A heart failure exacerbation can be triggered by:

• Not taking your heart failure medicines correctly.

• Infections.

• Eating an unhealthy diet or a diet that is high in salt (sodium).

• Drinking too much fluid.

• Drinking alcohol.

• Using drugs, such as cocaine or methamphetamine.

• Not exercising.

Other causes include:

• Other heart conditions such as an irregular heart rhythm (arrhythmia).

• Worsening heart valve function.

• Low blood counts (anemia).

• Other medical problems, such as kidney failure, thyroid problems, or diabetes mellitus.

When heart failure symptoms suddenly or slowly get worse, this may be a sign of heart failure exacerbation. Symptoms of heart failure include:

• Shortness of breath during activity or exercise.

• A cough that does not go away.

• Swelling of the legs, ankles, feet, or abdomen.

• Losing or gaining weight for no reason.

• Trouble breathing when lying down.

• Increased heart rate or irregular heartbeat.

• Fatigue.

• Feeling light-headed, dizzy, or close to fainting.

• Nausea or lack of appetite.

This condition is diagnosed based on:

• Your symptoms and medical history.

• A physical exam.

You may also have tests, including:

• Electrocardiogram (ECG). This test measures the electrical activity of your heart.

• Echocardiogram. This test uses sound waves to take a picture of your heart to see how well it works.

• Blood tests.

• Imaging tests, such as:

  • Chest X-ray.

  • MRI.

  • Ultrasound.

• Stress test. This test examines how well your heart functions while you exercise on a treadmill or exercise bike. If you cannot exercise, medicines may be used to increase your heartbeat in place of exercise.

• Cardiac catheterization. During this test, a thin, flexible tube (catheter) is inserted into a blood vessel and threaded up to your heart. This test allows your health care provider to check the arteries that lead to your heart (coronary arteries).

• Right heart catheterization. During this test, the pressure in your heart is measured.

This condition may be treated by:

• Adjusting your heart medicines.

• Maintaining a healthy lifestyle. This includes:

  • Eating a heart-healthy diet that is low in sodium.

  • Not using products that contain nicotine or tobacco.

  • Regular exercise.

  • Monitoring your fluid intake.

  • Monitoring your weight and reporting changes to your health care provider.

  • Not using alcohol or drugs.

• Treating sleep apnea, if you have this condition.

• Surgery. This may include:

  • Placing a pacemaker to improve heart function (cardiac resynchronization therapy).

  • Implanting a device that can correct heart rhythm problems (implantable cardioverter defibrillator).

  • Implanting a pulmonary arterial pressure monitor to monitor your fluid balance.

  • Connecting a device to your heart to help it pump blood (ventricular assist device).

  • Heart transplant.

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Do not stop taking your medicines or change the amount you take. If you are having problems or side effects from your medicines, talk to your health care provider.

• If you are having difficulty paying for your medicines, contact a social worker or your clinic. There are many programs to assist with medicine costs.

• Talk to your health care provider before starting any new medicines or supplements.

• Make sure your health care provider and pharmacist have a list of all the medicines you are taking.

Eating and drinking

• Avoid drinking alcohol.

• Eat a heart-healthy diet as told by your health care provider. This includes:

  • Plenty of fruits and vegetables.

  • Lean proteins.

  • Low-fat dairy.

  • Whole grains.

  • Foods that are low in sodium.

Activity

• Exercise regularly as told by your health care provider. Balance exercise with rest.

• Ask your health care provider what activities are safe for you. This includes sexual activity, exercise, and daily tasks at home or work.

Lifestyle

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. If you need help quitting, ask your health care provider.

• Maintain a healthy weight. Ask your health care provider what weight is healthy for you.

• Consider joining a patient support group. This can help with emotional problems you may have, such as stress and anxiety.

• Do not use drugs.

General instructions

• Stay up to date with vaccines. Talk to your health care provider about flu and pneumonia vaccines.

• Keep a list of medicines that you are taking. This may help in emergency situations.

• Keep all follow-up visits. This is important.