Fluid buildup indicates worsening heart failure. Learn how to spot it and treat it early.
The buildup of excess fluid in your body can take a variety of forms from belly bloating and swollen ankles to nausea, persistent coughing and fatigue. You may be tempted initially to dismiss this hodgepodge of problems as having little to do with your heart. However, they all signal water retention, which can mean trouble for people with a history of heart failure.
"Fluid buildup can quickly escalate into a life-threatening situation," says Dr. Eldrin Lewis, a heart failure specialist at Harvard-affiliated Brigham and Women's Hospital.
Heart failure may start with injury from a heart attack or develop as a result of damaged valves, infection or disease of the heart muscle cells. Many times, it is the product of years of toil against high blood pressure and clogged arteries. Regardless of what triggers the decline, heart failure culminates in a progressive weakening of your heart's power to pump.
Consequently, blood circulates through your heart and body more slowly; your cells thirst for fresh oxygen and nutrients. To compensate for its weakened state, the heart undergoes a series of structural transformations. Other physical processes also come into play. When the kidneys detect the diminished blood flow, they activate hormones that prompt the body to retain fluid and sodium in an effort to boost the volume of blood in circulation.
What to look for
The good news is that you can tell if you're beginning to retain fluid merely by getting on the scale. "Weight change is the earliest sign of a problem with fluid balance. Most people will retain 8 to 15 pounds of excess fluid before they see leg and belly swelling. However, symptoms such as coughing and shortness of breath, loose stools, nausea and feeling full when without eating much may develop at the 5-to-7 pound mark" says Dr. Lewis. He instructs his patients to take action as soon as they notice their weight going up. "Don't wait until you don't feel well, you may have gained 5 or more pounds by then and could be well on your way to a serious problem."
Daily weighing
The best method to monitor your weight is daily weighing. Your goal should be to keep your weight as close as possible to your "dry weight." This is your regular weight when you are not retaining fluid. If you recently have been in the hospital or had your medicines adjusted, you may already know your dry weight. If not, your doctor or nurse can help you determine the right number. To get an accurate picture of your weight trends:
- Record your dry weight and compare you daily scale readings to this number, not the previous day's scale weight. Write down your daily weights in a log or small notebook and bring this record to your doctor visits.
- Stick to a regular daily routine. Even small changes to your regular pattern can alter your weight by 2 pounds or more.
- Weigh yourself at the same time every day using the same scale. A good time is in the morning before you have had breakfast, but after you urinate (a full bladder can add as much as a pound). Weigh yourself without clothing or in underwear only.
Taking action against fluid retention
If you gain more than 2 pounds in a day or 4 pounds in a week, Dr. Eldrin advises taking these steps:
- Think about the foods you ate in the days before your weight gain and look for sources of extra sodium or fluid in your diet that you may be able to eliminate. (For example, did you eat out at a restaurant or indulge in a salty treat?)
- If your weight doesn't return to normal in a day or two, call your doctor or nurse for advice. You may need to increase your diuretic medicine (water pills) or reconsider how much fluid you are drinking.
Image: Rostislav_Sedlacek/Getty Images
FAQs
If too much fluid accumulates, it's not only a sign that heart failure is progressing, but you could also need emergency care, according to Harvard Health. Excessive fluid levels can be life-threatening because it can put too much pressure on key organs, like your lungs or liver.
How does fluid retention affect the heart? ›
As the fluid builds up, the nearby tissues respond by swelling. Cardiac edema occurs when the heart's diseased or overworked left ventricle (heart's lower chamber) isn't able to pump out enough of the blood it receives from your lungs. This causes the heart to hold an excess amount of fluid; therefore, swelling.
What stage of heart failure is edema? ›
Stage C: People show symptoms of heart failure, including fatigue, breathlessness, and edema. However, edema may not be a prominent feature, or it may be milder and localized. Stage D: In stage D, edema becomes more apparent.
Does fluid overload mean heart failure? ›
Causes of heart failure include coronary artery disease, heart attacks, high blood pressure and faulty heart valves. Heart failure can disturb the normal functioning of the kidney, weakening its ability to excrete sodium from the body and triggering mechanisms that cause water retention resulting in fluid overload.
What is the main cause of fluid retention? ›
Some of the many common causes of fluid retention include: Gravity – standing up for long periods of time allows fluid to 'pool' in the tissues of the lower leg. Hot weather – the body tends to be less efficient at removing fluid from tissues during the summer months. Burns – including sunburn.
How do you know if water retention is heart related? ›
When you have heart failure, your heart does not pump out enough blood. This causes fluids to build up in your body. If you consume too much sodium, this can lead to fluid retention. You may get symptoms such as swelling, weight gain, and shortness of breath.
What are three early warning signs your heart is failing? ›
Warning signs and symptoms of heart disease
- Chest Pain. ...
- Shortness of Breath. ...
- Coughing or Wheezing. ...
- Swelling in the Legs, Ankles, or Feet. ...
- Poor Blood Supply to Extremities. ...
- Fatigue. ...
- Fast or Uneven Heartbeat (Palpitations) ...
- When to Call the Doctor.
Symptoms that may indicate that heart failure is getting worse may include:
- increased shortness of breath.
- swelling in the ankles, legs, abdomen, or other parts of your body.
- fatigue.
- chest discomfort.
- sudden weight gain.
- reduced exercise tolerance.
- persistent cough or wheezing.
- increased heart rate.
You may have trouble breathing, an irregular heartbeat, swollen legs, neck veins that stick out, and sounds from fluid built up in your lungs. Your doctor will check for these and other signs of heart failure. A test called an echocardiogram is often the best test to diagnose your heart failure.
What do the final days of congestive heart failure look like? ›
The symptoms of end stage heart disease include trouble breathing, exhaustion, weight loss, changes in skin color, swelling, and abdominal pain all or most of the time. These can progressively worsen. Caring for someone with end stage heart failure may involve providing physical and emotional support.
Most of your hydration should come from water (do not drink sports drinks like Gatorade and PowerAde unless instructed by your health care provider because they have sodium and sugar added). Other examples of fluids are: Sparkling water (no sodium or sugar added) Milk.
What are three things that can worsen heart failure and why? ›
Factors that can worsen symptoms of heart failure
anaemia (a condition where the blood doesn't have enough healthy red blood cells) too much salt, fluid, or alcohol in your diet. pregnancy. some viral and bacterial infections.
What are the worst foods for water retention? ›
Processed, high-salt, high-fat, high-sugar foods and certain dairy products can make oedema worse. What foods to avoid for fluid retention? Avoid high-sodium foods, processed foods, unhealthy fats, and high-sugar beverages to avoid fluid retention.
What is the best drink for water retention? ›
Teas that contain natural diuretic properties include:
- Green tea. Green tea is rich in caffeine, which is a substance that has natural diuretic properties. ...
- Parsley tea. ...
- Dandelion tea. ...
- Horsetail tea. ...
- Hibiscus tea. ...
- Fennel tea. ...
- Linden tea. ...
- Espinheira santa tea.
If the kidneys do not work properly, they cannot remove waste material, including fluids and sodium. The fluid will therefore stay in the body. People with chronic kidney disease, for example, may notice swelling in the lower limbs, hands, or face.
What does stage 3 heart failure look like? ›
Like Stage II of CHF, Stage III can be exacerbated by physical activity. However, symptoms are often much more severe. Shortness of breath, leg weakness, swelling of the lower body, fatigue, and reduced ability to exercise are all notable signs of this advanced stage.
How long can you live with stage 4 congestive heart failure? ›
Most people with end-stage heart failure have a life expectancy of less than 1 year. 4.
Is edema in the legs life-threatening? ›
Is Leg Edema Dangerous? While leg edema itself is generally not life-threatening, if left untreated it can lead to serious complications. Prolonged edema can increase the risk of infections, deep vein thrombosis, and skin breakdown.
What is the prognosis for cardiac edema? ›
Outlook / Prognosis
Pulmonary edema is life-threatening, but your prognosis depends on what caused it. One year after discharge from a hospital, about 50% survive cardiac edema.
