What are symptoms of congestive heart failure that are visible before a diagnostic test?

Shortness of breath. Shortness of breath, initially with exercise, and in more severe cases even at rest. This may be worse when lying flat and may cause awakening with shortness of breath. Frequent nighttime awakening to pass urine may occur. Swelling of the ankles may develop, engorgement of veins in the neck may be seen. In very severe cases, there may even be swelling of the abdomen.