Which is NOT considered a sign of worsening heart failure?

In the context of heart failure, increased exercise tolerance is not considered a sign of worsening heart failure. In fact, a patient experiencing heart failure should typically have reduced exercise capacity due to fluid overload, diminished cardiac output, or other related complications.

Improving exercise tolerance indicates that the heart's function might be stabilizing or improving, which is a positive response to therapy rather than a sign of deterioration. Conversely, weight loss indicating cachexia, elevated levels of brain natriuretic peptide (BNP) or NT-proBNP, and frequent hospitalizations are associated with clinical worsening in heart failure management and suggest that the heart is struggling to meet the body’s demands. These may be signs of worsening fluid status or cardiac function, increasing the risk of adverse outcomes.