About Cardiac Decompensation

Cardiac decompensation is the failure of the heart to provide sufficient circulation to body tissues. Body tissues rely on a steady supply of blood to both provide oxygen and carry away wastes. Cardiac decompensation can be acute, having a sudden onset, like shock. Cardiac decompensation can also occur due to chronic health problems, as in congestive heart failure.

Importance of Oxygen

• When the heart fails to pump enough blood, the body is deprived of oxygen. The cells of the body rely on oxygen to perform cellular respiration--the cellular level process by which energy is produced from glucose or other high-energy molecules. Energy is produced in the form of ATP. ATP is a molecule that is an efficient form of stored energy readily used by the cell. The cells depend on ATP to carry out necessary functions like protein formation and the maintenance of nutrients in the cell body.

Waste Removal

• Energy production in the cell also produces wastes. Wastes like carbon dioxide and water are carried in circulation away from the tissues of the body. The wastes are carried to the lungs, where they are expelled from the body during exhalation. Tissue damage, and ultimately death, occurs if wastes are allowed to build up due to poor circulation.

Shock

• Shock results from the sudden failure of the heart, blood vessels or blood itself to perform their required functions. When the body goes into shock its primary response is to compensate in order to restore normal functioning. For example, when shock occurs due to a large blood loss--called hemorrhagic shock--the body compensates by constricting the blood vessels and increasing respiratory rate. This initial response keeps oxygen and nutrients flowing to the tissues.The body cannot continue to compensate for long, however. The respiratory rate soon slows and blood pressure drops. This stage is called decompensation.

  Once decompensation occurs, a patient's health can quickly proceed to irreversible shock. Irreversible shock occurs when the body can no longer circulate blood to vital tissues. Even if the patient regains normal heart and respiratory rates, the deprivation of blood to vital organs can result in organ failure and death--even days later.

Congestive Heart Failure

• Congestive heart failure is a syndrome, or collection of symptoms, that occurs when the heart is not pumping effectively enough to move fluids through the body. The heart slowly fails. The result of cardiac decompensation in terms of congestive heart failure is the buildup of fluid in the lungs and other tissues. Fluid buildup in the extremities like the hands, feet and face causes swelling, or edema. Fluid buildup in the lungs impairs respiratory function, further reducing the delivery of oxygen to the tissues and the removal of wastes from the body.

Prevention/Solution

• Congestive heart failure can be treated with medication, changes to diet and exercise under the supervision of a physician. You can learn to recognize the early signs of shock before it progresses to cardiac decompensation. The early symptoms of shock are increased heart rate, increased respiratory rate, pale, cool and clammy skin, and diminished mental function. To treat a patient in the early stages of shock, first lay him down. Cover him with a blanket to maintain body heat. Raise his feet slightly above the level of the heart. Do not raise his legs if he has undergone any trauma to the head or spine. Finally, give the patient oxygen if it is available.