What should you know about active heart failure?

Breathlessness, swollen ankles, unusual fatigue, reduced exercise capacity, a persistent cough and difficulty lying flat can develop when blood flow is inadequate or fluid accumulates.

Heart failure can occur when the heart muscle is weak, stiff or affected by a valve or rhythm problem. Pressure then builds behind the heart, encouraging fluid to collect in the lungs, legs or abdomen, while muscles and organs may receive less blood during activity.

A worsening episode can be triggered by infection, an abnormal heart rhythm, uncontrolled blood pressure, missed medicine, excess salt or fluid, kidney problems, or progression of the underlying heart condition. Clinicians use an examination, blood tests, an ECG and heart imaging to identify the pattern and trigger.

Contact your heart-failure team or GP promptly if breathlessness, swelling, cough or fatigue is increasing, or if ordinary activities become harder. If your care plan includes regular weight and blood pressure checks, record the readings alongside symptoms and medicine doses.

Take prescribed medicines as directed and do not double a missed dose or adjust a water tablet without agreed instructions. Limit salt and fluid only to the targets your clinician has set, since the appropriate amount depends on kidney function, medicines and the type of heart failure.

Call emergency services for severe breathlessness at rest, gasping, blue or grey lips, collapse, confusion, new chest pressure, or a very fast or irregular heartbeat accompanied by faintness. Sit upright while waiting if that makes breathing easier, and do not drive yourself.

Arrange same-day medical advice for rapidly increasing ankle or abdominal swelling, breathlessness that now wakes you or prevents lying flat, much less urine, or dizziness that makes standing unsafe. These changes can indicate fluid build-up, low blood pressure or worsening kidney function.

Ask which type of heart failure you have, what may have triggered the current symptoms, and whether any medicine needs monitoring with kidney or electrolyte blood tests. Request clear personal thresholds for calling the clinic, guidance on activity and fluid intake, and a written plan for missed doses or worsening swelling.