Sudden heart failure: what to know

Heart failure means the heart cannot meet the body's circulation needs as effectively as it should. A sudden deterioration may cause fluid to build in the lungs or tissues, making breathing difficult and reducing exercise tolerance. It can happen in someone already diagnosed with heart failure or appear with a new heart problem.

Warning patterns can include breathlessness while resting or lying flat, a cough with frothy sputum, rapid swelling of the ankles, unusual fatigue, a racing or irregular heartbeat, or sudden confusion. Atrial fibrillation and hypertension can place extra strain on the heart, but symptoms alone cannot establish the cause.

Sit upright, loosen tight clothing, keep prescribed emergency medicines nearby, and call emergency services if breathing is severely difficult, symptoms are rapidly worsening, or you have chest pain or faintness. Do not drive yourself. Keep a list of medicines and recent changes available for the medical team.

If symptoms are milder but new, contact your clinician promptly for examination and a treatment review. Do not change diuretics or other heart medicines without advice. A chronic disease review can help organise monitoring and medication decisions after the immediate problem is addressed.

Call emergency services for severe breathlessness, blue or grey lips, chest pain, fainting, confusion, inability to speak in full sentences, a new irregular heartbeat with weakness, or coughing up pink or frothy fluid. Urgent review is also needed when swelling, fatigue, cough, or breathlessness suddenly becomes worse than your usual pattern.

Ask what change in breathing, weight, swelling, or heartbeat should trigger emergency help; whether your medicines, kidney function, blood pressure, or heart rhythm need review; and how to monitor symptoms at home. Ask when a chronic disease review should follow the acute assessment.