Cardiac Cachexia Syndrome

*Teresa Raposo André,1 Adriana Lopes Santos,2 Isabel Galriça Neto3

1. Medical Oncology Department, Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Lisbon, Portugal
2. Internal Medicine Department, Hospital Santo António dos Capuchos – Centro Hospitalar Central E.P.E., Lisbon, Portugal
3. Unidade de Cuidados Continuados e Paliativos, Hospital da Luz, Lisbon, Portugal
*Correspondence to teresaandre@gmail.com

Disclosure: The authors have declared no conflicts of interest.
Received: 19.07.17 Accepted: 25.08.17
Citation: EMJ Cardiol. 2017;5[1]:101-107.

Abstract

Heart failure is a chronic, progressive, and incurable disease. Cardiac cachexia is a strong predictor of poor prognosis, regardless of other important variables. This review intends to gather evidence to enable recognition of cardiac cachexia, identification of early stages of muscle waste and sarcopenia, and improve identification of patients with terminal heart failure in need of palliative care, whose symptoms are no longer controlled by usual medical measures. The pathophysiology is complex and multifactorial. There are many treatment options to prevent or revert muscle waste and sarcopenia; although, these strategies are less effective in advanced stages of cardiac cachexia. In these final stages, symptomatic palliation plays an important role, focussing on the patient’s comfort and avoiding the ‘acute model’ treatment of aggressive, disproportionate, and inefficient care. In order to provide adequate care and attempt to prevent this syndrome, thus reducing its impact on healthcare, there should be improved communication between general practitioners, internal medicine physicians, cardiologists, and palliative care specialists since heart failure has an unforeseeable course and is associated with an increasing number of deaths and different levels of suffering.

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