Heart Failure: Warning Signs of a Flare-Up

Side view of leg showing ankle and foot swelling.

You have a condition called heart failure. Once you have heart failure, flare-ups can happen. Below are signs that can mean your heart failure is getting worse. If you notice any of these warning signs, call your healthcare provider.


  • Your feet, ankles, or lower legs get puffier.

  • You notice skin changes on your lower legs.

  • Your shoes feel too tight.

  • Your clothes are tighter in the waist.

  • You have trouble getting rings on or off your fingers.

Shortness of breath

  • You have to breathe harder even when you’re doing your normal activities or when you’re resting.

  • You are short of breath walking up stairs or even short distances.

  • You wake up at night short of breath or coughing.

  • You need to use more pillows or sit up to sleep.

  • You wake up tired or restless.

Other warning signs

  • You feel weaker, dizzy, or more tired.

  • You have chest pain or changes in your heartbeat.

  • You have a cough that won’t go away.

  • You can’t remember things or don’t feel like eating.

Tracking your weight

Gaining weight is often the first warning sign that heart failure is getting worse. Gaining even a few pounds can be a sign that your body is retaining excess water and salt. Weighing yourself each day in the morning after you urinate and before you eat, is the best way to know if you're retaining water. Get a scale that is easy to read and make sure you wear the same clothes and use the same scale every time you weigh. Your healthcare provider will show you how to track your weight. Call your doctor if you gain more than 2 pounds in 1 day, 5 pounds in 1 week, or whatever weight gain you were told to report by your doctor. This is often a sign of worsening heart failure and needs to be evaluated and treated before it compromises your breathing. Your doctor will tell you what to do next.