Symptoms of systolic heart failure

Reduced squeezing can leave the body with less effective blood flow during activity. Pressure may also build behind the heart, allowing fluid to move into the lungs or tissues. Breathlessness may appear with walking, when lying flat or during sleep; ankle swelling and a rapid change in exercise tolerance can reflect fluid retention. Fatigue may result from reduced circulation, poor sleep or the effort of breathing.

Palpitations can occur when the heartbeat feels forceful, fast or uneven, but they have many possible causes. A cough may relate to fluid in the lungs or another respiratory problem. Symptoms alone cannot confirm heart failure, so an assessment is needed.

Note when symptoms occur, what activity brings them on, whether you need extra pillows, and whether swelling is changing. A clinician may check your heart and lungs, blood pressure, rhythm and oxygen level, then arrange an ECG, blood tests or an echocardiogram if appropriate.

Follow the treatment plan and take medicines at the prescribed times. Mention new medicines, missed doses, fever or a change in salt and fluid intake. Keep planned reviews so the team can compare your symptoms with examination and test findings.

Seek emergency help for severe breathlessness, chest pain or pressure, fainting, sudden confusion, collapse or blue-grey lips. Ask for prompt clinical advice if breathlessness is worsening, you develop a new persistent cough, swelling is increasing, or palpitations continue with dizziness or weakness.

Ask whether your symptoms suggest fluid retention, a rhythm problem or another condition; which tests are planned; and how to recognise a meaningful change. Clarify who to contact outside office hours and what to do if a dose is missed.