The Early Stages of Heart Failure Can Be Surprisingly Easy to Miss

• Getting short of breath when exercising
• Having problems performing any kind of physical activity
• Experiencing swelling, also called edema, especially in their lower legs

Some people with vaginas may also have symptoms that seem like an upper respiratory infection, such as wheezing, coughing, or being short of breath—so you may think these are symptoms of something like bronchitis when they’re actually heart failure symptoms. That’s why it’s important to reach out to a doctor if you find yourself out of breath frequently when doing things like walking up the stairs or on a short stroll to the mailbox.

Heart failure is a known cause of illness and death in people assigned female at birth.¹ It’s true that most people with vaginas tend to develop heart failure at an older age than people with penises, but even if you’re on the younger side there are risks.¹ The biggest one is experiencing heart failure symptoms that you don’t recognize as such. If you don’t take steps to treat it, the heart failure can worsen and potentially cause things like heart valve problems and kidney damage, or become fatal if left ignored.

Mental health is another aspect that you’ll want to address. People with vaginas and heart failure are more likely to experience higher rates of depression than people with penises and heart failure. They also typically report worse quality of life, according to an article in the journal Clinical Cardiology.³

What are heart failure treatments by stage?

Now for the good news: You can definitely make changes to both prevent heart failure and to keep it from progressing to advanced stages. The power is (at least partially) in your hands.

“The habits you develop now will affect your heart 10, 20, or 30 years down the road,” Dr. Shufelt says. “Such habits include getting regular exercise, eating a Mediterranean-style diet, not smoking, and not being around people who smoke.”

Your doctor will consider your heart failure stage or your personal risks—like having diabetes or smoking—to make treatment recommendations. If you know you’re in a certain stage, talk to your doctor about making the changes that make the most sense for you.

It’s important to note that treatment guidelines are based on the ACC/AHA stages, as the NYHA system does not provide this information.⁴

Stage A

Here’s where you’ve really got to take a look at the lifestyle factors that could hurt your heart. According to Penn Medicine, this means:

• Stop smoking if you smoke.
• Engage in regular exercise—ideally 150 minutes per week.
• Stop illegal drug use if you use drugs.
• Stop drinking or limit your alcohol intake to no more than two drinks a day for people with penises or one drink a day for people with vaginas.
• Seek treatments for high blood pressure or high cholesterol.
• Take stock of other lifestyle behaviors and try to eat a balanced diet, get restful sleep, and manage everyday stress.

Stage B

When you’re in stage B, your heart is affected. That’s why doctors will usually prescribe medicines to help protect your heart. These include angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). Both of these medicine types help to relax veins and arteries, which is important because it helps get blood to all the various parts of your body. Think of it like this: You can move more water through a wider straw than a narrower one, and that’s exactly what these meds do for your blood.

Stage C

If you reach stage C, your activity is likely limited by your heart failure symptoms, per Penn Medicine. You’ll usually get short of breath, cough, and may even have some swelling that keeps you from moving well. Your doctor may suggest the following treatment options: