RELATED: If You Notice This While Resting Your Feet, Get Your Heart Checked. Congestive heart failure (CHF) occurs when the heart muscle becomes weak or stiff, and can no longer pump blood as well as it should. If this occurs, fluid can build up in the lungs, causing shortness of breath and a range of other symptoms. “Congestive heart failure is a disease that reduces the heart’s ability to pump blood around the body,” explains Medical News Today. “This impairment causes blood to build up in the chest. The fluid may then seep down into the abdomen, causing stomach swelling.” Heart failure may be behind your abdominal swelling if you also notice any of the following additional symptoms: persistent coughing or wheezing, shortness of breath, increased or irregular heart rate, fatigue, nausea, lack of appetite, new confusion, swelling in the legs or ankles, or impaired thinking. RELATED: Not Doing This Before Bed Could Be Hurting Your Heart, Experts Warn. In the event of heart failure, the heart’s pumping chambers can fail to fill properly between heartbeats. “The ventricles may stretch to the point that the heart can’t pump enough blood through the body. Over time, the heart can no longer keep up with the typical demands placed on it to pump blood to the rest of the body,” explains the Mayo Clinic. If your doctor suspects that this is happening to you, they can test how well your heart is pumping by measuring the “ejection fraction”—the amount of blood pumped out with each beat. Healthy hearts will have an ejection fraction of 50 percent or more, “meaning that more than half of the blood that fills the ventricle is pumped out with each beat,” the Mayo Clinic says. Most often, your doctor will determine the ejection fraction with the help of an echocardiogram, a non-invasive imaging test. Alternative methods include cardiac catheterization, MRI scans, CT scans, and nuclear medicine scans. RELATED: For more health news sent directly to your inbox, sign up for our daily newsletter. While it’s important to rule out heart failure from the list of possible underlying causes, there may be another explanation for your distended or swollen stomach. Experts say there are five common culprits, and your doctor can help you narrow down the possibilities by identifying which is most likely. “Healthcare providers diagnose a distended abdomen in terms of the “five ‘f’s,” explains the Cleveland Clinic. These are “flatus (gas), fetus (pregnancy), feces (trapped poop), fluid (from several causes), or fat,” their experts write.ae0fcc31ae342fd3a1346ebb1f342fcb Abdominal swelling caused by a buildup of fluid—as in the case of congestive heart failure—is known as ascites. Besides heart failure, this could also be caused by a range of other serious conditions including cancer, cirrhosis of the liver, infection, dialysis, low protein levels, and certain lung conditions, says Johns Hopkins Medicine. However, most cases of swelling in the abdomen are considered gastrointestinal in nature. Irritable bowel syndrome, lactose intolerance, certain forms of gastritis, intestinal blockage, gallstones, and more could all be to blame for this particular symptom, says Medical News Today. Persistent abdominal swelling can signal a serious condition, and it’s important to call your doctor if you don’t know what’s behind it. If your symptoms get worse, or are accompanied by severe abdominal pain, fever, vomiting, or bleeding, don’t hesitate to get it checked out. The Mayo Clinic says to call 911 if you believe you have signs of heart failure, including “fainting or severe weakness, rapid or irregular heartbeat associated with shortness of breath, chest pain or fainting, sudden severe shortness of breath, and coughing up white or pink foamy mucus.” They add that while heart failure can cause these symptoms, “There are many other possible causes, including other life-threatening heart and lung conditions. Don’t try to diagnose yourself.” Instead, talk to your doctor about your concerns and whether a full medical evaluation is necessary. RELATED: The 3 Signs Your Chest Pain Isn’t a Heart Attack, Experts Say