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Use this form to describe the severity of your heart failure symptoms and whether they get worse. Also, record any new symptoms that develop. Take this form with you when you visit your doctor.
Describe severity of symptoms and when they started
Shortness of breath
Swelling in your legs or ankles
Sudden weight gain
Tiredness or weakness
Dizziness or feeling like you might faint
Not sleeping well
Current as of: September 7, 2022
Author: Healthwise Staff
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
George Philippides MD - Cardiology
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