What should you know about chronic congestive heart failure?

Heart failure does not mean that the heart has stopped. It means pumping or filling is impaired, so pressure can build in the lungs or body tissues. This may cause breathlessness, cough, fatigue, reduced exercise tolerance or swollen ankles. Symptoms can fluctuate with fluid retention, infection, missed medicines, kidney changes or an irregular rhythm such as atrial fibrillation. Hypertension can strain the heart over time. A symptom such as fatigue or palpitations has several possible causes, so assessment is needed to understand its significance.

Take medicines as prescribed and do not stop them because you feel better without advice. Keep a record of breathlessness, swelling, weight changes if your clinician has asked for this, activity tolerance and palpitations. Follow the agreed plan for salt, fluids and activity rather than making major restrictions yourself. Avoid smoking and attend chronic disease reviews, where medicines, blood pressure, kidney function and symptoms can be reassessed. Ask what to do after a missed dose or during vomiting, diarrhoea or an infection.

Call emergency services for severe breathlessness at rest, blue lips, fainting, new confusion, severe chest pressure, or coughing up pink frothy material. Seek prompt medical advice for rapidly increasing swelling, a sudden drop in exercise ability, a new persistent fast or irregular heartbeat, or breathlessness that is worse than your agreed baseline. Early contact allows the care team to look for fluid build-up or a trigger.

What symptoms should trigger a same-day call? What is my target monitoring plan? How should I manage medicines during illness? Could my rhythm, blood pressure or kidney function be affecting symptoms?