Recognize the

Woman with heart failure - recognize the symptoms

All heart failure patients require support from healthcare professionals and family as they are likely to experience dyspnea and anxiety.1 However, women with heart failure are more symptomatic, have more evidence of volume overload, have lower health-related quality of life and greater impairment in their daily activities.2


  • More likely to have an ischemic etiology, history of MI and stroke.3
  • High prevalence of (systemic) hypertension.4
  • More likely to have a history of major comorbidities such as atrial fibrillation (AF), previous MI and stroke.3
  • Higher lifetime risk for systolic dysfunction – HFrEF.5
an illustration of a man and a woman


  • More likely to experience swollen ankles, peripheral edema and rales, as signs of congestion.3
  • Higher prevalence of (pulmonary artery) hypertension.2-5
  • More likely to have HFpEF which is associated with higher exercise intolerance.6
  • More likely to be older when diagnosed (after menopause).3-5,6

Symptoms of Heart Failure in Women

symptoms of heart failure misdiagnosis

Sadness, depression & anxiety


Coughing when lying down


Fatigue and shortness of breath


Abdominal bloating, discomfort & weight gain


Edema, swollen legs, ankles and feet


In addition to the differences in diagnosis and symptoms, women also suffer from more physical and social restrictions due to lack of energy and higher impact of HF on women’s psychological attitude.6  This continues after diagnosis. After 1-year follow-ups, women with HF have lower vitality and physical function than men.6  Fifty percent of women get the wrong treatment.7

Women survive 11% less than men after a heart failure diagnosis.8

graphic showing a line of people with a less than sign

What’s Next: Heart Failure Management Options


  1. Strömberg A, Mårtensson J; Gender differences in patients with heart failure; European Journal of Cardiovascular Nursing; Apr 2003; 2 (1): 7–18. doi:10.1016/S1474-5151(03)00002-1. PMID 14622644. S2CID 41171172.
  2. Mary Norine Walsh, Mariell Jessup, JoAnn Lindenfeld (2019) Women With Heart Failure: Unheard, Untreated, and Unstudied, Journal Of The American College Of Cardiology, vol 73, n°1, p. 41-43,
  3. Pooja Dewan, Rasmus Rørth, Pardeep S. Jhund, Li Shen, Valeria Raparelli, Mark C. Petrie, William T. Abraham, Akshay S. Desai, Kenneth Dickstein, Lars Køber, Ulrik M. Mogensen, Milton Packer, Jean L. Rouleau, Scott D. Solomon, Karl Swedberg, Michael R. Zile, John J.V. McMurray (2019) Differential Impact of Heart Failure With Reduced Ejection Fraction on Men and Women, Journal Of The American College Of Cardiology, vol 73, n°1, p. 29-40,
  4. Carolyn S.P. Lam , Clare Arnott, Anna L. Beale, Chanchal Chandramouli, Denise Hilfiker-Kleiner, David M. Kaye, Bonnie Ky, Bernadet T. Santema, Karen Sliwa, Adriaan A. Voors (2019) Sex differences in heart failure. European Heart Journal (2019); 40, 3859–3868. doi:10.1093/eurheartj/ehz835.
  5. Ersilia M. DeFilippis , Anna Beale, Trejeeve Martyn, Anubha Agarwal , Uri Elkayam , Carolyn S.P. Lam , Eileen Hsich (2022) Heart Failure Subtypes and Cardiomyopathies in Women Circulation Research. 2022;130:436–454. DOI: 10.1161/CIRCRESAHA.121.319900
  6. 2022 - J. Cardiovasc. Dev. Dis. - Scicchitano - Sex Differences in the Evaluation of Congestion Markers in Patients with Acute Heart Failure
  8. Taylor et al.; National trends in heart failure mortality in men and women. United Kingdom, 2000-2017. Eur J Heart Failure. doi:10.1002/ejhf.1996.

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