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Patient Education

Heart Health Library

Our Health Library does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their heart health. Our providers may not see and/or treat all topics found herein.

Our Health Library information does not replace the advice of a doctor. Please be advised that this information is made available to assist our patients to learn more about their health. Our providers may not see and/or treat all topics found herein.

Heart Failure: Symptom Record

Overview

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.

Symptoms

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



 

Other symptoms



 

Related Information

Credits

Current as of: June 24, 2023

Author: Healthwise Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Heart Topics

Browse our library of medical conditions and treatments

Heart Topics | Heart and Circulation | Heart Conditions

Symptom Checker

A body map to help you find and learn more about your symptoms.

Symptom Checker

Medical Tests

Learn more about your diagnostic exam.

Medical Tests

Medications

Get important information regarding your medications

Medications

Healthy Lifestyles

Tips on how to stay healthy

Healthy Eating | Weight

Interactive Tools

Tips on how to stay healthy

Take your first step to better health.

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