Heart conditions or structural damage to the heart can reduce blood flow throughout the body, leading to the heart working excessively to supply nutrients to the organs. When this phenomenon continues for an extended period, heart function weakens, and the heart can no longer fulfill its task of pumping blood to nourish the body, a condition known as decompensated heart failure.
What is Decompensated Heart Failure?
1. What is decompensated heart failure?
According to Cardiologist Dr. Vu Thi Tuyet Mai, decompensated heart failure is a clinical syndrome where the structure and function of the heart change, preventing it from supplying blood to the entire human body. At this point, the symptoms of heart failure become increasingly pronounced.
Acute decompensated heart failure accounts for 80% of cases of acute heart failure requiring hospitalization, while the remaining 20% are first-time occurrences of acute heart failure.
2. Causes of decompensated heart failure
Some causes leading to decompensated heart failure include:
- Decompensated heart failure developing from congestive heart failure: this is the most dangerous case as it is unlikely to be successfully treated.
- Decompensated heart failure due to cardiovascular diseases such as coronary artery disease, myocardial ischemia, and hypertension.
Other causes include:
- Acute pulmonary edema
- Systemic infections
- Viral infections affecting the heart
- Anaphylactic shock
- Severe arrhythmias
- Cardiac or artificial lung surgery.
3. Symptoms of decompensated heart failure
Unlike compensated heart failure, which does not show symptoms, decompensated heart failure presents very clearly and increasingly severe symptoms, including:
- Anxiety and poor appetite
- Memory loss
- Excessive sweating
- Shortness of breath, coughing during exertion, paroxysmal nocturnal dyspnea, and worsening symptoms when lying down
- Low blood pressure
- Strong heartbeat
- Swelling in limbs, soft edema, and pitting edema.
Unlike compensated heart failure, which does not show symptoms, decompensated heart failure presents very clearly.
As the disease progresses, the above symptoms become more pronounced and severely affect the patient’s quality of life. Patients may also suffer from myocardial infarction and stroke.
For elderly patients, those with weakened immune systems may not detect the symptoms of decompensated heart failure.
4. Treatment for decompensated heart failure
The goal of all treatment methods for decompensated heart failure is to stabilize symptoms to prevent further damage to the heart and preserve kidney function. Treatment methods include:
Medication
The medications commonly prescribed by doctors include:
- Diuretics: help reduce kidney volume overload, lessen the burden on the heart, and alleviate edema
- Vasodilators: decrease venous tension, reducing respiratory distress
- Inotropic agents: enhance the heart’s contractility
- Antiarrhythmic drugs
- Anticoagulants: prevent the formation of blood clots, which can lead to strokes and myocardial infarctions.
Surgical intervention
If oral medications do not effectively treat decompensated heart failure and symptoms worsen, doctors may consider surgical procedures such as:
- Coronary artery bypass surgery: If heart failure is caused by coronary artery disease, this method is chosen to enhance blood flow to the heart.
- Heart valve repair/replacement surgery: for patients with decompensated heart failure due to valvular heart disease.
- Pacing device implantation: helps stabilize heart rhythm and prevent further disease progression.
- Implantable cardioverter-defibrillator: this device normalizes heart rhythm if abnormalities are detected.
- Ventricular assist device: this device is implanted in the chest and abdomen to help the heart pump blood more effectively.
- Heart transplantation: when heart failure becomes severe and no treatment options remain effective, doctors will consider heart transplantation for the patient.
Lifestyle changes
In addition to medication and surgical intervention, patients need to adopt a scientific lifestyle to help improve their symptoms:
- Follow a heart-healthy diet: increase fruits, vegetables, whole grains, and healthy fats in the diet; reduce salt (below 1.5g/day), sugar, and foods high in unhealthy fats.
- Engage in at least 30 minutes of physical activity daily. Start with light exercises and gradually increase intensity based on ability.
- Avoid tobacco (both active smoking and passive exposure).
- Ensure full vaccinations to prevent infections.
- Regular cardiovascular check-ups: at least once a year or when unusual symptoms arise.
5. Prevention of decompensated heart failure
To prevent decompensated heart failure:
- For patients with cardiovascular diseases who have not yet progressed to heart failure, it is essential to follow treatment as directed by a doctor to prevent heart failure.
- For individuals who have lost significant blood due to accidents or surgeries, it is crucial to replenish nutrients after recovery.
- Avoid smoking to prevent increased heart rate, hypertension, and reduced blood oxygen levels. Smoking is also a contraindication for heart transplantation.
- Limit alcohol consumption.
- For overweight or obese individuals, weight loss and maintaining a suitable diet and exercise regimen are essential. Consulting with a nutritionist may be necessary.
- Reduce salt intake.
- Lower fat and cholesterol intake in the diet.
- Maintain a daily exercise routine.
- Minimize stress and anxiety in life.
