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Cardiac cachexia is a large weight loss from malnutrition in people with advanced heart failure. Treatments include exercise, medicines and nutritional supplements. Cardiac cachexia doesn’t have a good prognosis, but early treatment can improve your situation.
Cardiac cachexia (kuh KEK see uh) is a type of malnutrition and muscle loss that affects people with heart failure, usually in the end stage. Cachexia translates to “bad condition.” It can affect people with multiple illnesses that result in a state of unintentional muscle wasting and weight loss.
Multiple causes combine to make people with heart failure lose weight when they aren’t trying. Healthcare providers define the amount of unintentional weight loss for cardiac cachexia as 5% during the past year. Others say 6% or more weight loss (along with other symptoms) means you have cardiac cachexia.
Cardiac cachexia affects about 10% to 39% of people who have chronic heart failure with symptoms. More than 20 million people in the world have chronic heart failure.
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Symptoms of cardiac cachexia include:
Multiple factors add up to cause cardiac cachexia in people with severe heart failure, such as:
Cardiac cachexia can lead to sarcopenia (losing muscle mass) and sometimes scarring on your heart muscle. It can lead to frailty and weakness, which in turn can lead to falls and injuries. Loss of appetite can lead to electrolyte and fluid derangements. Cachexia can lead to osteoporosis, which causes decreased bone density and can make you more likely to have falls and fractures. Also, cardiac cachexia can get worse and be fatal.
A healthcare provider can diagnose cardiac cachexia when you’ve slowly lost 5% or more of your weight during the last year and also have at least three of these issues:
A provider will order lab tests and imaging tests, such as:
These tests are important because people with heart failure have swelling that can make it difficult to measure body mass index (BMI).
A right heart catheterization can help a provider see how much excess fluid you have. This can also help with figuring out how much weight you’ve lost and how much fluid your body is retaining (holding).
Cardiac cachexia treatment isn’t as simple as eating more food. This complex condition requires more than one kind of approach.
You can expect a provider to tell you to do some aerobic exercise to help you prevent more muscle loss. Researchers have found that exercise is one of the best forms of cardiac cachexia treatment. Cardiac rehab can help people with heart failure:
A healthcare provider may admit you to the hospital if you’re fainting and have very low blood pressure. They’ll keep checking your weight and how much you’re able to eat and drink. You can go home after you take in enough nutrition. Over the next two to four weeks, you’ll need to see a:
If your heart failure is at an advanced stage, it may not be possible to reverse cachexia without treating the underlying heart failure. This may require an appointment with an advanced heart failure specialist. They may be able to prescribe medications or (if appropriate) refer you for surgery including a mechanical heart pump or heart transplant.
A provider may order:
Side effects of more common medications for cardiac cachexia may include:
To help lower your risk of cardiac cachexia, a provider may prescribe medicines such as:
Cardiac cachexia often has a poor prognosis. However, getting a prompt diagnosis and treatment for cardiac cachexia can help improve your outcome. The sooner you start treatment, the better your chances of improving your situation.
Yes, it can. The prognosis for cardiac cachexia isn’t good. About 50% of people who have the condition die in 18 months. Some people only survive three, six or 12 months, according to one study.
Eating soft foods may help you avoid having shortness of breath while eating. Consuming smaller meals more often may help, too.
Healthcare providers have different opinions on how much salt you should have, so check with your provider for their recommendation. Many providers agree that the Mediterranean Diet and DASH diet are good for people with cardiac cachexia.
Take any nutritional supplements your provider believes will help you. These can improve your quality of life and survival. Improving your body’s intake of nutrients can help prepare you for surgery if you’re receiving a heart transplant.
Talk to your healthcare provider about how often they want to see you. You may need frequent check-ins, even if it’s just to report your weight and calorie intake.
Questions to ask your healthcare provider include:
A note from Cleveland Clinic
If you have advanced heart failure and notice some weight loss, talk to your healthcare provider right away. The swelling that happens in people with heart failure can keep you from seeing the severity of the weight loss. Be an advocate for yourself so you can get the help you need to keep cardiac cachexia from getting worse.
Last reviewed by a Cleveland Clinic medical professional on 02/21/2023.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy