The Family Health Guide

Don’t delay when heart failure threatens

Don't delay when heart failure threatens

When the "Check Engine" light starts flashing on the dashboard and a grinding sound emanates from under the hood, most people heed the warnings and head for a mechanic. People living with heart failure often get warnings like these from their bodies. Many ignore the signs that their condition is about to flare up, sometimes for days, before calling a doctor or heading to the hospital.

Waiting it out isn't a good idea. The symptoms don't usually fade away by themselves, and they can spiral out of control into what doctors call acute or decompensated heart failure. This usually requires hospitalization and often intensive care. Rapidly worsening heart failure can put a tremendous strain on the heart, lungs, kidneys, and other organs.

Heeding the warning signs, and taking action, can nip this in the bud.

Dangerous delays

Doctors, nurses, and public health experts make a big deal about the importance of getting to the hospital as fast as possible if you suspect you are having a heart attack. Worsening heart failure isn't accorded the same sort of urgency, though it should be.

In an effort to get a handle on how people respond to heart failure warning signs, researchers looked at the medical records.People who experienced acute symptoms — serious shortness of breath, swelling of the ankles or feet, a gain of 5 pounds in a week — waited an average of 13 hours before seeking medical help. Those with less severe or more vague symptoms waited nearly 10 days before calling a doctor or going to the hospital.

There are many reasons why people with heart failure hold off on calling their doctors or coming to the emergency department. Many have learned to live with their symptoms and don't recognize when they are getting out of hand. Some are afraid of what they'll learn. Others worry about crying wolf.

Warning signs of worsening heart failure

If you have heart failure, call your doctor if you notice any of these signs:

  • Shortness of breath not related to exercise
  • Sudden weight gain (2–3 pounds in one day or 5+ pounds in one week)
  • Extra swelling in the feet or ankles
  • Swelling or pain in the abdomen
  • Discomfort or trouble breathing when lying flat
  • Waking up short of breath
  • Cough or wheezing
  • Increased fatigue
  • Mental confusion
  • Loss of appetite.

Warning signs

Heart failure is something of a trickster. Long periods of stability can be punctuated by flare-ups, seemingly from out of the blue, that can push symptoms out of control. That's why you need to watch it like a hawk and heed the subtle signs. There aren't any hard-and-fast rules about when to call your doctor. If you have a feeling that something isn't right, it probably isn't. When in doubt, check it out.

Trying to prevent flare-ups is just as important as acting on them. If you have heart failure, here are some strategies that can keep it under control and keep you out of the hospital:

  • Take your medications, even when you are feeling fine.
  • Stick with your diet.
  • Go easy on the salt.
  • Drink the right amount of fluid.
  • Weigh yourself every day.
  • Have your potassium checked.
  • Exercise regularly.
  • Relax and reduce stress.
  • Guard against the flu and pneumonia with vaccinations and frequent hand washing.
  • Be alert for signs of a flare-up.
July 2008 update

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