Cardiac asthma is caused by fluid build-up in the lungs due to heart failure, and can mimic traditional asthma symptoms. Proper diagnosis and treatment is essential, including medications to relieve fluid build-up and strengthen the heart muscle, as well as lifestyle changes. Overuse of traditional asthma medications can worsen symptoms and should be avoided. Older people with congestive heart failure are at increased risk.
The difficulty breathing associated with congestive heart failure is known as cardiac asthma. Not considered a truly asthmatic condition, cardiac asthma results from a collection of fluid in the lungs, known as pulmonary edema. The symptoms associated with this condition can mimic those of traditional asthma, so determining the presence of heart failure is essential for appropriate treatment. Heart failure-induced asthma is considered a serious condition that can become life-threatening if proper treatment is not used.
Congestive heart failure is characterized by impaired functioning of the heart muscle, which negatively affects the circulatory system and the function of major organs. Heart failure-related asthma results from the inability of the heart to pump effectively, which negatively affects proper lung function. When the heart’s pumping becomes impaired, fluid begins to build up in the lungs, narrowing the air passages and reducing the flow of oxygen. The resulting blockage of airflow causes the individual to wheeze and develop further symptoms associated with respiratory distress.
Individuals with cardiac asthma may gasp or have difficulty breathing during exercise, during daily activities, or at night when in bed. Fluid collecting in the lungs induces symptoms that include coughing, wheezing, and shortness of breath. Individuals with cardiac asthma may also develop pronounced swelling of the legs and ankles, increased heart rate and blood pressure, and anxiety. Those with heart failure-induced asthma may find that they are able to breathe better at night if they sleep sitting up in a chair, otherwise they wake up feeling uncomfortable and breathless when trying to sleep lying down.
A diagnosis of congestive heart failure can be made by applying a variety of tests. Individuals may undergo tests that include a chest X-ray, an echocardiogram, and a magnetic resonance imaging (MRI) test of the heart. A cardiac catheterization and cardiac stress test may also be conducted to evaluate heart function and determine any rhythm disturbances within the heart muscle. The existence of a pleural effusion or fluid buildup around the lungs can be detected during a physical exam.
A correct diagnosis is essential for the successful treatment of cardiac asthma. Treatment for individuals with cardiac asthma focuses on improving heart function. You may need corrective procedures or surgery to restore heart function, such as valve replacement or coronary artery bypass surgery. Some individuals may receive a single- or dual-chamber pacemaker or an implantable cardioverter-defibrillator to restore proper heart rhythm and pumping ability. To relieve asthma symptoms, supplemental oxygen and bronchodilators may be given in addition to the treatment given for heart failure.
The drugs can be used as part of an individual’s treatment regimen when a diagnosis of congestive heart failure has been confirmed. Diuretics help relieve fluid collection in the lungs and allow for easier breathing without wheezing. Additional medications may be prescribed to help strengthen the heart muscle to regulate its pumping ability and restore function, such as digitalis glycosides, angiotensin converting enzyme (ACE) inhibitors, and beta-blockers. Lifestyle and dietary changes may be required as part of an individual’s treatment regimen.
Older people who have been diagnosed with congestive heart failure and who commonly experience shortness of breath or difficulty breathing are at increased risk of developing cardiac asthma. Those who have not received a diagnosis of congestive heart failure, but experience symptoms associated with cardiac asthma, should not overuse traditional asthma medications. The use of such drugs by people without asthma can induce cardiac arrhythmias and worsen existing symptoms, further complicating existing heart failure.
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