Decompensated heart failure

Decompensated heart failure is the term used to define heart incapacity of pumping enough blood in the main arteries, according to the organism needs. What distinguishes decompensated heart failure from a compensated heart failure is the fact that defensive mechanisms are not efficient anymore and the blood amount delivered to the tissues is no longer sufficient, which determines a variety of symptoms as we are going to reveal next.
How do you know you have a decompensated heart failure and if u need to go to the hospital? Decompensated heart failure has different manifestations, as following:

•  when the left heart is inefficient, blood will stagnate into the heart chambers forcing them to enlarge or increase the number of muscle fibers in order to increase cardiac force; this is a defensive mechanism, which will compensate for a while the inefficient function of the heart. Once this mechanism is no longer able to control the situation, blood will stagnate in the lungs, increasing the pressure in the pulmonary vessels and from this point on, pulmonary edema (accumulation of water in the lungs) and pulmonary hypertension may occur. All these manifestations are a sign that the heart can no longer compensate its diminished function, so we are facing a decompensated heart failure.
•  in right heart insufficiency, cardiac muscle won’t be able to pump blood into the pulmonary arteries, so the blood will flow back in the venous system, determining accumulation of water in different tissues (lower limbs, abdomen-ascites, pleural space).

In clinical practice, people with decompensated heart failure will experience important shortness of breath, being unable to breathe while lying (a condition known as orthopnoea), blue color of the lips and limbs extremities, fatigue, palpitations or rapid heart beats, incapacity of performing daily activities. In more advanced cases, hypotension, fainting, ischemia of lower limbs, stroke or renal failure may occur, these manifestations being the consequence of the low blood flow in the arteries that feed the brain, kidney, or limbs.

What is the cause for decompensated heart failure?

There are many causes for decompensated heart failure, the most important ones are the following:

•  hypertension-if patients don’t follow the treatment, high blood pressure will increase the labor of an already weak heart, making it impossible to accomplish body needs,
•  salt intake-will favor water accumulation in the body, increasing blood volume and requesting a higher cardiac labor,
• infections: respiratory infections, heart wall infections like myocarditis,
• heart attacks, arrhythmia,
• weight gain is common cause of decompensated heart failure,
• patients that no longer respect their heart medication,
• patients that continue to smoke, drink alcohol, with high levels of blood lipids etc.

What are the steps to follow in decompensated heart failure ? People in this condition must be admitted to hospital, carefully watched, investigated for different conditions that might have provoked decompensated heart failure and follow a well established therapy (diuretics and cardiotonic medication will be needed in order to eliminate the overload of water and increase cardiac muscle force).
People with heart failure will have a different number of hospital admissions, followed by „free” periods of time, when the symptoms will be stable. However, the compliance to medical recommendations will determine how fast this disease will evolve, together with the other conditions we enumerated above. Despite the correct treatment and compliance of the patient, heart failure will progress until the only option left is cardiac transplant, but the speed of this evolution can be controlled by avoiding the conditions that favor heart failure to decompensate.

Please call your doctor to find out mode about decompensated heart failure.