Definition

Heart failure exacerbations are a worsening of symptoms.

Causes

Symptoms may be made worse by trouble with the treatment plan, other illness, or progression of disease. Examples include:

• Uncontrolled high blood pressure
• A buildup of fluids and sodium
• Health problems that make the heart work harder, such as anemia
• Hormonal problems
• Infection, such as pneumonia

Risk Factors

Factors that raise the risk of heart failure exacerbations are:

• High blood pressure
• Being obese or overweight
• Kidney problems
• Taking certain medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs)
• Eating foods that are high in salt and fat

Symptoms

People with heart failure exacerbations have heart failure symptoms that have gotten worse. It may include one or more of the following:

• Shortness of breath that happens with activity, when lying flat, or when bending down
• Dry, hacking, cough
• Trouble sleeping
• Sudden weight gain more than 2 to 3 pounds in 24 hour period
• Increased swelling of the feet, ankles, and legs
• Enlarged belly

Diagnosis

The doctor will ask about your symptoms and history of heart failure. A physical exam will be done. Your blood and urine will be tested.

Tests will be done to view your heart and see how it is working. This can be done with:

• ECG
• Echocardiogram—to measure how well your heart is pumping out blood. It can estimate an ejection fraction. It will be compared to earlier tests to look for changes.
• Coronary angiography

Treatment

Treatment steps will depend on what is making your symptoms worse. Infections or other medical conditions will need to be treated. Medical care can help to support your heart until the issue has passed.

Your overall treatment plan may also need to be changed. Keep in touch with your care team. Let them know how your treatment plan is working. Some steps include:

Prevention

Exacerbations cannot always be prevented. Following your care plan can help your heart stay as healthy as possible.