decompensated

Decompensation is a medical term describing the loss of the body’s ability to maintain stability and function in the face of stress or disease. It denotes a transition from a compensated state, where mechanisms compensate for underlying pathology, to an decompensated state, where those mechanisms fail and clinical deterioration becomes evident. The term is used across organ systems and clinical contexts.

In cardiology, decompensated heart failure refers to a state in which the heart cannot meet the circulatory demands of the body. Patients may experience worsening shortness of breath, fatigue, edema, orthopnea, and fluid accumulation in the lungs or extremities. Triggers include infection, renal dysfunction, myocardial ischemia, arrhythmias, or nonadherence to therapy. Management typically involves stabilization, diuretics to reduce fluid overload, vasodilators or inotropes for hemodynamic support, oxygen as needed, and treatment of the underlying cause, with consideration of advanced therapies in selected cases.

In hepatology, decompensated cirrhosis occurs when liver dysfunction leads to complications such as ascites, jaundice, hepatic encephalopathy, variceal bleeding, or coagulopathy. Management focuses on treating complications (for example, diuretics for ascites, antibiotics for bacterial infections, lactulose for encephalopathy), addressing precipitating factors, and evaluating for liver transplantation.

Decompensation can also occur in other chronic illnesses and in psychiatry, where stressors or illnesses overwhelm coping mechanisms, leading to a worsening of symptoms or a crisis. Across contexts, decompensation signals a transition to higher-risk illness requiring prompt assessment and often intensified therapy.