One of the most common symptoms of heart disease is fatigue. Fatigue, in this case, means feeling very tired or even exhausted, even though you haven't been working too hard or missing sleep. In people living with heart disease, extreme tiredness commonly occurs alongside other symptoms like dyspnea (shortness of breath), heart palpitations (noticeable irregular or abnormal heartbeats), high blood pressure, chest discomfort, and angina (chest pain). “Always fighting fatigue,” wrote one MyHeartDiseaseTeam member. Another said, “Today is another day I battle with fatigue.”

Everyone feels exhausted from time to time. But fatigue goes beyond everyday tiredness, and often, it can have a significant impact on your ability to perform daily activities and quality of life. However, you and your health care provider or cardiology team can work together to find ways to manage this symptom. Here is what you need to know about fatigue in heart disease, including what causes it and how you can manage it.

How Do People With Heart Disease Experience Fatigue?

There are several types of heart disease, and they can cause different problems that affect the heart and blood vessels, like heart failure or coronary artery disease (CAD). One member of MyHeartDiseaseTeam described it as “feeling weak and low-energy.”

For some people, fatigue comes and goes, while for others, it’s inescapable. One member shared, “Sometimes I feel great, but I quickly become exhausted.”

Fatigue can make it hard to do simple things, like taking a walk or doing daily tasks. Another member said, “I want to take a walk but get worn out after half a block.”

Fatigue can also affect your overall quality of life. One person said, “I’m tired all the time and sleep more and more.” This constant tiredness can even affect your mood and make you feel down or depressed.

What Causes Fatigue in Heart Disease?

The causes of fatigue can differ depending on the type of heart disease. For example, people with heart failure experience fatigue when their heart can’t pump enough blood to meet the body’s demands. When that happens, the body chooses to pump blood to the most vital areas first, including the heart and brain. As a result, other areas — such as the limbs and muscles — receive less blood flow, leading to the feeling of fatigue.

Fatigue can be associated with muscle or kidney issues and lower cardiac (heart) function in people without diagnosed heart disease. On top of that, there is a complex relationship between fatigue, heart disease, and the endocrine (hormonal) system that is not fully understood.

Beta-Blockers

Beta-blockers are medications commonly taken by people living with heart disease. These drugs can contribute to fatigue and “beta-blocker fog” (difficulty thinking).

Because these medications help keep you healthy and treat your heart disease, it’s essential to work with your health care provider to determine if they’re related to your fatigue. Take your provider’s medical advice on how to combat this exhaustion while treating your condition.

Surgery

Many MyHeartDiseaseTeam members report extreme fatigue after heart surgery. One member wrote, “It’s been three months since my surgery. ... Everyone says I look great, and I am doing more and more, but it’s not enough, and I get tired easily.”

Another added, “I had bypass surgery 10 months ago. I am doing better every day. However, I am still very tired.”

“I don’t think you ever get back to how you were before,” wrote another member. “I just accept how I am now and make the most of it.”

It’s normal to experience fatigue after major surgery. But if you don’t feel like you’re recovering well, talk with your doctor. Ask what you can expect for recovery, such as how long it may take and when you should start to feel better. You and your health care provider can come up with a plan to help you work through postsurgery fatigue.

Is Fatigue a Sign of Heart Attack?

Fatigue can sometimes be a warning sign of a heart attack, especially in women, according to the medical journal Circulation. In some cases, people may experience unusual or extreme tiredness in the days, weeks, or months leading up to a heart attack. This type of fatigue often feels different from everyday tiredness — it may feel sudden, overwhelming, or persistent even after you rest.

Types of Heart Disease That Cause Fatigue

Fatigue is a common symptom across many types of heart disease, but some heart conditions cause fatigue due to the way they affect the heart's ability to pump blood. These include:

Heart Failure and Extreme Tiredness

One of the most common symptoms of heart failure is fatigue. When the heart can’t pump enough blood to meet the body’s needs, it redirects blood flow to vital organs like the brain and heart. This leaves other areas, like muscles, with reduced oxygen and energy, and this can cause extreme tiredness. People with congestive heart failure often find it difficult to perform simple activities like walking or climbing stairs without feeling fatigued.

Coronary Artery Disease

Coronary artery disease occurs when the arteries supplying blood to the heart become narrowed or blocked by a buildup of fats, cholesterol, and other substances. It’s another condition that can cause significant fatigue. CAD limits blood flow to the heart muscle, especially during physical activity, leading to a feeling of exhaustion.

Arrhythmias

Arrhythmias (irregular heart rhythms) can reduce the heart’s efficiency and blood circulation, which causes fatigue. When the heart beats too fast or irregularly, it may not be able to pump enough oxygen-rich blood to the body, leaving people feeling tired or weak.

Other Potential Causes of Fatigue

Fatigue in people with heart disease can also be caused by other medical conditions, including:

• Thyroid disorders
• Kidney disease
• Sleep apnea (a sleep disorder where breathing repeatedly starts and stops)
• Anemia (low levels of red blood cells)

If you’re experiencing fatigue, make sure to talk to your doctor. They will be able to evaluate you for other potential causes of fatigue and determine effective treatments for any conditions you might be living with in addition to heart disease.

Managing Fatigue Related to Heart Disease

A variety of strategies can help you manage fatigue related to heart disease.

Treat Your Heart Disease

When heart disease itself is causing fatigue, treating your condition may help alleviate the symptom. There are many treatments for heart disease, including medication, surgery, and lifestyle changes. Finding an effective treatment can help improve the overall health of your heart, allowing it to more effectively pump all the blood your body needs.

As one member explained, “I felt brand-new when I woke up from the operation and could do more than I had before, like walking and enjoying the world. You have a new lease on life because your heart has been fixed.”

Another wrote, “After a year, I felt well enough to climb and bike.”

Be More Active

Studies have shown that increasing your activity level is one of the best ways to improve your heart health, curb weight gain, and combat fatigue associated with heart disease. This may feel counterintuitive — fatigue often makes you want to move less, not more.

Members have shared their tips for getting more exercise with heart disease. “I force myself to do things,” one wrote.

Another recommended using a fitness tracker: “It helps you keep count of steps daily and monitors almost everything. I use it to force myself. I have it set to 5,000 steps a day as a must.”

If your doctor is concerned that strenuous activity might harm your heart, they may refer you to a physical therapist or cardiac rehabilitation program experienced in working with people who have heart disease. They can help you design an activity plan that will be safe and help you feel better. If you’re cleared for exercise, your physician may ask you to keep an eye on your heart rate.

Manage Mental Health Conditions

Depression is very common among people with heart conditions, especially during the few months after a heart attack, heart surgery, or hospitalization. It can occur for many reasons:

• A reaction to the diagnosis itself,
• A response to how fatigue or tiredness interferes with daily life
• An effect of beta-blockers

The relationship between higher fatigue and lower quality of life may be more common in women than it is in men, according to a study published in the journal Progress in Cardiovascular Nursing.

Treating depression — and the symptoms of stress, poor sleep, and inadequate relaxation that can come along with it — may help improve fatigue in some people who are living with heart disease.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. On MyHeartDiseaseTeam, more than 62,000 members come together to share stories with a community of people who understand life with heart disease.

Has heart disease given you fatigue that you can’t shake? Have any tips on boosting energy levels in a heart-healthy way? Share your experience in the comments below, or start a conversation by posting on your Activities page.