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Heart failure - home monitoring

What to Expect at Home

Knowing your body and the symptoms that tell you your heart failure is getting worse will help you stay healthier and out of the hospital. At home, you should watch for changes in your:

  • Blood pressure
  • Heart rate
  • Pulse
  • Weight

When watching out for warning signs, you can catch problems before they get too serious. Sometimes these simple checks will remind you that you forgot to take a pill, or that you have been drinking too much fluid or eating too much salt.

Be sure to write down the results of your home self-checks so that you can share them with your health care provider. Your doctor's office may have a "telemonitor," a device you can use to send your information automatically. A nurse will go over your self-check results with you in a regular (sometimes weekly) phone call.

Throughout the day, ask yourself:

  • Is my energy level normal?
  • Am I getting more short of breath when I am doing my everyday activities?
  • Are my clothes or shoes feeling tight?
  • Are my ankles or legs swelling?
  • Am I coughing more often? Does my cough sound wet?
  • Do I get short of breath at night?

These are signs that there is too much fluid building up in your body. You will need to learn how to limit your fluids and salt intake to prevent these things from happening.

Checking Your Weight

You will get to know what weight is right for you. Weighing yourself will help you know if there is too much fluid in your body. You might also find that your clothes and shoes are feeling tighter than normal when there is too much fluid in your body.

Weigh yourself every morning on the same scale when you get up -- before you eat and after you use the bathroom. Make sure you are wearing similar clothing each time you weigh yourself. Write down your weight every day on a chart so that you can keep track of it.

Call your health care provider if your weight goes up by more than 3 pounds in a day or 5 pounds in a week. Also call your health care provider if you lose a lot of weight.

Checking Your Heart Rate and Pulse

Know what your normal pulse rate is. Your health care provider will tell you what yours should be.

You can take your pulse in the wrist area below the base of your thumb. Use your index and third fingers of your other hand to find your pulse. Use a second hand and count the number of beats for 30 seconds. Then double that number. That is your pulse.

Your health care provider may give you special equipment to check your heart rate.

Checking Your Blood Pressure

Your health care provider may ask you to keep track of your blood pressure at home. Make sure you get a good quality, well-fitting home device. Show it to your doctor or nurse. It will probably have a cuff with a stethoscope or a digital readout. 

Practice with your provider to make sure you are taking your blood pressure correctly.

Blood pressure

Watch this video about:
Blood pressure

When to Call the Doctor

Call your health care provider if:

  • You are tired or weak.
  • You feel short of breath when you are active or when you are at rest.
  • You are wheezing and having trouble breathing.
  • You have a cough that does not go away. It may be dry and hacking, or it may sound wet and bring up pink, foamy spit.
  • You have swelling in your feet, ankles, or legs.
  • You have to urinate a lot, especially at night.
  • You have gained or lost weight.
  • You have pain and tenderness in your belly.
  • You have symptoms you think might be from your medicines.
  • Your pulse or heartbeat gets very slow or very fast, or it is not regular.
  • Your blood pressure is lower or higher than is normal for you.


Januzi JL, Mann DL. Clinical assessment of heart failure.  In: Mann DL, Zipes DP, Libby P, et al. eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 23.

Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009 Apr 14;119(14):1977-2016. Epub 2009 Mar 26.

Mant J, Al-Mohammad A, Swain S, Laramée P; Guideline Development Group. Management of chronic heart failure in adults: synopsis of the National Institute for Health and Clinical Excellence guideline. Ann Intern Med. 2011 Aug16;155(4):252-9.

Riegel B, Moser DK, Anker SD, Appel LJ, Dunbar SB, Grady KL, Gurvitz MZ, Havranek EP, Lee CS, Lindenfeld J, Peterson PN, Pressler SJ, Schocken DD, Whellan DJ; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Cardiovascular Nursing; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Nutrition, Physical Activity, and Metabolism; American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research. State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation. 2009 Sep 22;120(12):1141-63.

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013 Oct 15;128(16):e240-327. Epub 2013 Jun 5.

Review Date: 8/12/2014
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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