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Heart Failure: 8 Signs Your Treatment Is Not Working

4. Weight Gain

Putting on pounds may be evidence that the body is retaining fluids. This suggests a decline in the heart's pumping action. Gaining 3 or more pounds in a single day or 5 or more pounds in a week means it's time to alert the doctor.

Since weight gain is such a reliable indicator of potential trouble, doctors urge heart failure patients to weigh themselves every day. Use the same scale at the same time each day, while wearing little or no clothing.

For example, you or your family member might hop on the scale first thing in the morning. Keep a written record of these daily weigh-ins. This can help the doctor assess any problems.

5. Swelling in Different Parts of Your Body

In addition to weight gain and shortness of breath, fluid retention can cause swelling in the lower extremities. This can be apparent when shoes feel tight or socks leave indentations in your ankles. But swelling can also affect other parts of the body.

"Most people know to look for swelling in the ankles," Yancy says. "But edema can also affect the thighs, buttocks, hands, and even the scrotum or vulva."

People who develop fluid retention in the abdomen (a condition known as ascites) may experience nausea or a loss of appetite or feel uncomfortably bloated. Or they may simply notice that clothes that used to fit now feel tight. In any case, the doctor should be alerted.

6. Palpitations

Heart rhythm disturbances known as arrhythmias are more common among people with heart failure. Some arrhythmias are benign, but others can raise the risk for stroke, heart attack, or even sudden death.

For this reason, it's best to alert the doctor to any new or recurring change in heart rhythm. Similarly, let the doctor know if it feels like your heart is racing or throbbing.

Some arrhythmias stem from a potassium deficiency caused by the diuretics used to treat heart failure. In such cases, a medication adjustment or potassium supplements may be all that's required.

7. Fainting

Severe arrhythmias sometimes cause a loss of consciousness; so can extremely low blood pressure. No matter what the suspected cause, any heart failure patient who faints or blacks out should seek urgent medical attention.

8. Changes in Blood Pressure

"A significant decrease in blood pressure without a change in medication can be a sign that the heart muscle is not functioning as well," says Fonarow. An increase in blood pressure might suggest that medication needs to be adjusted. In either case, it's important to alert the doctor.

Dealing With Signs of Heart Failure: Don't Wait and See

The sooner potentially worrisome symptoms are reported to the doctor, the better the outcome is likely to be. "The best way to get out of trouble is to avoid trouble to begin with," Yancy says.

Reviewed on January 26, 2010

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