If you or a member of your family is among the 5 million Americans who
suffer from heart failure, you may already know how important it is to take all
prescribed medication. (This is not always easy because it can mean taking 15
to 20 drugs and working with multiple health-care professionals).
You already know the importance of cutting back on salt, staying physically
active, not smoking, and if weight is an issue, losing the extra
The symptoms of heart failure can be related to the pooling of fluid in the body or can be secondary to decreased blood flow to the body. Some people with heart failure don't experience symptoms, but here are some of the more common signs:
Shortness of breath with exercise or difficulty breathing at rest or when lying down
Swollen legs, ankles, or abdomen
Dry, hacking cough, or wheezing
Other symptoms may include:
Fatigue, palpitations, or pain during normal activities
But even if you or your family member is a model patient, you still need to
watch for new or recurrent signs and symptoms of heart failure. And you need to
alert the doctor at once if trouble seems to be brewing.
"Heart failure is a progressive condition," says Gregg C. Fonarow, MD,
professor of medicine at UCLA David Geffen School of Medicine and director of
the Ahmanson-UCLA Cardiomyopathy Center in Los Angeles. "Patients may be stable
for weeks or months or years and then have a worsening of symptoms. It can be
very subtle. That's why there's a need for close follow-up."
Here are eight signs to watch out for. Call your doctor if you or a family
member with heart failure experiences any of them.
Even in the absence of specific symptoms you can point to, experts say it's
prudent to alert the doctor if you or a family member with heart failure begins
to feel ill at ease.
"Heart failure is very heterogeneous, and it's different for each patient,"
says Clyde W. Yancy, MD, medical director of the Baylor Heart and Vascular
Institute at Baylor University Medical Center in Dallas and president of the
American Heart Association.
"You know what heart failure felt like before. If something isn't feeling
right to you now, don't wait to see if it will pass. Call someone."
2. Unusual Fatigue
Feeling unusually tired or listless -- during exercise or while going about
daily activities -- might be evidence that you or your family member's
condition has taken a turn for the worse. "If you had been able to walk two
blocks without becoming winded but now find you can now walk only one block,
that can be worrisome," says Fonarow.
"You don't get a medal for bravery" for putting up with fatigue, Yancy adds.
"Pick up the phone and call the doctor."
3. Shortness of Breath
Breathing trouble is a leading cause of hospitalization for people affected
by heart failure. The problem arises when a reduction in the heart's pumping
efficiency causes fluid to accumulate in the lungs. This is called pulmonary
Severe breathing trouble is a medical emergency, of course. It warrants an
urgent call to 911. But even mild "air hunger" should be reported to the
doctor, especially if it occurs at rest or with minimal exertion.
In certain cases, people with heart failure have trouble sleeping because
they find it hard to breathe when lying down (a condition known as orthopnea).
"Some patients can sleep only if they prop themselves up with a pillow or two,"
says Yancy. "If you see that you are going to three pillows, that should prompt
a call to your doctor in the morning."