November 4, 2022

Signs and symptoms that heart failure is getting worse, and when to call the doctor.

With heart failure, flare-ups of symptoms can happen. Call your health-care provider if any of the following happen, because these symptoms could mean that your heart failure is getting worse.


  • Your feet, ankles or lower legs get puffier.
  • Your shoes feel too tight.
  • Your clothes are tighter in the waist.
  • You have trouble getting rings on or off your fingers.

Feeling short of breath

  • You have to breathe harder even with normal activity or at rest.
  • You’re short of breath walking up stairs or even short distances.
  • You wake up at night short of breath or coughing.
  • You need to use more pillows or sit up to sleep.
  • You wake up tired or restless.

Other symptoms of heart failure getting worse

  • You feel weaker, dizzy or more tired.
  • You have chest pain or changes in your heartbeat.
  • You have a cough that won’t go away.
  • You have trouble remembering things.
  •  You don’t feel like eating, or you feel full more quickly than usual.

Tracking your weight

Gaining weight is often the first warning sign that heart failure is getting worse. Gaining even a few pounds can be a sign that your body is retaining extra water and salt. Weighing yourself each day — in the morning, after you urinate and before you eat — is the best way to know if you’re retaining water. Get a scale that’s easy to read. Make sure you wear the same clothes and use the same scale every time you weigh yourself. Your health-care provider will show you how to track your weight.

Call your provider if you gain:

  • More than 2 pounds in one day.
  • More than 5 pounds in one week.
  • Or whatever weight gain you were told to report by your provider.

If you quickly recognize signs that your heart failure is getting worse, this helps your doctor adjust your medicines. You may need an appointment to help prevent you from ending up in the hospital. 

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Vanderbilt University Medical Center has one of the top heart failure programs in the nation with the expertise to care for all stages and causes of heart failure, from the most basic to the most complex. Vanderbilt’s innovative treatments offer hope when you need it most.

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