Heart & Vascular Institute of FloridaHeart & Vascular Institute of Florida http://myheartdoc.org Board Certified Cardiologist Specializing in Consultive, Diagnostic and Interventional Cardiology. Wed, 22 Feb 2012 02:18:58 +0000 en-US hourly 1 http://wordpress.org/?v=3.4.2 Accepting Your Diagnosis http://myheartdoc.org/accepting-your-diagnosis/ http://myheartdoc.org/accepting-your-diagnosis/#comments Tue, 21 Feb 2012 01:58:28 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=552 Facing Your Future

A heart failure diagnosis takes some getting used to. As you try to understand and accept what it means to have heart failure, you will probably feel a range of emotions. Your outlook on the future may also change, depending on your prognosis. Heart failure can be mild or severe, and people respond differently to treatment. For some people, heart failure symptoms are reversible with proper treatment; for others, symptoms get worse over time.

Given the uncertainty of your diagnosis, it’s natural – and even healthy – to grieve for yourself. Managing your feelings about heart failure is an important aspect of taking care of yourself. The emotional stages you may expect after a diagnosis of heart failure are described below.

Your Initial Reaction

Your initial reaction may be shock, disbelief, denial, or numbness. For the first few months, you may have a hard time acknowledging your condition. It’s tough to be told you have heart failure – it’s a new and unwelcome companion to your life.

Adjusting to Your Condition

For 3-12 months after your diagnosis, you may experience preoccupation, fear, anxiety, anger, or hopelessness. During this time, you may struggle to integrate new routines – and a new sense of responsibility – into your daily life. Yet from questions of “why me?” and “what if?”, you will probably move gradually toward more acceptance of your condition.

New Habits Become Routine

Finally, when new habits become routine and your understanding of heart failure improves, you’ll probably begin to feel more peaceful about your diagnosis. You may get satisfaction from the adjustments you’ve made in your life, and feel new resolve and hope about the future.

Throughout these emotional stages, be patient with yourself. Adjusting to life with heart failure isn’t easy, but many people have learned to accept their diagnosis and lead lives filled with a renewed sense of purpose and hope. With time, support, and patience, you can feel that way too.

Is There a Cure For Heart Failure?

Heart failure is a chronic condition that in most cases cannot be cured. However, it can be managed. For most people with heart failure, management means SELF-management – taking medications and making positive lifestyle changes.

Reach Out For Support!

Since self-management is so critical to your health, it’s important to understand and accept your emotional reactions to your diagnosis so that they don’t interfere with following your care plan. If you need encouragement, advice, or just someone to talk to, reach out to others for support.

Your Care Team

Many people will work together to help you live better with heart failure.

  • Your primary care provider. This is the person you usually see for health problems. Your primary care provider could be a family practice physician, a general internist, a nurse practitioner, or a physician assistant.
  • Your cardiologist. This is a physician specializing in the diagnosis and treatment of heart and blood vessel diseases.
  • Other healthcare professionals. Many other professionals – including nurses, dietitians, pharmacists, exercise physiologists, care managers, and social workers – may contribute to different aspects of your care.
  • You and your family. You and your family are at the center of this team! You need to be active participants in your care. This means learning as much as you can about your condition and treatment, following your treatment plan, and, most importantly, communicating with the rest of your healthcare team.
]]> http://myheartdoc.org/accepting-your-diagnosis/feed/ 0 Symptoms http://myheartdoc.org/symptoms/ http://myheartdoc.org/symptoms/#comments Tue, 21 Feb 2012 01:55:44 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=548 Recognize Your Symptoms

As you learn to manage your heart failure with the MAWDS plan, you’ll soon be aware of how important YOU are in maintaining your health. The last component of the MAWDS plan highlights your responsibility to recognize your heart failure symptoms and take appropriate action.

What if my symptoms become worse?

It’s your job to monitor your symptoms and communicate with your healthcare providers about any changes. This way, they can make any necessary adjustments in your treatment – before your symptoms become too severe. This can prevent unnecessary trips to the hospital.

What if I have no symptoms?

It’s possible to have heart failure without symptoms such as fatigue or shortness of breath. Your lack of symptoms does not mean that you can ignore your diagnosis and treatment plan. Instead, like all other heart failure patients, you need to follow every aspect of your treatment plan. This includes taking prescribed medications to prevent the progression of your heart disease.

Dear Diary…

Use your Heart Failure Self-Care Diary to help you monitor your symptoms and keep you on the right track with every aspect of your MAWDS plan. Even if you don’t notice any symptoms, continue to follow your MAWDS treatment plan faithfully.

To help you monitor your condition – and prevent a bad situation from becoming worse – use this Heart Failure Action Plan. Your Action Plan divides your symptoms into three zones. Use your Heart Failure Self-Care Diary to record your zones every day.

Heart Failure Action Plan

Go (Green) – Maintain Therapy

  • Feeling well
  • Breathing is easy
  • Weight is stable
  • Symptoms are stable

Keep up the good work! Follow MAWDS every day!

Caution (Yellow) – Step Up Therapy

  • Not feeling well
  • Weight is up 2 or more pounds in one day or up 5 pounds over your target weight
  • Noticeable swelling or bloating
  • Some difficulty breathing with activity and at night
  • Symptoms are worsening

Call your healthcare provider to find out how to prevent symptoms from becoming severe.

Alert (Red) – Get Help Now

  • Breathlessness or chest heaviness at rest
  • Weight is up more than 5 pounds in one day
  • Fainting
  • Symptoms are severe

Call your healthcare provider or go directly to the emergency room. DO NOT try to treat this yourself.

]]> http://myheartdoc.org/symptoms/feed/ 1 Diet http://myheartdoc.org/diet/ http://myheartdoc.org/diet/#comments Tue, 21 Feb 2012 01:53:40 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=545 Follow Your Diet

When you’re diagnosed with heart failure, you’ll need to make 3 important adjustments to your diet:

  1. Salt: Lose your salt shaker! Consume less than 2 grams (2,000 mg) per day.
  2. Fluids: Limit your intake to less than 8 cups (64 ounces, 2 quarts, or 2 liters) per day.
  3. Alcohol: Limit your drinking to one cocktail, beer, or glass of wine each day, if any.

You may also need to make other adjustments in the way you eat and drink. These adjustments can ease your heart’s workload and help you feel better. A care provider or dietitian can give you specific guidelines and suggestions.

Healthy Additions

At the same time that you’re limiting salt, fluids, and alcohol in your diet, you can be adding healthy foods for balance. This means eating moderate amounts of the following:

  • Fresh and dried fruits and vegetables
  • Low-fat, low-salt cheeses
  • Cooking oils, such as olive, canola, and safflower oil
  • Fresh fish, chicken, and turkey
  • Lean cuts of beef, veal, pork, and lamb
  • Breads, cereal, grain, and other starches (potatoes, pasta)

Limiting Salt in Your Diet

Most healthcare providers will recommend that you eat less than 2,000 mg of salt (sodium) per day. To meet this goal, you’ll need to follow a low-salt (low-sodium) diet. In addition to following the guidelines given by your healthcare providers, you should develop the following habits as part of your low-salt diet:

  • Take the salt shaker off the table. If it’s not there, you can’t use it!
  • Substitute other spices for salt in your cooking. Try these flavor-enhancers: allspice, dill, lemon, onion, curry, pepper, and garlic powder (not garlic salt). If you want to try salt substitutes, ask your healthcare providers which are safest.
  • Substitute fresh or frozen vegetables for canned foods. Canned foods often contain salt.
  • Rinse canned foods for 30 seconds. If you can’t substitute fresh or frozen vegetables, you can still reduce sodium content 30% by first rinsing canned food with water.
  • Avoid processed meats. Foods such as hot dogs, salami, bacon, and other lunch meats usually contain a lot of salt.
  • Stay away from salty snacks, such as potato chips, salted nuts, and pretzels.
  • Cut out headache or heartburn medicines that contain salt in the form of sodium bicarbonate or sodium carbonate. (The labels will tell you whether sodium is an ingredient.)
  • Choose foods labeled “unsalted,” “no salt added,” or “low sodium.” You’ll be pleasantly surprised that many of your favorite foods also come in low-salt versions.
  • Take time to read and compare food labels.
  • Ask that your food be prepared with less salt (or no salt) when eating out.

Limiting Your Fluid Intake

Another way to reduce the fluid retention caused by your heart failure is to drink less fluid – only 8 cups a day (64 ounces). Keep in mind that feeling thirsty doesn’t mean your body needs more fluid. So, instead of drinking liquids when you’re thirsty, try these alternatives:

  • Chewing gum
  • Sucking on ice chips or hard candy
  • Rinsing your mouth with water

Limiting Your Alcohol Consumption

Here are a couple of good reasons to limit your alcohol intake to one drink per day:

  • It helps limit your fluid intake to reduce the strain on your heart.
  • It prevents heart muscle damage that may be caused by more-than-moderate alcohol use.

Your one-drink limit allows one beer, glass of wine, or cocktail each day.

]]> http://myheartdoc.org/diet/feed/ 0 Weigh http://myheartdoc.org/weigh/ http://myheartdoc.org/weigh/#comments Tue, 21 Feb 2012 01:50:47 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=542

Weigh Yourself Each Day

Every morning when you wake up, you can take one of the most important steps toward controlling your heart failure symptoms: stepping on your scale. Weighing yourself daily and keeping a record will help you and your healthcare providers know if your heart failure is under control. Rapid changes in your weight can mean you are gaining or losing fluid.

Your Weight and Your Heart

As you learned from the first section of this guide, heart failure causes fluid buildup in your body. This fluid shows up as extra weight on your scale. Generally speaking, the more severe your heart failure, the more fluid buildup in your tissues. An increase in your weight could mean a downturn in the condition of your heart. For this reason, you need to monitor your daily weight as a measure of your heart’s health.

Is there a right way to weigh myself?

Although weighing yourself is as simple as stepping on the scale, there are a few things you can do to ensure that your daily record is accurate and complete:

  • Use the same scale every day.
  • Weigh yourself at the same time every morning – after urinating but before eating or drinking.
  • Weigh yourself when you’re dry, not wet from a shower or bath.
  • Write down your daily weight faithfully and accurately – you want a detailed record of your weight pattern, not just a general idea.

When should I call my healthcare provider about my weight?

Call your healthcare provider if you see either of these weight-gain warning signs:

  • You gain 2 or more pounds in one day.
  • You gain 5 pounds over your target weight.

These signs could mean that your body is retaining fluid, and may warrant a change in your treatment plan. You should also call if you have any questions about your target weight, or any other aspect of your management plan.

When You’re Gaining…

An increase in your weight means either of these conditions:

  • You’re gaining weight in fluids.
  • You’re gaining weight in fat.

Fat weight gain happens more slowly than fluid weight gain. Talk with your healthcare provider to determine why you’re gaining weight – and whether it warrants a change in your treatment plan.

When You’re Losing…

A decrease in your weight may mean you’re dehydrated. Consult with your healthcare providers to determine why you’re losing weight – and whether it warrants a change to your treatment plan.

]]> http://myheartdoc.org/weigh/feed/ 0 Activity http://myheartdoc.org/activity/ http://myheartdoc.org/activity/#comments Tue, 21 Feb 2012 01:48:15 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=538

Stay Active Each Day

People with heart failure often have a lot of questions about the safety and benefits of physical activity. This section provides some basic guidelines.

Benefits of Exercise

Even though you have heart failure, you CAN enjoy physical activity and exercise. In fact, you SHOULD stay active: a little exercise can make a big difference in your health. Here are a few of the benefits you can expect from regular activity:

  • Increased energy
  • Better sleep at night
  • Stronger muscles, so everyday tasks aren’t as tiring
  • Help in maintaining your weight (or losing weight if needed)
  • Improved mood and outlook

The “Best” Exercise Plan

The best exercise plan is one that is tailored to your current health, habits, and interests. Make sure to speak with your healthcare providers before starting any activity or exercise plan. They can help you find an exercise level that’s right for you. They may also tell you whether to avoid certain types of exercises.

Most people can choose from a range of safe activities and exercises. Daily walking, swimming, and biking are all great forms of exercise, and you can perform these activities at different levels of intensity to match your fitness level. Yet whether it’s golfing or gardening, the key is picking activities that you enjoy. This way, you’re more likely to be consistent with your physical activity – and motivated to continue over the long term.

Keep in mind that regular activity is your goal, and you should start off slowly and increase the time and level of activity gradually. You’ll likely have good days and bad days, so you should listen to your body and learn your limits. Adjust your activities as needed.

Staying Safe While Exercising

What if you don’t really know your physical limits yet? How can you be sure you’re exercising safely?

First, you should follow your healthcare providers’ general guidelines about the amount and type of activity that’s right for you. Beyond that, you need to monitor your body’s reaction to activity. Make sure that you can carry on a conversation during exercise, and that you’re not exhausted the next day. Always include regular periods of rest in your daily schedule, and stop and rest whenever you feel tired or short of breath.

Stop exercising and consider calling your healthcare provider if you experience any of the following symptoms:

  • Pressure or pain in your chest, neck, arm, jaw, or shoulder
  • Dizziness or lightheadedness
  • Nausea
  • Unusual shortness of breath
  • Unusual tiredness
  • Fast or slow heartbeat
  • Irregular heartbeat

Talk Your Walk

A good guideline to ensure you’re exercising within your limits: make sure you can carry on a conversation during activity.

]]> http://myheartdoc.org/activity/feed/ 1 Medications http://myheartdoc.org/medications/ http://myheartdoc.org/medications/#comments Tue, 21 Feb 2012 01:45:33 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=534

Take Your Medications

Your healthcare providers can prescribe your medications, but it’s up to you to take them properly. You also need to communicate with your healthcare providers about your medications. They need your feedback to understand how you’re responding to treatment and make any necessary adjustments.

Your medications are proven to help improve your quality and length of life. It’s vital that you take your medications exactly as prescribed. Missing a dose, or taking too much, can cause serious problems. In fact, not taking your medications as instructed is one of the most common reasons people with heart failure need to be hospitalized.

Tips For Taking Your Medication Safely and Consistently

  • Make sure you know exactly how to take your medications. Always ask healthcare providers about the following:
    • When to take each medication
    • How much to take
    • If there are any special instructions, such as taking a pill with a meal or on an empty stomach
    • Any side effects you may encounter
  • Tell your healthcare providers about any other medications you’re taking. They can help ensure there are no harmful interactions between drugs.
  • Talk to your healthcare provider before you take over-the-counter medications or other supplements. People sometimes get into trouble when they add over-the-counter substances to their daily medication regimen. NEVER take any new substances without first consulting your healthcare providers. This includes pain relievers (such as aspirin, ibuprofen, and naproxen) and dietary supplements (including herbal, vitamin, and mineral supplements).
  • Write down what to do if you accidentally skip a dose.Everyone makes mistakes – so be prepared and talk with your healthcare provider about what you should do if you miss a dose of your medication. Don’t try to make up for a missed dose by taking 2 doses at once (unless your healthcare provider specifically tells you to).
  • Don’t skip a dose because you feel better. Most heart failure medications must be taken regularly to keep you healthy.
  • Develop a routine to take your medications. For example, you can take your medications right after brushing your teeth in the morning, or while watching the evening news.
  • Set an alarm clock to remind you when it’s time to take your medications.
  • Organize your pills. Use a divided pillbox for different times of the day, or different days of the week. Some pillboxes even have a built-in alarm clock to remind you when to take your pills.
  • When you have 2 weeks of medications left, order more. Pharmacies sometimes have a delay in filling orders, and it’s important to avoid running out of your prescription.
  • Carry a card. Keep a written list of all your medications and dosages in your wallet or purse. Keep a list of any medical allergies with this list.
]]> http://myheartdoc.org/medications/feed/ 0 Lifestyle Management http://myheartdoc.org/lifestyle-management/ http://myheartdoc.org/lifestyle-management/#comments Tue, 21 Feb 2012 01:42:13 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=529

Managing heart failure means creating and following a regimen that reduces the strain on your weakened heart and improves your heart’s ability to do its work. For most people, this means following a MAWDS plan every day:

Medications

Your healthcare providers can prescribe your medications, but it’s up to you to take them properly.

Activity

People with heart failure often have a lot of questions about the safety and benefits of physical activity. This section provides some basic guidelines.

Weigh

Weighing yourself daily and keeping a record will help you and your healthcare providers know if your heart failure is under control.

Diet

When you’re diagnosed with heart failure, you’ll need to make 3 important adjustments to your diet: limiting salt, fluid intake, and alcohol consumption.

Symptoms

It is your responsibility to recognize your heart failure symptoms and take appropriate action.

]]> http://myheartdoc.org/lifestyle-management/feed/ 0 Treatment http://myheartdoc.org/treatment/ http://myheartdoc.org/treatment/#comments Tue, 21 Feb 2012 01:36:05 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=525
Your heart failure treatment will depend on several factors, including the cause and severity of your condition and the overall state of your health. Your healthcare providers will carefully assess each of these factors to create a comprehensive treatment plan for you. Your treatment will include one or more of the following components:

  • Medical procedures
  • Medication
  • Lifestyle management

The goals of treatment are to ease the workload on the heart, prevent further damage, and, if possible, to improve the function of your heart.

Medical Procedures

Some people with heart failure benefit from surgical procedures or from procedures performed in the hospital’s catheter laboratory (“cath lab”). These procedures can accomplish the following:

  • Open or bypass coronary arteries. If your heart failure is caused by atherosclerosis, your healthcare provider may recommend a procedure to open or bypass the arteries that deliver oxygen to the heart.
  • Repair or replace heart structures. Occasionally heart failure is caused by structural problems such as an abnormal heart valve or a hole between the chambers of the heart. In this case, your healthcare provider may suggest a procedure to repair or replace a faulty heart valve or to fix a defect.
  • Implant cardiac devices. Your healthcare provider may advise surgery to provide you with a pacemaker or other device such as an internal defibrillator. Such devices can help you maintain a healthy heart rate and rhythm and prevent life-threatening changes in your heart rhythm.
  • Replace or assist your heart. For severe, unresponsive heart failure that can’t be stabilized by other means, your healthcare provider may recommend heart transplant surgery or surgery to implant an assist device (such as a left ventricular assist device, or LVAD).

Medication

Nearly every person with heart failure will receive a treatment plan that includes medication. Different medications will produce different effects. Your providers may start treatment by prescribing one or more medications, and assess their effectiveness and ensure that your body is tolerating them. They can then make adjustments to your regimen, if necessary. We recommend that you learn the purpose of your specific prescriptions. It’s likely that your medications fall into these categories:

Medication Description Examples*
ACE-I/ARB therapy: ACE inhibitors or Angiotensin II receptor antagonists (ARBs) Block stress hormones and relieve stress on the heart’s pumping action. These medications improve symptoms, reduce hospitalizations, and improve survival rates.
ACE inhibitors:benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace)
Angiotensin II receptor antagonists (ARBs):candesartan cilexetil (Atacand)**, eprosartan mesylate (Teveten), irbesartan (Avapro)**, losartan (Cozaar), telmisartan (Micardis),
Aldosterone receptor antagonists Help rid the body of excess fluids, block a hormone that can cause you to retain water, and help reduce the loss of electrolytes from your body. spironolactone (Aldactone), eplerenone (Inspra)
Beta blockers Block stress hormones, relieve stress on the heart’s pumping action, and can improve your heart’s function. Shown to reduce symptoms and lessen the chance of future hospitalizations. carvedilol (Coreg), metoprolol succinate (Toprol XL)
Diuretics (“water pills”) Help rid your body of excess fluid. bumetanide (Bumex), furosemide (Lasix), metolazone (Mykrox, Zaroxolyn), torsemide (Demedex)
Minerals Replace potassium and/or magnesium that may be lost with diuretics. magnesium oxide, potassium (K-Dur, K-tab, K-Lyte, Micro K, Slow K)
Digitalis Strengthens the heart muscle, treats irregular heart rhythms, and improves exercise tolerance. digoxin (Lanoxin)
Anticoagulants (“blood thinners”) Help prevent blood clots from forming or getting larger. heparin, warfarin (Coumadin), enoxaparin (Lovenox)
Inotropes Strengthen the pumping action of the heart. Started in the hospital and requiring an IV, inotropes are usually reserved for patients with severe symptoms. dobutamine (Dobutrex), milrinone (Primacor)
]]> http://myheartdoc.org/treatment/feed/ 1 Diagnostic Test http://myheartdoc.org/diagnostic-test/ http://myheartdoc.org/diagnostic-test/#comments Tue, 21 Feb 2012 01:33:28 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=522
Heart failure can range from mild to severe. Although your symptoms provide one indication of your condition, they don’t always tell the whole story. Your healthcare providers will want to do other tests to assess the nature and degree of your heart failure. This will help them determine a treatment plan that suits your specific condition.

Initial Assessment

To determine whether or not you have heart failure, your healthcare providers will first ask you about your medical history, your symptoms, and your health in general. They will also perform a physical examination of your entire body, head to toe.

Further Assessment

After learning your health history and performing a physical examination, your healthcare providers may then recommend additional tests to measure your heart function and determine the cause of your heart failure. Some of these tests are described below.

  • Blood tests. Blood tests can assess a variety of health factors, including your red cell count, electrolytes, and the function of your kidney, liver, and thyroid. In some instances, blood tests can identify the cause of your heart failure.
  • Urinalysis. Studying a sample of your urine will help detect any problems with your kidneys or bladder that may be contributing to your heart failure.
  • Chest x-ray. An x-ray image of your chest shows the size of your heart and can help determine the presence of fluid buildup in your lungs.
  • EKG (ECG, electrocardiogram). This test records the electrical activity of your heart and displays it on a screen for your healthcare providers to study. The procedure involves placing electrical wires with patches or suction cups on your chest, arms, and legs. These additional tests can help detect heart damage, assess heart function, and determine your body’s response to treatment.
  • Stress tests. This test shows how your heart responds to stress. It involves stressing your heart either with physical exertion (walking on a treadmill or riding a stationary bike) or with medication. During this period of stress, your healthcare provider checks your vital signs and monitors your EKG to assess your heart’s response. Sometimes you may have a nuclear imaging test (see below) along with a stress test to provide even more information.
  • Echocardiogram (echo). An echocardiogram uses sound waves to create an image of the structure and movement of your heart. This will show your healthcare providers how efficiently your heart is pumping. The test will also look at how well your heart valves are working and how enlarged the heart is.
  • Imaging tests. Imaging tests can involve injecting a special dye into your bloodstream and then taking x-rays. The resulting images can show blood flow and distribution, and reveal the heart’s structure and movement. This helps your providers detect problems with blood flow and determine how effectively your heart is pumping.
  • Angiogram. This test produces an image of the heart and helps assess for clogged vessels. A long, thin tube (a catheter) is inserted into a blood vessel (usually in the groin area). The catheter is carefully guided through the vessel until it reaches the heart. At this point, a dye is injected through the catheter and special x-rays can track the flow of blood to your heart muscle.

Timing of Tests

It’s not uncommon to need repeated tests. Most of the tests discussed here are useful not only for initial diagnosis, but also for ongoing monitoring. By repeating tests at various time intervals, your healthcare providers can get an accurate picture of your response to treatment.

]]> http://myheartdoc.org/diagnostic-test/feed/ 0 Symptoms of Heart Failure http://myheartdoc.org/symptoms-of-heart-failure/ http://myheartdoc.org/symptoms-of-heart-failure/#comments Tue, 21 Feb 2012 01:23:22 +0000 Dr. Irfan Siddiqui http://myheartdoc.org/?p=512

Your heart failure symptoms are due to either fluid buildup or lack of oxygen in your tissues. You may notice some or all of these heart failure symptoms.

  • Shortness of breath. You may experience shortness of breath at any time. This is due to the fluid buildup in your lungs, which makes breathing harder. This breathing difficulty tends to occur first during physical activity – and may also occur at night when you’re trying to lie flat.
  • Cough. Many people with heart failure complain of a frequent cough. Sometimes this cough is dry and hacking, and other times it produces phlegm. For some, this cough occurs primarily at night. For others, it can last all day. Like shortness of breath, this cough is likely a side effect of fluid buildup in your lungs, especially if phlegm is pink-tinged.
  • Excessive fatigue. When your heart can’t pump enough blood to meet your body’s needs, you’re bound to feel more tired than usual. You may also feel weak. Your muscles and organs simply aren’t getting the blood they need, and even a good night’s sleep won’t help.
  • Weight gain. Weight gain may be one of the earliest signs of fluid buildup in your body. Extra fluid in your body translates into extra weight showing up on your scale – at a rate of about 2 pounds for each quart of additional body fluid. For this reason, keeping track of your weight is a great measure of your heart failure management.
  • Swollen ankles, feet, belly, lower back, and fingers.Fluid buildup will show up as swelling in different parts of your body. The ankles, feet, belly, lower back, and fingers are places where extra fluid is most likely to collect as it seeps out of blood vessels into your tissues. Swelling in your belly can cause you to feel bloated or nauseated, and can decrease your appetite. Swelling is usually worse at the end of the day.
  • Poor concentration and memory lapses. Some people with heart failure complain of these symptoms. They may be explained by lack of oxygen to the brain.

Right-sided Heart Failure

When the right side of the heart isn’t pumping effectively, the blood returning to the heart from the body backs up in the veins. When blood backs up in the veins, excess fluid in the blood leaks out into the surrounding tissues. This can cause:

  • Swelling in the liver
  • Bloating in the stomach
  • Swelling in the legs and ankles

Left-sided Heart Failure

When the left side of the heart isn’t pumping effectively, blood backs up, causing fluid accumulation in the lungs. This can cause:

  • Swelling in the liver
  • Bloating in the stomach
  • Swelling in the legs and ankles
  • Shortness of breath
  • Cough
  • Fatigue and weakness

It is possible to just have right-sided heart failure, left-sided heart failure, or both.

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