Decompensated

Decompensated heart failure is a critical phase of heart failure where the heart is unable to pump sufficient blood to meet the body's needs. This condition is marked by severe symptoms and often requires immediate medical intervention. Decompensation can occur in a patient with a history of heart failure or as the first manifestation of heart disease.

Causes

Decompensated heart failure can be triggered by several factors, including:

• Inadequate adherence to heart failure medications
• Hypertension (high blood pressure)
• Myocardial infarction (heart attack)
• Arrhythmias (abnormal heart rhythms)
• Infections that affect the heart
• Anemia
• Excessive intake of fluids or salt
• Kidney failure

Symptoms

Symptoms of decompensated heart failure may include:

• Severe shortness of breath
• Edema (swelling), particularly in the legs, ankles, and feet
• Rapid weight gain due to fluid retention
• Fatigue and weakness
• Persistent cough or wheezing with white or pink blood-tinged phlegm
• Increased heart rate

Diagnosis

Diagnosis of decompensated heart failure involves a combination of medical history, physical examination, and diagnostic tests, including:

• Echocardiogram to assess heart function
• Blood tests to measure levels of certain substances like natriuretic peptides
• Chest X-ray to view the heart and lungs
• Electrocardiogram (ECG or EKG) to record the heart's electrical activity

Treatment

Treatment aims to improve symptoms, stabilize the patient, and prevent further heart damage. Strategies include:

• Medication adjustments, including diuretics to reduce fluid overload, ACE inhibitors or ARBs, beta-blockers, and aldosterone antagonists
• Intravenous medications for rapid symptom relief in the hospital setting
• Lifestyle modifications, such as dietary changes and fluid restriction
• Monitoring and managing triggers, such as hypertension and arrhythmias
• In severe cases, mechanical support devices or surgery may be considered

Prevention

Preventing decompensation in patients with heart failure involves:

• Close monitoring of heart failure symptoms
• Adherence to prescribed treatment regimens
• Regular follow-up with a healthcare provider
• Lifestyle changes, including diet, exercise, and avoiding tobacco and alcohol

See Also

• Cardiomyopathy
• Heart failure
• Pulmonary edema