Wheezing, coughing, breathlessness: Cardiologist Dr Binay Kumar explains the lesser-known signs of heart failure
Recognizing the Hidden Signs of Heart Failure: A Cardiologist's Perspective
Bharatmorningnews.com – Many individuals associate wheezing, persistent coughing, and difficulty breathing primarily with asthma. Yet these familiar symptoms may occasionally signal a different underlying issue: heart failure. Known medically as cardiac asthma, this condition develops when the heart struggles to pump blood efficiently, causing fluid to accumulate within the lungs.
Dr. Binay Kumar, who serves as the Director of Interventional Cardiology and Electrophysiology at Yatharth Super Speciality Hospital in Sector 88, Faridabad, recently shared insights on distinguishing cardiac asthma from typical respiratory conditions. He outlined the warning indicators, diagnostic approaches, and therapeutic options available for patients.
Understanding the Difference
"Cardiac asthma is not a type of asthma; it's an episode of breathing difficulty as a result of heart failure," Dr. Kumar clarified. "When it's left heart failure, it leads to congestion in the lungs. These conditions in the lungs increase when you lie down during the night."
When the left ventricle weakens, fluid begins pooling in pulmonary tissues, creating respiratory distress. "In people who have heart problems and go into heart failure, even low-grade heart failure, there's fluid that gets into the lungs and fluid that gets into the airway. Therefore, people start experiencing wheezing, cough and shortness of breath. That's not really due to asthma, but it occurs owing to the heart," he noted.
Conventional asthma operates differently. It stems from bronchospasm—a narrowing of the airways that produces audible wheezing sounds during inhalation and exhalation. "Asthma is a condition where the airways go into spasm, or the airways are narrowed, and when we breathe in and breathe out, we hear wheezing noises. We have an obstruction to the airflow," Dr. Kumar explained.
Triggers for typical asthma include seasonal shifts, pollen exposure, air pollution, and environmental allergies. Some individuals experience intrinsic asthma, where airway spasms occur without identifiable external causes. Cardiac asthma, conversely, connects directly to heart dysfunction and pulmonary fluid buildup.
Identifying the Condition
The overlapping nature of symptoms between cardiac and bronchial asthma frequently complicates accurate identification. Patients should evaluate whether cardiovascular issues might be responsible for their respiratory complaints.
"If you are coughing, wheezing and having shortness of breath, always think of possibilities. Is my heart functioning well? Have I got edema of the lower extremities? Do I get chest discomfort, chest pain, heart rhythm problems? If you have those, think about maybe it's your heart that's the cause of your wheezing," Dr. Kumar advised.
Individuals with preexisting cardiovascular conditions face heightened risk for developing cardiac asthma, particularly those whose health profiles increase susceptibility to heart disease and subsequent heart failure.
Diagnostic Challenges and Methods
Because cardiac asthma mimics conventional asthma presentations, establishing an accurate diagnosis presents challenges. "Diagnosis of cardiac asthma is crucial as it points out congestive heart disease. It's quite difficult to figure out due to the signs matching those of asthma. Because of this, cardiac asthma is often misdiagnosed, which can turn life-threatening," Dr. Kumar emphasized.
Medical professionals typically begin with a comprehensive physical examination, followed by blood work and specialized cardiac assessments. Electrocardiograms (ECG) and echocardiograms provide valuable information about heart function. Chest X-rays help detect cardiac enlargement or fluid presence. In complex cases, computed tomography (CT) scans or magnetic resonance imaging (MRI) may offer additional clarity.
Treatment Approaches
Since cardiac asthma and bronchial asthma originate from different mechanisms, their management strategies diverge significantly. "In cardiac asthma, you have fluid in the lungs, so the patients are given a diuretic to flush out the extra fluid from the lungs and also given medications to minimise the load on the heart. This is how we treat heart failure," Dr. Kumar described.
Conventional allergic asthma treatment typically involves bronchodilators to relax airway muscles, anti-inflammatory inhalers to decrease swelling, and anti-leukotriene or antihistamine medications. Nebulizers serve as alternative delivery systems when inhalers prove challenging to use effectively.
Managing cardiovascular risk factors remains essential for cardiac asthma patients. Dr. Kumar recommends regular consultation with a cardiologist to ensure proper diagnosis and ongoing care, especially when respiratory symptoms accompany leg swelling, chest discomfort, or pain.
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