Compensated heart failure involves heart failure that causes minimal symptoms. Decompensated heart failure refers to heart failure that has progressed, leading to a worsening of symptoms.
Heart failure is a chronic condition, and people with it may experience symptoms that come and go or sometimes worsen. Doctors use the terms “compensated” and “decompensated” to describe the symptoms. They may also use staging or classification systems, such as the American Heart Association (AHA) system.
This article looks at the differences between decompensated and compensated heart failure, symptoms, causes and risk factors, diagnosis, treatments, and life expectancy for both.
Heart failure occurs when the heart muscle cannot pump enough blood to meet the body’s needs.
In compensated heart failure, the body responds to this problem by increasing blood pressure and heart rate and retaining salt and water. This ensures blood continues to pump around the body despite the decreased function of the heart.
In contrast, decompensated heart failure occurs when the body cannot compensate for the heart failure, meaning symptoms suddenly appear or worsen significantly. Doctors also refer to it as a heart failure exacerbation.
Decompensation can occur in those without a previous diagnosis of heart failure or in those with chronic heart failure that has worsened.
Heart failure can cause a range of symptoms, such as:
- shortness of breath, particularly when exercising
- edema, or swelling
- increased heart rate
- reduced exercise tolerance
- higher blood pressure
- lethargy
- malaise
- unexplained weight gain
- pulmonary edema
In compensated heart failure, there are few or no symptoms. People with this condition can go about their daily activities without difficulty.
In decompensated heart failure, shortness of breath and excess fluid can cause difficulties, and someone may require admission to the hospital.
Generally, heart failure
- coronary heart disease
- heart inflammation
- high blood pressure
- cardiomyopathy
- an irregular heartbeat or arrhythmias
- infections
There are also
- excessive water and salt intake
- not adhering to or being unable to access treatment for heart conditions
- heart arrhythmias, such as atrial fibrillation
- systemic hypertension
- pulmonary embolism
- myocardial ischemia
- nutritional deficiencies
- anemia
- thyroid disease
- using illegal drugs
- using medications that worsen heart failure
- acute coronary syndrome
- acute infections, such as pneumonia
- renal failure
Doctors distinguish between compensated and decompensated heart failure based on symptoms. If the symptoms are mild or stable, it may signal compensated heart failure, but more severe symptoms signify decompensated heart failure.
Health professionals will base an initial heart failure diagnosis on a person’s medical history and a physical examination. They may run the
Sometimes, doctors may also be able to make an accurate diagnosis according to a person’s response to treatment.
Treatment for heart failure varies depending on the type a person has and how severe it is.
Lifestyle changes
For compensated heart failure, lifestyle changes
- reducing salt intake
- maintaining a moderate body weight
- regularly exercising
- quitting smoking, if applicable
- avoiding or limiting alcohol
- managing related heart or lung conditions
- managing stress
- practicing sleep hygiene
Medications
If a person with heart failure has reduced ejection fraction, a doctor
- vasodilators to open blood vessels
- diuretics to remove salt and water from the body
- inotropic drugs, which change the heart’s contractions
- beta-blockers, which block the action of adrenaline in the heart
- sodium-glucose cotransporter 2 inhibitors
Doctors may also regularly monitor blood pressure and heart activity or use oximetry to test blood oxygen levels.
Procedures
Decompensated heart failure is potentially life threatening, so people may require hospitalization or emergency treatment when their cardiovascular function becomes compromised.
Sometimes, a person may need to undergo procedures to maintain heart function for longer. They
- a biventricular pacemaker, which helps both sides of the heart contract in synchronization
- an implantable cardioverter defibrillator, which detects and treats dangerous heart rhythms
- a mechanical heart pump, either as a temporary measure or as a long-term treatment
- a heart transplant
There is no cure for heart failure, and the symptoms
People with decompensated heart failure generally have a lower life expectancy compared to those with compensated heart failure.
A cohort study from 2020 of over 18,000 people from different parts of the world found that
There were some significant factors relating to mortality rates, such as:
- anemia
- older age
- chronic kidney disease
- other related heart conditions
- income inequality
The life expectancy for people with compensated or milder heart failure may vary depending on factors such as their overall health and their ability to access or stick to a treatment plan.
Compensated heart failure refers to heart failure with minimal or no symptoms. When symptoms worsen significantly, doctors may describe a person’s heart failure as decompensated.
People with compensated heart failure may have few symptoms and can remain stable for some time. Decompensated heart failure involves significant and noticeable symptoms and can require a stay in the hospital.
The outlook for heart failure depends on the type and severity of the condition and the presence of any other risk factors. Treatment may involve lifestyle changes, medications, or procedures to help maintain heart function for as long as possible.