3. Difficulty Breathing When Lying Flat (Orthopnea)
Orthopnea is another common sign of heart failure. It refers to difficulty breathing when lying flat. People with this condition often need to stack two or three pillows behind their back or even sleep sitting in a chair. When lying flat, fluid from the lower body shifts toward the chest and lungs, worsening congestion and making it harder to breathe.
Patients may not even realize it at first. They may just say, “I cannot sleep flat anymore,” or “I feel suffocated when I lie down.” This symptom is very characteristic of heart failure.
Take the case of Mr. Khan, a 65-year-old retired driver. He noticed that whenever he lay flat on his bed, he felt like he was drowning. To sleep, he began propping up pillows. When he finally saw a doctor, he was told he had orthopnea due to heart failure. With diuretics (water pills) and fluid restriction, his symptoms improved, and he was able to sleep more comfortably.
Orthopnea is more than just discomfort — it signals fluid overload and poor heart function. It is important for patients and families to mention this to doctors, as it helps in both diagnosis and treatment monitoring.