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
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
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.
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.
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.