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Heart Failure: Symptom Record

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Heart Failure: Symptom Record

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Overview
Credits

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

Credits

Current as of: September 7, 2022

Author: Healthwise Staff
Medical Review:
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
George Philippides MD - Cardiology

Current as of: September 7, 2022

Author: Healthwise Staff

Medical Review:Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology & Martin J. Gabica MD - Family Medicine & Adam Husney MD - Family Medicine & George Philippides MD - Cardiology

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

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