Which statements indicate possible heart failure exacerbation?

Which statements indicate possible heart failure exacerbation?

• A. I've gained 6 lb in one week.
• B. While I sleep I have to prop myself up with a pillow so I can breathe.
• C. I haven't noticed any swelling in my feet or hands lately.
• D. Both A and B are correct.

Answer: (D)

In heart failure, signs of decompensation mainly come from fluid overload and congestion. A rapid weight gain, such as 6 pounds in one week, signals fluid retention as the body holds onto more water because the heart isn’t pumping effectively. That increase in preload can point to worsening heart failure. Orthopnea—needing to prop up with extra pillows to breathe at night—reflects pulmonary congestion; lying down allows fluid to redistribute to the lungs, making breathing harder and improving when upright. Together, these two findings strongly indicate possible heart failure exacerbation because they show both systemic fluid overload and lung congestion. The absence of swelling doesn’t necessarily rule out decompensation, but on its own it doesn’t counter these other signs. So, the statements about weight gain and orthopnea together best indicate a possible HF flare.

In heart failure, signs of decompensation mainly come from fluid overload and congestion. A rapid weight gain, such as 6 pounds in one week, signals fluid retention as the body holds onto more water because the heart isn’t pumping effectively. That increase in preload can point to worsening heart failure. Orthopnea—needing to prop up with extra pillows to breathe at night—reflects pulmonary congestion; lying down allows fluid to redistribute to the lungs, making breathing harder and improving when upright. Together, these two findings strongly indicate possible heart failure exacerbation because they show both systemic fluid overload and lung congestion. The absence of swelling doesn’t necessarily rule out decompensation, but on its own it doesn’t counter these other signs. So, the statements about weight gain and orthopnea together best indicate a possible HF flare.