A woman thought her 40-pound weight gain was due to aging, but it was fluid buildup causing heart failure

• Tannie Coward thought her weight gain and acid reflux were unfortunate realities of aging.
• She really had congestive heart failure, including nearly 40 pounds of fluid weakening her heart.

Tannie Coward was in her early 50s when she started gaining unexplained weight.

The court service officer in Houston enjoyed an active lifestyle that included three kids, a side hustle running a wedding planning company, and frequent rounds of golf. And yet, over the course of a few years, her petite frame tacked on nearly 40 pounds and her acid reflux flared.

Coward told Insider she and doctors thought it was an unfortunate reality of aging, but her symptoms escalated. She became increasingly out of breath on the golf course, and had to prop herself up on more and more pillows in bed to prevent the reflux.

Then, one night, she woke up gasping for air. "I was literally choking in my sleep," she said. She called her then-fiance, now husband, to take her to urgent care. After one look at her X-rays, clinicians told the couple to go to a major hospital — stat.

There, she was diagnosed with congestive heart failure, when fluid buildup around the heart strains its ability to pump properly. Coward said she was told her heart was only functioning at 12%.

"It was like someone punched me in the gut," she said. While her dad died of a heart attack at age 45, he smoked and drank. Her brother has congestive heart failure, but he's overweight, she said.

"I'm the person who walks two to three miles a day, and plays one to two rounds of golf a week. Are you sure you're talking about me?" she said she thought.

Now Coward is advocating through the Hear Your Heart initiative, which aims to empower women with heart failure, especially Black and Latina women, to prioritize their heart health.

"The diagnosis isn't the end of your story," she said. "For me, it's a wake-up call. It means I need to get moving and take better care of my body. I want to encourage other women to go out and get that support.

'I don't want any other woman to go through this by herself'

Coward said she and doctors didn't worry too much about her weight gain before the diagnosis since it was evenly distributed on her body and made her about a size 12 — still smaller than the average American woman.

Coward even celebrated some aspects of her fuller figure. "My legs are super super skinny, but at the top of the diagnosis, I had nice, pretty fluffy legs," she said. "I was so excited because I thought, 'I look nice in this golf outfit.'"

But once doctors discovered the cause, they gave her water pills to drain nearly 40 pounds of fluid from her body. "I literally sat on the toilet for 2 days," she said. With the fluid gone, her acid reflux subsided.

For her longer-term care, Coward was put on a medication regimen to support her heart, given an external defibrillator vest for a year in case of sudden cardiac arrest, and had a pacemaker implanted to control her heartbeat.

Because her condition put her at higher risk of complications from infectious diseases, Coward also retired from her job, which required close contact with people who'd just left prison or jail. She shut down her wedding planning company to further minimize stress.

"When I was first diagnosed, I was a basket case. I didn't cry a little bit, I was boo-hoo crying," Coward, now 60, said. "I was thinking, 'This is my life?'" with no job and wearing the vest. "I was really depressed, but no one saw the depression."

Now, advocating for women's heart health gives her purpose. "When I was diagnosed, I didn't see support groups or anything for women who look like me: African-American women," she said. "I don't want any other woman to go through this by herself."

Heart failure can be hard to diagnosis

"Heart failure" is a general term to describe the gradual decline of the heart's ability to pump and circulate blood, according to Harvard Health. "Congestive heart failure" refers to the stage in which fluid buildup inhibits the heart's job.

Heart failure is the leading cause of hospitalization, and a top cause of death, for women over 65. According to the Hear Your Heart campaign, which is run by the pharmaceutical companies Boehringer Ingelheim and Eli Lilly, clinicians are less likely to follow proper protocols when treating heart failure in women compared to men. Black and Latina heart failure patients are especially vulnerable to subpar care.

Heart failure often occurs as a result of other conditions that weaken the heart, like coronary artery disease (or a buildup of fatty deposits in the arteries), high blood pressure, or a heart abnormality you're born with.

The symptoms, like fatigue and shortness of breath, can be mild and progress slowly, making it easy to mistake for other conditions.

The condition is incurable, but can be managed with medications, a low-sodium diet, and exercise. Good communication with a doctor you trust is critical.

"I wasn't advocating for myself at all," Coward said of pre-diagnosis self. Now, she keeps track of her symptoms day-to-day, and asks doctors to reserve five minutes at the end of each appointment for her to ask questions. "They're the experts in their field," she tells other women, "but they're not the experts in your body."