What should you know about decompensated heart failure?

When the heart cannot keep up with the body's demands, fluid may build up in the lungs or tissues and circulation may become less effective. Existing [Heart Failure](/conditions/heart-failure/) can worsen after an infection, a heart rhythm problem such as [Atrial Fibrillation](/conditions/atrial-fibrillation/), uncontrolled [Hypertension](/conditions/hypertension/), missed medicines, or changes in fluid and salt intake. Sometimes no clear trigger is found.

Possible changes include increasing breathlessness, a new or worsening [Cough](/symptoms/cough/), reduced ability to lie flat, marked tiredness, rapid weight change from fluid, or [Swollen Ankles](/symptoms/swollen-ankles/). These signs need clinical context rather than self-diagnosis.

Contact your heart-failure team or an urgent medical service promptly if your symptoms are worsening. Keep taking prescribed medicines unless a clinician tells you otherwise, and do not increase, stop, or share medicines on your own. Bring your medicine list and note when the change began, breathlessness, swelling, cough, palpitations, and any recent illness.

Sit upright if breathing is uncomfortable while arranging help. Follow the fluid, salt, and daily monitoring plan already given to you; do not make major changes without advice. A [Chronic Disease Review](/treatments/consultations-and-assessment/chronic-disease-review/) can help review control and treatment after the acute problem is addressed.

Call emergency services for severe breathlessness at rest, inability to speak in full sentences, blue or grey lips, fainting, new confusion, chest pressure, or rapidly worsening symptoms. Do not drive yourself if you are severely unwell. Prompt action matters because fluid and circulation problems can progress quickly.

Ask what may have triggered the deterioration, which symptoms should prompt emergency help, and how to adjust your monitoring plan. Confirm the purpose and timing of each medicine and when your next review should occur.