We talk about cachexia destroying skeletal muscle in our arms, legs, and core. But there is another muscle nobody talks about: the heart. And cachexia attacks it too.
Cardiac cachexia is the wasting of heart muscle, which develops as the same inflammatory cytokines driving skeletal muscle loss reach the heart. The heart muscle atrophies. Contractility weakens. The heart pumps less effectively with every beat.
The downstream effects are devastating and interconnected. Reduced cardiac output means less oxygen and fewer nutrients are delivered to the struggling muscles. Fatigue deepens, not only from the cancer, but from a heart that simply cannot keep up with the body’s demands. Physical activity becomes harder, and inactivity accelerates muscle loss even further.
What makes cardiac involvement particularly dangerous is that it is largely invisible until it becomes severe. Patients and even clinicians may think that worsening fatigue is due to cancer or chemotherapy. It is easy to miss the heart entirely.
Monitoring cardiac function in cachectic patients, particularly those with significant weight loss and declining physical performance, is a critical part of comprehensive cachexia care.
