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What are the signs and symptoms of heart failure? We talked about you can either have a problem with relaxation or you can have problem with pumping. But the net effect is the same like you mentioned, is you get congestion in the lungs and the body. Lets go through this. Youll be restless. Obviously, you have lot of fluid buildup, so youre going to be anxious. You might have some confusion. Why is that? Because your heart if its not pumping adequately might not get good blood flow to the brain. Orthopnea basically means that at night youll be sleeping with extra pillows at night. You cant lie flat because when you lie flat, you get more congestion in the heart. A lot of our patients say they cant sleep flat at night. They need to use pillows or sleep in a chair. Exertional dyspnea, when they walk, they get shortness of breath with limited distances. Fatigue could be a sign that the heart is very weak. As a result of congestion in the lungs, theyll have a cough. Usually, its a