Cardiac decompensation is a complication of heart failure that may require emergency hospitalization. We take stock of the causes, signs and treatments.
Cardiac decompensation is the complication of heart failure, a common pathology in Old personaffecting up to 10% of the over 70s according to Public Health France. Among the signs, cardiac decompensation is manifested by palpitations, malaise, shortness of breath, And of the edema may appear. What is the difference between the right heart decompensation and left? What causes cardiac decompensation? What treatments in case of cardiac decompensation?
Definition: what is cardiac decompensation?
Cardiac decompensation is a complication of heart failure : it occurs when the mechanisms activated by the body to compensate for the deficiency no longer work properly. In the case of heart failure, the heart becomes weak and unable to pump the amount of blood it needs to the needs of the organization. The symptoms are then fatigue, palpitations and shortness of breath during usual activities, then during less than usual activity and finally at rest. Cardiac decompensation occurs when these compensatory mechanisms are no longer sufficient. In the case of global cardiac decompensation, it is the entire heart (right and left) that is affected. The symptoms can then be a change in the pulse, palpitations, the occurrence of discomfort when changing position with a drop in blood pressure. Lower limb edema is associated with shortness of breath testifying toacute pulmonary edema (OAP). Emergency hospital treatment is recommended.
Left heart decompensation
In the case of left heart decompensation, acute pulmonary edema (APO) appears. It’s about a intense dyspnoea (difficulty breathing) which manifests itself suddenly, sometimes in a dramatic picture that can be life-threatening. OAP requires you to stay in a seated position to breathe, which can be very distressing. This emergency situation requires immediate attention to the hospital to set up respiratory support and drainage of the edema.
Right heart decompensation
In the case of a right heart decompensation, the liver is affected with a significant increase in its size and pain on palpation and during exertion (hepatalgia). It is generally characterized by digestive disorders such as nausea, vomiting, bloating, but also a jaundice (jaundice), edema important lower limbs and very rapid weight gain (due to water retention). Emergency hospital treatment is necessary to evacuate the edema quickly.
What are the signs of cardiac decompensation?
Symptoms of cardiac decompensation appear when the heart is overwhelmed and can no longer send blood efficiently to the whole body. Depending on which part of the heart is affected (right, left or global), symptoms can range from dyspnea (left involvement) has edema of the lower limbs (right reach). In all cases, cardiac decompensation causes impaired general health, drops in blood pressure, cognitive impairment and anxiety.
What causes cardiac decompensation?
Cardiac decompensation can be due to several causes, including: infection (most often pulmonary), a myocardial ischemia (heart attack), a chronic anemia, heart rhythm disturbances, pulmonary embolism, overhydration, or pregnancy. It can also result from the aggravation of a renal or respiratory failure. Cardiac decompensation may be related to a medical treatment : non-compliance or discontinuation of treatment, deviation from diet (excess salt), recent intake of non-steroidal anti-inflammatory treatment. The risk factors for cardiac decompensation are the same as those for heart failure:
- THE smoking,
- excess LDL-cholesterol,
- high blood pressure arterial,
- obesity,
- THE diabetes,
- addiction to the alcohol,
- physical inactivity,
- untreated hyperthyroidism,
- untreated sleep apnea syndrome.
The diagnosis of cardiac decompensation is based on a clinical examinationand on additional examinations such as electrocardiogram, chest x-ray and cardiac echo-doppler. As soon as difficulty breathing or edema of the lower limbs appears, an emergency consultation is required. Management is generally hospitalized in a cardiology department.
Cardiac decompensation requires emergency hospital care in a cardiology department. A oxygen therapy in case of breathing difficulties is necessary. Some drugs then improve the pumping function of the heart and reduce symptoms such as angiotensinogen converting enzyme (ACE) inhibitorsTHE beta-blockers and especially diuretics which allow the edema to be evacuated.
Afterwards, preventive measures such as certain simple dietary measures (salt-free diet, fluid restriction, quitting smoking) and taking a background treatment against heart failure are necessary to avoid decompensation. “The prevention of cardiac decompensation is that of its causes, in particular cardiovascular diseases. The fight against high blood pressure, excess cholesterol, obesity and diabetes, as well as regular physical activity and smoking cessation are the most effective preventive measures“, confirms Dr. Claire Lewandowski, specialized in general medicine, psychiatry, addictology and victimology.