decompensate

Decompensation is a medical term used to describe the failure of the body's normal compensatory mechanisms to maintain stable function in the face of stress, injury, or disease. When compensation succeeds, a person may have little or no symptoms despite underlying pathology. Decompensation occurs when these mechanisms are overwhelmed or exhausted, leading to a rapid or progressive decline in organ function and the appearance of new or worsened symptoms.

In clinical practice the term is most often applied to organ systems where compensatory responses are well described. Cardiac decompensation refers to the deterioration of previously compensated heart function, commonly seen in heart failure. Patients may develop worsening shortness of breath, fatigue, edema, weight gain, and reduced exercise tolerance. Hepatic decompensation occurs in people with cirrhosis, presenting with ascites, jaundice, coagulopathy, hepatic encephalopathy, or renal dysfunction. Decompensation in the lungs or airways can manifest as acute respiratory failure, while renal decompensation involves a decline in kidney function that may require prompt intervention. In psychiatry, decompensation can describe a relapse of psychiatric symptoms or crisis triggered by stress, illness, or nonadherence to treatment.

Common precipitating factors include infections, arrhythmias, dehydration, medication changes, alcohol or toxin exposure, and uncontrolled underlying disease. Management focuses on treating the underlying cause, supporting failing organ systems, and addressing precipitating factors. Early recognition and intervention are associated with better outcomes, whereas prolonged or severe decompensation can lead to organ failure and increased mortality.