Techniques are provided for use by an implantable medical device or diagnostic sensor for detecting and discriminating euvolemia, hypervolemia and hypovolemia. In one example, the device detects a pressure signal within the patient representative of changes in cardiac pressure overall several cardiac cycles. The device generates separate time-domain and frequency-domain representations of the pressure signal and then discriminates among euvolemia, hypervolemia and hypovolemia within the patient based on an analysis of the time-domain and the frequency-domain representations of the signal. Depending upon the capabilities of the device, suitable warnings may be generated to alert the patient or caregiver. Diuretics or other medications can be titrated to address abnormal fluid conditions such as a fluid overload during hypervolemia. Techniques for detecting a pressure alternans pattern indicative of imminent decompensation are also described.