When to worry about shortness of breath with heart failure

Heart failure can cause breathlessness during activity, when lying flat, or when waking at night. Worsening symptoms may occur with fluid build-up and can accompany ankle swelling, a cough, unusual tiredness, or rapid weight change. Breathlessness may also have other causes, so a new pattern needs assessment rather than a self-diagnosis.

Sit upright and follow the self-management plan from your heart team. Take medicines exactly as prescribed and do not add or stop water tablets without advice. Record when symptoms occur and whether they happen at rest or lying down. Contact your clinician promptly if your usual symptoms are increasing or your treatment seems less effective.

Call emergency services for severe breathlessness, pink or frothy sputum, chest pain, fainting, confusion, blue or grey lips, or inability to speak comfortably. Seek same-day advice for new breathlessness at rest, needing more pillows, waking repeatedly gasping, or rapidly increasing swelling. Keep your medicine list ready for the assessment.

Ask which changes in breathing or swelling should prompt a call, how to follow your fluid and medicine plan, and whether you should track symptoms at home. Clarify who to contact outside clinic hours and when your next heart review is due.