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Heart Failure Health Center

Heart Failure: 8 Signs Your Treatment Is Not Working

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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 edema.

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."

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.

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