Heart failure: you can recognize acute decompensation by these warning signs
In patients with heart failure, acute decompensation can occur during the course of the disease, in which the function of the heart suddenly deteriorates massively. However, if recognised in time, the decompensation process can be slowed down under certain circumstances. The warning signs you should pay particular attention to are discussed below.
What happens in the event of decompensation?
In heart failure, the heart becomes too weak to pump enough blood to meet the body’s needs. At first, your body tries to compensate—that means it works behind the scenes to keep things running smoothly. It does this by:
- Raising your blood pressure
- Holding on to salt and water to increase blood volume
- Making your heart beat faster and harder
These changes help for a while, and you might not notice any symptoms. This stage is called compensated heart failure.
Decompensation Over time, the heart gets more strained, and the body’s tricks stop working. This is called decompensated heart failure. That’s when symptoms become more noticeable, such as:
- Shortness of breath, even at rest
- Fatigue and low energy
- Swelling in the legs or belly (called oedema)
- Frequent nighttime urination
- Coughing at night or while lying down
These signs mean the heart is no longer able to keep up, and medical treatment is needed.
Acute decompensation: when the heart suddenly fails
A slow, gradual deterioration in heart function is typical of the natural course of chronic heart failure. Under certain circumstances, however, the performance of the heart can also deteriorate massively and very suddenly in those affected. The causes of such acute decompensation are usually factors that put additional strain on the already weakened heart. These include, for example
- Inflammations or infections
- Major surgical interventions
- Liver or kidney disease
- Disorders of the electrolyte balance
- Anemia
- Incorrect intake of prescribed heart medication
How can I recognise an imminent acute decompensation?
Acute decompensation is a serious complication of heart failure and can lead to life-threatening consequences such as shock or sudden cardiac death. Last but not least, any decompensation can cause lasting damage to the heart muscle and worsen the heart failure. Treatment as quickly as possible is therefore essential in order to eliminate the triggers, optimise drug therapy and improve heart function again.
For this reason, it is particularly important for heart failure patients to monitor their body closely. This is because acute decompensation does not usually come on suddenly, but often announces itself a few days in advance through various warning signs. You should be particularly alert if you notice the following changes:
- New or worsening swelling (oedema) of the ankles and lower legs
- Significant and rapid increase in weight or abdominal girth
- Increased respiratory rate
- Shortness of breath even with little exertion
- Persistent cough
- Palpitations
- Cold extremities
- Small amounts of urine
- Tiredness
A weight diary helps to recognise water retention
Weight gain in particular can be an important warning sign that the body is beginning to retain more water if eating habits remain unchanged. Ideally, you should therefore weigh yourself daily, preferably every morning immediately after getting up and urinating. In order to recognize even minor weight changes, you should always weigh yourself undressed and on the same scale. A weight diary, in which you record your weight daily, helps you to keep track of your body weight. If you gain one to two kilograms within two to three days or more than 2.5 kilograms in a week, you should consult your doctor.
Recognise decompensation before symptoms occur
Based on the typical symptoms, acute decompensation can often be recognised a few days in advance. However, changes in heart function that are not perceptible to the person affected, but require the use of technical aids, become apparent even earlier. These include, for example, increased pressure in the pulmonary artery or fluctuations in the heart rate. With the help of small, implantable measuring probes, it is now possible to permanently monitor the heart function of selected patients with regard to such changes. This enables the attending physician to recognise the decompensation process even earlier. By adjusting the medication intake, they can more easily prevent acute decompensation and hospitalisation. Such an implanted measuring probe is useful, for example, if heart failure patients continue to suffer from symptoms even with minimal physical exertion despite optimal therapy and have been hospitalised within the last 12 months. Your doctor can advise you whether such monitoring is an option for you."