What should you know about worsening heart failure symptoms?

Heart failure can make it harder for the heart to move blood forward effectively. Fluid may then collect in the lungs or body tissues. People with heart failure can notice increasing breathlessness, a new cough when lying down, swollen ankles or legs, a heavier feeling around the abdomen, tiredness, or a drop in usual activity tolerance. Some people notice palpitations. A change can follow an infection, a heart-rhythm problem, missed medicines, extra salt or fluid, or another medical problem. The pattern and speed of change matter more than trying to identify the cause at home.

Follow the self-management plan agreed with your heart team. Take medicines as prescribed and do not change doses unless your plan or clinician tells you to. Contact your clinician or heart-failure service promptly if swelling, breathlessness, cough, fatigue, or palpitations are increasing. Note when symptoms occur, whether lying flat is harder than usual, and any change in daily weight if you have been asked to monitor it. Bring your medication list, home readings, and notes about recent illness to a chronic disease review.

Call emergency services for sudden or severe shortness of breath, chest pain or pressure, fainting, new confusion, blue or grey lips, or coughing up pink frothy fluid. Get urgent help if you cannot speak comfortably because of breathlessness or if you feel rapidly worse. Do not drive yourself. These warning signs need urgent assessment even when they have happened before, because treatment may be needed quickly to support breathing and manage fluid overload.

Ask what symptom changes should trigger a same-day call, whether your action plan needs updating, and how to manage medicines when you have vomiting or diarrhoea. Ask whether a new irregular heartbeat could be contributing and what monitoring is appropriate. Confirm who to contact outside routine clinic hours.