Knowing your body and the symptoms that tell you your heart failure is getting worse will help you stay healthier and out of the hospital. At home, you should watch for changes in your:
When watching out for warning signs, you can catch problems before they get too serious. Sometimes these simple checks will remind you that you forgot to take a pill, or that you have been drinking too much fluid or eating too much salt.
Be sure to write down the results of your home self-checks so that you can share them with your doctor. Your doctor’s office may have a "telemonitor," a device you can use to send your information automatically. A nurse will go over your self-check results with you in a weekly phone call.
Throughout the day, ask yourself:
Is my energy level normal?
Am I getting more short of breath when I am doing my everyday activities?
Are my clothes or shoes feeling tight?
Are my ankles or legs swelling?
Am I coughing more often? Does my cough sound wet?
Do I get short of breath at night?
These are signs that there is too much fluid building up in your body. You will need to learn how to limit your fluids and salt intake to prevent these things from happening.
Checking Your Weight
You will get to know what weight is right for you. Weighing yourself will help you know if there is too much fluid in your body. You might also find that your clothes and shoes are feeling tighter than normal when there is too much fluid in your body.
Weigh yourself every morning on the same scale when you get up -- before you eat and after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it.
Call your doctor if your weight goes up by more than 3 pounds in a day or 5 pounds in a week. Also call your doctor if you lose a lot of weight.
Checking Your Heart Rate and Pulse
Know what your normal pulse rate is. Your doctor or nurse will tell you what yours should be.
You can take your pulse in the wrist area below the base of your thumb. Use your index and third fingers of your other hand to find your pulse. Use a second hand and count the number of beats for 30 seconds. Then double that number. That is your pulse.
Your doctor may give you special equipment to check your heart rate.
Checking Your Blood Pressure
Your doctor may ask you to keep track of your blood pressure at home. Make sure you get a good quality, well-fitting home device. Show it to your doctor or nurse. It will probably have a cuff with a stethoscope or a digital readout.
Practice with your doctor or nurse to make sure you are taking your blood pressure correctly.
You feel short of breath when you are active or when you are at rest.
You are wheezing and having trouble breathing.
You have a cough that does not go away. It may be dry and hacking, or it may sound wet and bring up pink, foamy spit.
You have swelling in your feet, ankles, or legs.
You have to urinate a lot, especially at night.
You have gained or lost weight.
You have pain and tenderness in your belly.
You have symptoms you think might be from your medicines.
Your pulse or heartbeat gests very slow or very fast, or it is not regular.
Your blood pressure is lower or higher than your doctor says is normal for you.
Mant J, Al-Mohammad A, Swain S, Laramée P; Guideline Development Group. Management of chronic heart failure in adults: synopsis of the National Institute For Health and Clinical Excellence guideline. Ann Intern Med. 2011 Aug16;155(4):252-9.
Greenberg B and Kahn AM. Clinical assessment of heart failure. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald'sHeart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Saunders; 2011:chap 26.
Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009 Apr 14;119(14):1977-2016. Epub 2009 Mar 26.
Riegel B, Moser DK, Anker SD, Appel LJ, Dunbar SB, Grady KL, Gurvitz MZ, Havranek EP, Lee CS, Lindenfeld J, Peterson PN, Pressler SJ, Schocken DD, Whellan DJ; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009 Sep 22;120(12):1141-63.
Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.