Feet swelling and heart failure: what to know

When the heart cannot move blood around the body effectively, pressure can rise in the veins. Fluid may then move into nearby tissues, often causing swelling around the feet and ankles. It may be worse after standing and improve after sleep. Heart failure may also present with breathlessness, reduced exercise tolerance, fatigue, a cough, or rapid weight change from retained fluid. Other causes include vein problems, medicines, kidney disease, and a clot, so an examination matters.

If you have known heart failure, follow your agreed fluid, salt, and medicine plan. Do not stop prescribed treatment or double a dose because your feet look more swollen. Raise your legs when resting, record changes in swelling and breathing, and weigh yourself only as your care team has advised. Arrange a review if your usual shoes become tight, you are waking breathless, or activity feels harder than usual. A chronic disease review can help check symptoms, medicines, blood pressure, and kidney function.

Call emergency services for severe or sudden breathlessness, chest pain, fainting, blue or grey lips, confusion, or inability to speak comfortably because of breathing difficulty. Seek urgent assessment for a rapidly increasing swelling, new one-sided painful swelling, or breathlessness that is worsening at rest. Palpitations with dizziness or fainting also need prompt care. Do not wait for a routine appointment when these symptoms appear.

Could this swelling be fluid retention or another condition? What changes in breathing or weight should trigger a call? Should my medicines, salt intake, or fluid plan be reviewed, and what should I do if I miss a dose?