Symptom: Swelling and Sudden Weight Gain

Reviewed by: HU Medical Review Board | Last reviewed: November 2019

Swelling, often referred to by the medical term edema, occurs when fluid builds up in the body tissues.1-2 When the swelling is associated with heart failure it describes congestion, meaning the fluid is trapped in the tissues. Edema can also be caused by medications, pregnancy, or other underlying medical conditions including kidney and liver disease.2


When the heart is weak and cannot pump blood as effectively, blood flow can slow down.2-3 As this happens, there is an increased amount of fluid in the blood that is returning to the heart and it can begin to back up. This back up of fluid is called edema or swelling. Swelling or fluid build-up causes weight gain.

Swelling is most commonly found in the feet, ankles, or lower legs, but can occur anywhere in the body.2,4 If fluid accumulates in the lungs, known as pulmonary edema, it makes breathing more difficult and can lead to shortness of breath.2,3 Fluid buildup can also build up in the abdomen causing swelling and discomfort in the abdomen. This can be uncomfortable and can interfere with eating and digestion. At the same time, the kidneys struggle to keep up with eliminating the extra fluid which includes sodium and water, adding to the congestion.1

Pitting edema is a kind of swelling that can be a sign of heart failure or other medical conditions. It is characterized by a dimple or indentation that develops when you press into your finger into your skin and the mark does not immediately disappear.2,4

Worsening symptoms

Keep a lookout for symptoms for worsening heart failure. These include:5-6

  • A sudden weight gain of 2–3 pounds in a single day or 5+ pounds in one week
  • Increased swelling in the feet or ankles
  • Swelling or pain in the abdomen

Try keeping track of your daily weight. This may alert you to any changes in your heart condition before you feel other symptoms.7 Similarly, if the shoes you wear regularly are suddenly tight or your pants are too tight in the waste, then call your healthcare team and let them know about these changes.7

Management strategies

Managing heart failure generally involves taking medications, making lifestyle changes including regular exercise, eating a low sodium diet and limiting fluid intake. Monitor yourself for any changes in new or worsening heart failure signs or symptoms.8 Weight gain due to fluid retention is different from weight gain due to a high-calorie diet.6 Controlling fluid intake will likely be recommended by your healthcare team.2 They will advise how much fluid and salt you should consume, as well as prescribing the use of diuretics. Diuretics, also known as water pills, help your body increase the amount of water and salt eliminated as urine.9

Some tips to help you reduce your fluid intake when you are thirsty:3

  • Use a smaller cup
  • Distribute your fluid intake over the course of the day
  • Drink very cold or very hot fluids, they are harder to guzzle when you are thirsty
  • Suck on an ice cube, frozen fruit, cough drops or hard candy
  • Limit caffeine and alcohol
  • Chew gum
  • Swab your mouth

When to call your healthcare team

If you experience an unexplained change in weight, or a sudden increase of swelling in your feet, ankles, legs, or abdomen, call your doctor or nurse. It is better to report a change in symptoms before they lead to more severe complications.8

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