Cardiac cough, a lesser-known symptom of heart disease, often goes unrecognized and untreated. While many people are familiar with coughs caused by respiratory issues such as colds, flu, or allergies, cardiac cough originates from the heart.
This article delves into what causes cardiac cough, its symptoms, and potential treatments.
What Is Cardiac Cough?
Cardiac cough, also known as heart cough, is a type of cough that occurs as a symptom of heart disease. It is not caused by issues in the respiratory system but rather due to problems in the cardiovascular system. This type of cough is often overlooked because its symptoms can be similar to those of more common respiratory conditions.
Symptoms of Cardiac Cough
Recognizing the symptoms of cardiac cough is crucial for timely diagnosis and treatment. Some of the common symptoms include:
- Persistent coughing, especially at night or when lying down
- A wet cough that produces frothy or blood-tinged sputum
- Shortness of breath
- Swelling in the legs, ankles, or abdomen
- Fatigue and weakness
- Rapid or irregular heartbeat
If you experience these symptoms, it’s important to consult a healthcare professional for proper evaluation and diagnosis.
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What Causes Cardiac Cough?
Cardiac cough is typically associated with conditions that affect the heart’s ability to pump blood efficiently. Here are the primary causes:
Heart Failure
Heart failure is the leading cause of cardiac cough. When the heart’s ability to pump blood is compromised, it leads to a buildup of fluid in the lungs, known as pulmonary congestion or pulmonary edema. This fluid accumulation triggers coughing as the body attempts to clear the excess fluid.
In heart failure, the heart’s reduced efficiency causes blood to back up into the veins that return blood from the lungs to the heart. The increased pressure in these veins forces fluid into the alveoli (air sacs) in the lungs, resulting in congestion and coughing.
Left Ventricular Dysfunction
The left ventricle is responsible for pumping oxygenated blood to the rest of the body. When the left ventricle fails to function properly, it leads to left ventricular dysfunction. This condition can cause fluid to back up into the lungs, similar to heart failure, resulting in a cardiac cough.
Mitral Valve Disease
The mitral valve regulates blood flow between the left atrium and left ventricle of the heart. Mitral valve disease, such as mitral valve prolapse or mitral valve stenosis, can lead to improper blood flow and increased pressure in the left atrium.
This increased pressure can cause fluid to leak into the lungs, triggering a cough.
Atrial Fibrillation
Atrial fibrillation (AFib) is an irregular heartbeat that can lead to blood clots, stroke, and heart failure. AFib can cause the atria (the heart’s upper chambers) to quiver instead of contracting properly, leading to blood pooling in the heart. This pooling can increase the risk of fluid buildup in the lungs, contributing to a cardiac cough.
Pulmonary Hypertension
Pulmonary hypertension is a condition characterized by high blood pressure in the arteries of the lungs. This increased pressure can strain the right side of the heart, causing fluid to accumulate in the lungs and leading to a persistent cough.
Medications
Certain medications used to treat heart conditions can also cause a cough as a side effect. For instance, angiotensin-converting enzyme (ACE) inhibitors, commonly prescribed for high blood pressure and heart failure, can cause a dry cough in some patients. Although this type of cough is not directly caused by heart disease, it is related to the treatment of heart conditions.
Diagnosing Cardiac Cough
Diagnosing cardiac cough involves a thorough evaluation by a healthcare professional. The process typically includes:
Medical History and Physical Examination
The doctor will take a detailed medical history to understand the patient’s symptoms and any underlying heart conditions.
A physical examination will help identify signs of heart failure, such as swelling in the legs and abnormal heart sounds.
Imaging Tests
Imaging tests such as chest X-rays, echocardiograms, and CT scans can provide detailed pictures of the heart and lungs.
These tests help identify fluid buildup in the lungs and assess the heart’s structure and function.
Blood Tests
Blood tests can detect markers of heart failure and other heart-related issues. These tests may include measuring levels of B-type natriuretic peptide (BNP), which is elevated in heart failure.
Electrocardiogram (ECG or EKG)
An ECG records the electrical activity of the heart and can help detect irregular heart rhythms, such as atrial fibrillation, that may contribute to cardiac cough.
Pulmonary Function Tests
Pulmonary function tests assess how well the lungs are working and help rule out respiratory causes of the cough.
Treatment Options for Cardiac Cough
Treating cardiac cough involves addressing the underlying heart condition. The treatment plan may include:
Medications
Various medications can help manage heart failure and other heart conditions. These may include:
Diuretics: These medications help reduce fluid buildup in the lungs by increasing urine output.
ACE Inhibitors or ARBs: These drugs help relax blood vessels and reduce blood pressure, easing the workload on the heart.
Beta-Blockers: These medications slow the heart rate and reduce blood pressure, helping the heart pump more efficiently.
Anticoagulants: These drugs help prevent blood clots in patients with atrial fibrillation.
Lifestyle Changes
Lifestyle modifications can play a significant role in managing heart conditions and reducing symptoms of cardiac cough.
These changes may include:
Dietary Adjustments: Reducing salt intake can help prevent fluid retention. Eating a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can improve overall heart health.
Exercise: Regular physical activity can strengthen the heart and improve circulation. It’s important to consult a doctor before starting any exercise program.
Weight Management: Maintaining a healthy weight can reduce the strain on the heart and improve symptoms of heart failure.
Surgical Interventions
In some cases, surgical procedures may be necessary to treat the underlying heart condition. These procedures can include:
Valve Repair or Replacement: Surgery to repair or replace a damaged mitral valve can improve blood flow and reduce pressure in the heart and lungs.
Pacemaker or Defibrillator Implantation: These devices can help regulate the heart’s rhythm and improve its pumping efficiency.
Coronary Artery Bypass Grafting (CABG): This procedure can improve blood flow to the heart in patients with coronary artery disease.
Managing Pulmonary Hypertension
For patients with pulmonary hypertension, specific treatments may be required to reduce the pressure in the arteries of the lungs. These treatments can include medications that relax blood vessels, oxygen therapy, and lifestyle changes.
When to See a Doctor
If you experience a persistent cough, especially if it is accompanied by symptoms such as shortness of breath, swelling in the legs, or chest pain, it is important to seek medical attention. Early diagnosis and treatment of the underlying heart condition can improve outcomes and prevent complications.
Conclusion
Cardiac cough is a symptom of underlying heart disease that often goes unrecognized. Understanding what causes cardiac cough is essential for timely diagnosis and effective treatment. Heart failure, left ventricular dysfunction, mitral valve disease, atrial fibrillation, pulmonary hypertension, and certain medications are common causes of cardiac cough.
Diagnosing this condition involves a comprehensive evaluation by a healthcare professional, including medical history, physical examination, imaging tests, blood tests, and pulmonary function tests. Treatment options focus on managing the underlying heart condition through medications, lifestyle changes, and, in some cases, surgical interventions.
Recognizing the symptoms and seeking prompt medical attention can help manage cardiac cough and improve overall heart health. If you or someone you know experiences symptoms of cardiac cough, consult a healthcare professional for proper evaluation and treatment.