Which vital sign change could indicate worsening heart failure?

An increased respiratory rate is an important vital sign change that can indicate worsening heart failure. In heart failure, the heart's ability to pump blood effectively is compromised, leading to fluid buildup in the lungs (pulmonary congestion). As this fluid accumulation occurs, oxygen exchange is hindered, prompting the body to compensate by increasing the respiratory rate in an attempt to enhance oxygen intake and maintain adequate oxygen levels in the bloodstream. This response can manifest as tachypnea (rapid breathing) and is a critical sign for healthcare providers to monitor in patients with heart failure.

In contrast, a decreased heart rate may not directly correlate with the worsening of heart failure and can sometimes occur due to medications or changes in the autonomic nervous system, which need not reflect more severe heart failure. Stable blood pressure generally indicates that the patient's cardiovascular system is functioning relatively consistently, and may not highlight an acute change in status. Increased temperature may suggest infection or inflammation but is not a hallmark of heart failure itself. Thus, an increased respiratory rate is a key indicator of deteriorating heart function and deserves careful observation in patients with heart failure.