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Cardiac Decompensation Symptoms

By Dr. Tina M. St. John ; Updated August 14, 2017

Cardiac failure is a chronic condition wherein a structural abnormality or disease limits the heart's capacity to pump an adequate amount of blood through the body. Medications augment heart function in people with cardiac failure, also known as heart failure. Cardiac decompensation is a sudden worsening in symptoms associated with heart failure. This situation may occur due to the progression of cardiac failure or a change in circumstances, such as missing doses of medication or the development of an infection or anemia.

Increasing Shortness of Breath

Patients with heart failure characteristically have some degree of shortness of breath. People with mild disease experience this symptom only with substantial physical exertion whereas those with severe disease may become breathless with minimal activity. Increasing shortness of breath associated with less physical exertion than previously experienced is a common symptom of cardiac decompensation. The symptom occurs due to oxygen deprivation in the tissues resulting from sluggish blood flow and fluid leakage into the lung air sacs.

Wheezing and Coughing

Weakening of the heart muscle associated with cardiac decompensation causes sluggish blood flow and increased pressure in the blood vessels transporting blood from the lungs to the heart. Under the influence of increased pressure, fluid leaks from the blood vessels into the lung tissues, congesting the air sacs. The presence of fluid in the air sacs, or pulmonary edema, commonly triggers wheezing and coughing. Cough associated with pulmonary edema is characteristically worsened by lying down, which further increases the pressure in the lung blood vessels. Coughing associated with pulmonary edema often produces foamy mucus, which may be tinged with blood.

Worsening Fatigue

Cardiac decompensation indicates a decline in the volume of oxygen-rich blood reaching the body tissues. Oxygen fuels the body's energy needs; decreased oxygen availability compromises the body tissues; capacity to fuel normal metabolic activities. This situation manifests as a pervasive feeling of fatigue, or tiredness. People with a sudden decline in cardiac function commonly experience worsening fatigue.

Tissue Edema

Sluggish blood flow due to cardiac decompensation can increase blood pooling and pressure in body tissues beyond the lungs. Fluid leakage occurs in this circumstance, causing swelling, or edema, in various body tissues. Increased edema in the lower legs, feet and hands commonly occurs with cardiac decompensation. Fluid may also accumulate in the abdomen, causing abdominal distention and an associated increase in body weight. Fluid accumulation in the chest cavity around the lungs, called pleural effusion, characteristically aggravates breathlessness and air hunger.

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