Breadcrumb

Home
Illnesses & Conditions
Heart Health and Stroke
Heart Failure: Symptom Record

Print
Feedback
Email a link
Share

Content Map Terms

Heart Failure: Symptom Record

Topic Contents

Topic Overview
Credits

Topic 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: August 31, 2020

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: August 31, 2020

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.

About This Page
General Feedback
Email Link
Physical Activity Services

We appreciate your feedback. Comments submitted through the form below can help us fix errors in page content, get rid of interface bugs, and update the HealthLinkBC website to better suit the needs of the people who use it.

To submit feedback about this web page, please enter your comments, suggestions, compliments or questions in the form below. To submit general feedback about the HealthLink BC website, please click on the General Feedback tab.

Page

Feedback Regarding:

Content

Functionality

Message:

Your name:

Your email:

Do you want a reply?

Yes

Leave this field blank

To submit general feedback about the HealthLink BC website, please enter your comments, suggestions, compliments or questions in the form below. To submit feedback about a specific web page, please click on the About This Page tab.

Please note that we are unable to provide general health information or advice about symptoms by email. For general health information or symptom advice, please call us at 8-1-1 any time of the day or night.

For questions about food and nutrition, please click on Email a HealthLinkBC Dietitian.

What is your message about?

Message:

Your name:

Your email:

Leave this field blank

To share this link, enter the information below and click on the "submit" button.

Fields marked with an asterisk (*) are mandatory.

To (email):

From (email):

Message:

Leave this field blank

There are many ways you can add physical activity to your healthy lifestyle, no matter your age or activity level. Ask us your physical activity question. Physical activity related questions will be answered by one of HealthLink BC’s qualified exercise professionals.

To submit your question about physical activity, please complete the form below.

For questions not related to physical activity, please use the General Feedback tab.

indicates required fields

Terms and Conditions

Please read and accept our Terms and Conditions.

I accept.

Consent

You may be sharing personal information when you submit this form. Consent is required to receive a reply. Please confirm that you are providing consent to receive a reply from physical activity services with your non-encrypted personal information submitted in the email below, and that you understand and accept the risks of sending / receiving your personal information through email. Please do not submit personal information or requests on behalf of someone else unless you are the parent or guardian of a minor who is incapable of acting on their own behalf.

I consent.

Your name:

Your email (Please make sure the email address you have entered is accurate)

Please select one of the following:

Female

Male

Age (in years)

Postal Code (no space)

Enter your physical activity question here:

Leave this field blank