How Do I Know if My Loved One's Heart Failure Is Getting Better?

Start by making sure your loved one's heart failurehas at least stabilized. The best way to tell is by watching for improved symptoms, such as decreased shortness of See also:
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See all 82 questions about Heart Concerns breath and decreased swelling of the legs and belly. For some people, their appetite will improve, they'll sleep better, and they'll have more energy. Often activity tolerance improves. Daily monitoring of weight, swelling, and other symptoms is going to be your best indicator of whether the person you're caring for is having fewer symptoms of heart failure. If he or she tends to have abdominal swelling, measuring girth can be an indicator of this. Notice and record any change in breathing, such as whether middle-of-the-night waking decreases or it's easier to breathe lying down. Pay attention to improvements in what doctors call "functional status," which is how well the person you're caring for is able to accomplish daily tasks, like getting dressed or walking the dog.

As fluid retention decreases, hopefully you'll see an improvement in other symptoms, such as coughing, appetite, and fatigue. One thing to be aware of is that some heart failure medications, such as diuretics, cause an immediate improvement in symptoms. Others, such as ACE inhibitors and ARB's (angiotensin receptor blockers), take much longer to work -- so you may not see progress for several months. Keep in mind, though, that medications such as ACE inhibitors and ARB's can improve long-term heart function.

While it's important to track symptoms, doctors also assesses progress by monitoring the structural damage to the heart, which may have enlarged, changed shape, or become stiffer. The treatments used for heart failure can "reverse remodel" the heart, getting it closer to its original shape and size. An echocardiogram is used to measure and assess size and structural damage, including the size of the chambers, valve problems, blood flow, and pressure inside the heart. The echocardiogram will assess how strongly the heart pumps by measuring the quantity of blood the heart "ejects" with each contraction, a measurement known as the ejection fracture (EF).

Familiarize yourself with measurements such as the ejection fracture, and ask the doctor what this measurement has been in the past, and what he's hoping for in terms of improvement. This will help you know if your loved one's heart failure is getting better or worsening.

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