortness of breath when the patient lies flat. Sometimes they awaken at night, gasping for air. (Orthopnoea and Paroxysmal Nocturnal Dyspnoea respectively)
• Some patients can’t sleep unless sitting upright.
• Increased urination: especially at night
• When the intestines or liver get affected, features like nausea, abdominal pain, and decreased appetite walk in.