What is Cardiac Cachexia?

Cachexia is a severe form of weight loss from chronic illness. Also known as wasting syndrome, cachexia causes extreme fat and muscle loss. It also creates fatigue, weakness, and loss of appetite. Cardiac cachexia refers to a syndrome specific to end-stage cardiac failure. Systemic changes in chronic heart disease create several problems in the gastrointestinal, metabolic, and immune systems. This develops into a syndrome that prevents the body from absorbing food or maintaining muscle mass, resulting in the loss of fat and muscle.

Causes of Cardiac Cachexia

The causes of cardiac cachexia are complex and involve the breakdown of several systems in the body due to heart disease. Heart disease and heart failure cause widespread inflammation in the body. The resulting chemicals affect the immune system, which shuts down the appetite. The stomach and intestinal wall also become swollen, which decreases the absorption of food. Heart failure also increases tumor necrosis factor, which further decreases lean body mass. As muscles break down, a cyclic syndrome develops — the patient becomes weaker and muscles break down further due to lack of activity.

Incidence

Most people experiencing advanced heart disease are over 65 years old. In older age, the body is less resilient to illness, which may increase susceptibility to weight loss. Also, a reduction in body mass is a normal age-related change in older people. Therefore, people over 65 who have heart disease are at higher risk of experiencing cardiac cachexia.

Physical Symptoms

People with cardiac cachexia tend to be very thin with extreme fatigue, muscle wasting, dark circles around the eyes, lack of appetite, shortness of breath and limited ability to get around. These symptoms are due to both heart disease and the resulting cachexia. The condition also affects other organs, such as the lungs, bone marrow, kidneys, and liver, and these failures contribute to symptoms as well.

Systemic Symptoms

Reduced cardiac functioning leads to swelling in other parts of the body such as the legs, stomach, and lungs. This reduces appetite and can also cause a loose cough with gagging. The failing heart puts a strain on all the organs. This may cause other symptoms such as kidney issues, mental fog, lowered immunity, infection, and neuroendocrine disorders.

Diagnosis

People diagnosed with conditions that cause gradual heart failure will likely develop cardiac cachexia. When a person loses over 5% of body weight, doctors suspect the condition and will analyze blood tests and symptoms to help confirm the diagnosis. A doctor will also look at the percentage of muscle and fat loss. Worsening heart failure usually accompanies cardiac cachexia.

Medical Prevention

Treating the pre-existing cardiac issue is the most common method of medical prevention. Preventing heart failure is the best way to stop cachexia. Other medical prevention strategies help reduce appetite and weight loss through medications that stimulate the appetite, improve gastrointestinal absorption, decrease fluid build-up, and support the immune system. Also, nutritional support to help with protein loss, anemia, and iron deficiency will improve cardiac cachexia.

Natural Prevention

Natural health strategies that can help prevent cardiac cachexia include exercise, nutrition, and stress management. A doctor will recommend exercise regimens to safely and gently maintain muscle mass. Also, yoga and walks in nature are beneficial as they reduce stress and support muscle maintenance. Reducing stress is very important. Mindfulness activities such as meditation, music therapy, journaling, and sound therapy can be helpful, as can dietary and nutritional support from a dietician or naturopath. The use of cannabis and cannabidiols have excellent results in increasing appetite and lowering pain and stress.

Treatment

Cardiac cachexia is a result of long-term chronic cardiac disease and is associated with end-stage heart failure. There is no real treatment, only prevention and easing of the symptoms. The best course of action is to treat the underlying heart disease and prevent heart failure in the first place.

Prognosis

The prognosis for cardiac cachexia is usually not good. Once a patient progresses to end-stage heart failure, cardiac cachexia is unavoidable. Prevention helps maintain the body systems and keeps cachexia to a minimum. However, once a patient reaches that stage, they benefit from a more palliative approach to care including medical and non-medical measures to increase comfort and quality of life.

Awareness

Some people with severe heart disease are unaware of the possibility of cardiac cachexia. This syndrome shows up later in the disease and is associated with a poor prognosis. However, awareness can aid in prevention and encourage preparation. Understanding cardiac cachexia can help with future decision-making about natural and medical prevention strategies to maintain body weight and minimize other symptoms.