Patient education: When your lungs fill with fluid (The Basics)

Why do your lungs fill with fluid when you have heart failure? — When you have heart failure, your heart does not pump as well as it should. It does not squeeze or fill as well as before. As a result, the heart struggles to keep blood moving, but it lags behind. The organs in your body might not get as much blood as they used to, especially when you exercise. Also, fluid builds up in the body.

Fluid can build up in the feet and ankles. That's why people with heart failure sometimes get swollen ankles (figure 1). Fluid can also build up in the lungs. That's why people with heart failure sometimes have trouble breathing. Having fluid in the lungs can be life-threatening. Fluid in the lungs is the number 1 reason people with heart failure end up in the hospital. But it is often avoidable.

To keep heart failure from getting worse, and to keep yourself breathing as well as possible, one of the most important things you can do is to keep your body from holding onto extra fluid. That's why it is so important to take your medicines for heart failure and look for warning signs. These 2 things are explained more below.

Why are medicines for heart failure so important? — Medicines to treat heart failure can help you feel better and live longer. They can help keep fluid out of your lungs and help you breathe better. Missing just one dose of medicine can make a big difference in how you feel.

One type of heart failure medicine is a "diuretic" (sometimes called a water pill). A diuretic helps the body get rid of extra salt and fluid. That way fluid is less likely to build up in the ankles, belly, or – most importantly – the lungs.

Some people skip their diuretic because they do not like having to go to the bathroom all the time. But if you are going to the bathroom a lot to urinate, that means the medicine is working. It means your lungs are less likely to fill with fluid.

Ask your doctor or nurse which of your medicines is a diuretic. The most commonly used diuretic for heart failure is called "furosemide" (brand name: Lasix).

Are there warning signs that my lungs are filling with fluid? — Yes, often there are! When heart failure is getting worse, the body gives off the following clues:

●Weight gain

●Increased swelling in the feet, ankles, legs, or other parts of the body

●Increased tiredness or trouble breathing

If you spot one or more of these signs, you should take action. Your body is telling you that things are starting to go wrong.

You and your doctor or nurse can write up an "action plan." The action plan will tell you what to do if you spot signs that your heart failure is getting worse (figure 2 and figure 3).

Why must I weigh myself every day? — Water is heavy, so your weight will go up if your body is holding onto extra fluid. If you weigh yourself every day, you will know right away when fluid starts to build up. Weight gain can be an early sign that your heart failure is getting worse. If you spot a weight change, you can take steps to keep the problem from getting worse.

Here's what you should do:

●Weigh yourself every morning after you urinate and before you eat or drink.

●Use the same scale and wear roughly the same amount of clothing (or wear nothing) every time you weigh yourself.

●Keep a chart near the scale and write down your weight every day.

●Each time you write down your weight, check if the number has gone up from the day before and the week before. If so, follow your action plan.

For most people, a weight gain of 2 to 3 pounds in 1 day is cause for concern. Gaining 5 pounds in 1 week is also a bad sign. Weight gains like these are often signs that your body is holding onto extra fluid.

Why must I check for swelling every day? — If you become swollen, that's another sign that your body is holding onto extra fluid. If any part of your body looks more swollen than usual, don't ignore it. Even if you do not feel any differently than usual, this might be a sign that your heart failure is worse.

Follow an action plan! — Now that you know how to spot the clues that your heart failure is getting worse, you need to know what to do if you notice those changes. Ask your doctor or nurse to fill out an action plan with you. An action plan is a set of instructions on what to do if you have changes in symptoms (figure 2 and figure 3).

Take your action plan seriously. Keep it on the refrigerator or someplace where you can easily find it. If you follow your action plan closely, you might be able to avoid a trip to the hospital or know when it is important to call an ambulance to go to the hospital.

More on this topic

Patient education: Heart failure (The Basics)
Patient education: Medicines for heart failure with reduced ejection fraction (The Basics)
Patient education: Low-sodium diet (The Basics)
Patient education: Side effects from medicines (The Basics)
Patient education: Coping with high drug prices (The Basics)

Patient education: Heart failure (Beyond the Basics)
Patient education: Low-sodium diet (Beyond the Basics)
Patient education: Coping with high prescription drug prices in the United States (Beyond the Basics)