Heart Failure: The Practical To-Do List
Heart Failure: what is worth doing, what is worth avoiding, and when to stop and see a doctor.
A condition in which the heart cannot pump efficiently enough to meet the body's demands. It is common, treatable and frequently mistaken for ageing, and daily weight change is one of the earliest signs of deterioration.
Key takeaways
- Common symptoms: breathlessness, fatigue, swollen ankles
- Key investigation: a BNP or NT-proBNP blood test, then an echocardiogram
- Most useful single change: Weigh yourself daily at the same time and record it.
- Commonest mistake: NSAIDs such as ibuprofen, which worsen fluid retention.
- See a doctor if any of the signs under "When to speak to a doctor" below apply to you.
Do
- Weigh yourself daily at the same time and record it
- Report a rapid rise in weight or swelling promptly
- Take medicines exactly as prescribed, including diuretics
- Ask about cardiac rehabilitation; supervised exercise helps
Do not
- NSAIDs such as ibuprofen, which worsen fluid retention
- Adding salt, or using potassium-based substitutes without advice
- Assuming breathlessness is just age
The numbers behind the list
The reasoning behind both lists, in numbers.
| Measure | Figure |
|---|---|
| Common symptoms | breathlessness, fatigue, swollen ankles |
| Key investigation | a BNP or NT-proBNP blood test, then an echocardiogram |
| Weight gain warranting review | more than 2kg in 2-3 days |
| Salt and fluid | often restricted; follow your own team's advice |
| Exercise | cardiac rehabilitation is recommended, not rest |
If you change one thing
Weigh yourself daily at the same time and record it. It heads the list. If you take nothing else from this page, take that.
Where to go next
- Heart Failure: A Beginner-Friendly Start
- A Q and A on Heart Failure
- Heart Failure — the reference entry
- Cardiac Rehabilitation: What the Evidence Actually Says
- What the Guidance Really Says About Statins
When to speak to a doctor
Contact your heart failure team or GP promptly for weight gain of more than 2kg in two or three days, increasing ankle swelling, or breathlessness that is worsening or wakes you at night. Call 999 for severe breathlessness at rest, chest pain, fainting, or coughing up pink frothy sputum.
Where this comes from
- NICE — Chronic heart failure in adults
- British Heart Foundation — heart failure
How this page was put together
Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.
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