Cough with heart disease: what it means and how to treat it

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Cardiac cough is a symptom of respiratory and cardiac pathology. This problem is most often encountered by adults; children are less likely to get sick.

This symptom is often combined with shortness of breath, chest pain, swelling and other signs.

A cough may indicate a serious pathology, which, if not properly treated, leads to dangerous consequences (pneumonia, pulmonary edema, sudden cardiac death).

Causes of cardiac cough

Cardiac cough is a symptom of the following diseases:

1. Acute left ventricular failure (cardiac asthma). This pathology is characterized by stagnation of blood in the small (pulmonary) circle. Cardiac asthma can be a complication of severe unstable angina, acute infarction, acute inflammation, aneurysm, cardiosclerosis and paroxysmal arterial hypertension.
2. Arrhythmias (atrial flutter, atrial fibrillation).
3. Valve defects (aortic insufficiency, mitral valve stenosis).
4. Heart tumors (myxomas).
5. Acute intracardiac thrombosis and thromboembolism.
6. Cardiovascular failure. With this pathology, the pumping function of the heart decreases, as a result of which its blood supply deteriorates.
7. Cardiomyopathies. The development of the disease is based on processes not associated with cardiac ischemia and inflammatory processes.
8. Infectious pathology (myocarditis, pericarditis).
9. Rheumatism.
10. Pathological changes in the aorta.

Predisposing factors are old age, high blood pressure (above 139/89 mmHg), smoking, acute and chronic intoxication, stress, alcohol dependence, family history, atherosclerosis, low physical activity and endocrine disorders.

How does cough occur in heart disease?

The depression of respiratory function and the occurrence of coughing in heart pathology are based on the following processes:

1. Damage to the left ventricle.
2. Violation of myocardial contractile function.
3. Increase in pressure in a small circle.
4. Filling of the chambers of the heart with blood.
5. Edema of the lung tissue. It occurs as a result of blood vessels overflowing, increasing their permeability and the release of plasma into the intercellular space of the lungs.
6. Violation of ventilation.
7. Sclerosis and obliteration of blood vessels.
8. Slowing blood flow in small vessels.
9. Deterioration of gas exchange.
10. Neuroreflex disorders as a result of excitation of the respiratory center.

What diseases accompany cardiac cough?

A cough may indicate acute and chronic forms of coronary heart disease, heart failure, infections, neoplasms, arrhythmias and valve pathology.

Cough due to heart failure

Heart failure is a pathology in which the heart muscle is unable to meet the oxygen needs of organs. It is characterized by a decrease in cardiac output during systole. Cough often occurs against the background of acute left ventricular failure such as cardiac asthma. In heart failure, the symptoms are specific. The following features are characteristic of cough:

1. Initially dry (no phlegm). Then it becomes moist with pink phlegm mixed in.
2. Often accompanied by hemoptysis.
3. In the early stages, it appears when a person is lying down and during physical activity.
4. Paroxysmal.
5. Excruciating.
6. It occurs reflexively in response to swelling of the bronchi.
7. Does not disappear after sputum separation.
8. Occurs mainly at night.
9. May be triggered by stress.
10. Appears suddenly.
11. It is combined with shortness of breath, cyanosis (blue discoloration) of the skin, suffocation and arterial hypertension.
12. Decreases or disappears when taking nitrates (Nitroglycerin) and other cardiac medications.
13. It is not controlled by antitussives and mucolytics.
14. On physical examination, fine bubbling rales are detected. A man breathes through his mouth.

Symptoms of cardiac cough

The cough is dry, not accompanied by pus, intense and accompanied by other symptoms. These include:

1. Cyanosis. Occurs due to oxygen deficiency of tissues as a result of impaired pulmonary ventilation. A person's fingertips, earlobes and lips turn blue.
2. Feeling of fear of death.
3. Sweating.
4. Increase or decrease in blood pressure.
5. Swelling of veins in the neck area.
6. Edema of the lower extremities.
7. Chest pain.
8. Tachycardia (fast heartbeat).
9. Forced body position. To reduce symptoms, people adopt a sitting posture.
10. Weakness.
11. Dizziness.
12. Dyspnea.
13. Attacks of suffocation.
14. Discharge of pink foam from mouth and nose.
15. Excitation.
16. Anxiety.
17. Feeling of lack of air and interruptions in heart function.
18. Dry wheezing.

Symptoms of cardiac cough in a child

In childhood, this pathology is diagnosed extremely rarely. The cough is most often dry, sharp, short-lived, loud and paroxysmal. It is accompanied by bubbling sounds, lack of air, heart rhythm disturbances, weakness, impaired consciousness up to its loss, and anxiety of the child. Signs of respiratory failure often appear in the form of blue skin and tachypnea.

Treatment of cardiac cough

Treatment of cardiac cough is carried out after the diagnosis has been clarified. You will need:

1. Examination of the skin and mucous membranes.
2. Collecting anamnesis of life and illness.
3. Physical examination (percussion of the chest and back, listening to the lungs and heart, palpation). Signs of cardiac asthma include bubbling breathing, fine wheezing, muffled heart sounds and rapid heartbeat.
4. Electrocardiography. Helps assess the functional state of the heart and identify heart attack, arrhythmias, hypertrophy of the heart chambers and other pathologies.
5. Echocardiography (ultrasound). The most common findings include thinning or thickening of the walls of the left chambers of the heart, decreased contractility, and valve defects.
6. X-ray in 2 projections.
7. Study of blood gas composition.
8. Lipidogram.
9. Blood pressure measurement.
10. Coronary angiography.
11. Load tests.

Once you know certain etiological factors, you need to determine a treatment regimen. The main aspects of the treatment of cardiac cough are:

• elimination of symptoms;
• elimination of etiological factors;
• decreased excitability of the respiratory center;
• improvement of heart function;
• normalization of blood flow;
• eliminating stagnation in a small circle;
• prevention of complications.

Therapy involves:

1. Hospitalization. It is required for: the first attack of cough against the background of acute left ventricular failure, in the case of the development of myocardial infarction, the first detected attack of arrhythmia, arterial hypotension and symptoms of alveolar pulmonary edema.
2. Providing emergency (pre-hospital) care. The patient is seated comfortably with his legs hanging off the bed. Hot foot baths have a good effect. To unload the small circle, it is recommended to apply a tourniquet to the lower limbs.
3. Use of medications.
4. Oxygen therapy (introduction of humidified oxygen).
5. The use of folk remedies. They are of auxiliary value and cannot replace medications. Treatment with folk remedies is carried out with the permission of a cardiologist. When coughing against the background of pulmonary edema, decoctions of flax seeds and cyanosis roots, a mixture based on soda and honey, can be used.
6. Avoiding intense physical activity.
7. Normalization of nutrition. The diet involves limiting the consumption of table salt, simple carbohydrates (found in bakery and confectionery products) and animal fats. It is recommended to steam, bake or boil food. It is necessary to limit fluid intake to 1-1.5 liters per day. People suffering from obesity and atherosclerosis need to reduce the total caloric content of food. It is also important to give up alcohol.
8. Lifestyle changes (giving up bad habits, maintaining work and rest schedules, increasing physical activity, avoiding stress and hypothermia).

For cardiogenic cough, the following medications can be used:

1. Cardiac glycosides (Strophanthin). Indicated for cough against the background of heart failure, tachysystolic flutter and atrial fibrillation.
2. Loop diuretics (Lasix, Furosemide). These drugs relieve pulmonary edema and can also relieve cough.
3. Narcotic analgesics (opioid receptor agonists). The most commonly used are Morphine, Promedol and Omnopon. These medications are injected to suppress the respiratory center.
4. Tranquilizers (sedatives). This group includes Relanium, Sibazon and Relium. They are not prescribed for acute respiratory failure and severe hypercapnia.
5. Vasodilators (drugs that widen blood vessels). Nitrates are effective for coughs (Perlinganite, Nitroglycerin, Naniprus and Nitro Pol Infuse). The mechanism of action of nitrates is associated with the dilation of small vessels, a decrease in blood flow to the heart and a decrease in peripheral vascular resistance.
6. Antihypertensive drugs. Indicated for high blood pressure.
7. Antimicrobials (antibiotics, antivirals). Indicated for infectious cough (myocarditis).
8. Antiarrhythmic drugs (Ethacizine, Novocainamide and Amiodarone). Indicated for cough due to arrhythmia.
9. Ganglioblockers.
10. Beta blockers.
11. Antiplatelet agents and anticoagulants. Prescribed for cardiogenic cough due to myocardial infarction and acute thrombosis.
12. Drugs that increase blood pressure (Dobutamine, Dopamine).

Treatment should be carried out until the cough, foam and sputum disappear, the patient’s skin color, blood pressure and heart rate (heart rate) normalize.

It should be remembered: all medications should be taken better, taking into account the patient’s age and contraindications; Take medications only as prescribed by a doctor.

If necessary, after eliminating the symptoms of pulmonary edema, surgery is performed (valve replacement, coronary artery bypass grafting, angioplasty).

Cardiac cough, causes, symptoms and treatment Link to main publication

Source: https://RuPulmonolog.ru/kashel-simptomy-lechenie/serdechnyj-kashel-prichiny-simptomy-i-lechenie

Cardiac cough: symptoms, treatment

Many people believe that cough is a symptom of only respiratory diseases, but this is not true. The lungs are closely interconnected with the heart and blood vessels.

That is why disturbances in blood circulation can affect the functioning of the respiratory organs, and a person will develop a cardiac cough. This symptom of many diseases of the cardiovascular system may appear before or because of treatment.

A cardiac cough resembles the cough of ordinary bronchitis, but is not accompanied by sputum production. In severe cases, streaks of blood may appear in the coughed-up contents.

In this article we will look at the main causes of the appearance, mechanism of development, symptoms and treatment methods for cardiac cough. This knowledge will help you suspect the onset of the disease in time and take the necessary measures to eliminate it, which will prevent the development of serious complications.

Causes

The main cause of cardiac cough is stagnation of blood in the lungs, which occurs when the heart is unable to pump blood normally. Such congestion, which decompresses the activity of the heart, leads to the accumulation of fluid in the lungs, causing irritation of the bronchi and the cough itself. Heart failure can be provoked by many acute and chronic pathologies of the heart and blood vessels, such as:

Also, causes of cardiac cough can be diseases of the endocrine system, alcohol abuse, smoking, severe forms of anemia, taking certain medications for the treatment of cardiovascular pathologies, and frequent and severe stress.

Why does a cardiac cough occur?

Blood supply to the lungs is provided by the pulmonary circulation, and its effectiveness largely depends on the full functioning of the left ventricle and atrium. The development of cardiac cough goes through several stages. The mechanism of respiratory depression is as follows:

1. Pathological processes occurring in the left ventricle cause a decrease in its contractility, and it cannot effectively pump blood coming from the pulmonary arteries to the aorta. Such changes in the functioning of the heart lead to an increase in pressure in the lungs and a slowdown in blood microcirculation.
2. Slow blood flow causes increased venous pressure and oxygen starvation of tissues.
3. Due to hypoxia, collagen fibers are deposited on the interalveolar septa and walls of small vessels, which cause the development of pneumosclerosis.
4. The small vessels of the lungs gradually become sclerotic and completely obliterated (overgrown with connective tissue). Such pathological processes lead to a decrease in blood flow in the lungs and an even greater increase in pressure in the pulmonary vessels.
5. Increased pressure in the pulmonary artery leads to increased load on the left ventricle, and it hypertrophies.
6. Then dilatation (expansion of the boundaries) of the right half of the heart occurs, which causes stagnation of the systemic circulation. The liquid part of the blood seeps into the lung tissue and irritates the bronchial receptors. The patient develops a cardiac cough, which is chronic, appears when trying to take a horizontal position and worsens in the evening or at night.
7. With severe complication of the pathological process in the heart (for example, the development of a new attack of heart attack, arrhythmia, ventricular fibrillation, etc.), acute left ventricular failure develops, and its rapid progression can cause attacks of cardiac asthma or pulmonary edema.

Symptoms

Having collected complete information about the nature of the cough, the doctor determines the tactics for further examination of the patient.

A cardiac cough has a number of characteristic features that distinguish it from a cold or bronchial cough:

1. Cardiac cough is dry. During a cough, the patient does not produce sputum, mucus or pus. During acute attacks, bloody discharge may appear.
2. The cough is accompanied by cyanosis (blue discoloration) of the lips, nasolabial triangle, earlobes or fingertips.
3. When coughing, the patient experiences rapid breathing. At first, shortness of breath and cough appear only during physical activity, but as the disease progresses, even a long conversation can cause a suffocating dry cough and rapid breathing.
4. The cough is accompanied by pain in the heart and palpitations, which are caused by an overload of blood in the heart.
5. A cough may be accompanied by lightheadedness or vomiting, which is provoked by an increase in chest pressure and a decrease in the volume of blood flowing to the heart.
6. During coughing attacks, the veins in the patient's neck swell.
7. A cough appears or intensifies when trying to lie down, because in this position of the body the left ventricle is even more overloaded. Some patients even have to sleep in a half-sitting position. The same symptom can be observed in bronchial asthma, and therefore this patient’s condition requires differential diagnosis.
8. At the onset of the disease, the cough is accompanied by severe weakness, sweating and dizziness. Next, the patient develops ankle swelling in the evening. In the later stages, swelling becomes denser, more stable and does not disappear by morning.

The above features of cardiac cough can manifest themselves to varying degrees. Their severity depends on the cause of the cough and the severity of the underlying heart disease.

A cardiac cough can be:

• irritating and dry - in the initial stages of the disease, when stagnation in the systemic circulation has not yet developed;
• sharp, short and dry, combined with pain in the heart - often observed with rheumatism, which was complicated by pericarditis;
• dry and paroxysmal, accompanied by difficulty breathing - often observed with mitral stenosis;
• evening or night, loud and debilitating, appearing in a lying position or when trying to take a horizontal position - characteristic of chronic left ventricular failure;
• cough with hemoptysis - appears with severe congestion in the lungs due to atrial fibrillation and right ventricular failure, may indicate the development of thromboembolism.

When the first episodes of cardiac cough appear, the patient must consult a doctor and undergo an examination that will identify the cause of abnormalities in the heart. Timely treatment of the detected disease will quickly get rid of the cough and slow down the progression of the underlying disease.

Diagnostics

A survey X-ray of the chest organs allows the doctor to identify congestive changes in the lungs and conduct a differential diagnosis with various diseases that are accompanied by cough.

Symptoms of a cardiac cough may be similar to those of many diseases of the heart and respiratory system. To make an accurate diagnosis, the patient is prescribed the following diagnostic methods:

• ECG – to detect myocardial ischemia and hypertrophy;
• Echo-CG - to study and evaluate the contractility of the ventricles and a more detailed study of the structures of the heart;
• radiography - to identify congestion in the lungs;
• tomography – for a detailed study of the state of the myocardium.

Treatment

To eliminate cardiac cough, the patient is prescribed a course of treatment for the underlying disease that caused it. Self-medication of this unpleasant symptom is unacceptable, because...

attempts to suppress it can lead to undesirable consequences. During a cardiac cough, the bronchi are cleared, and inhibition of these processes will cause an accumulation of discharge from the lungs.

That is why the course of therapy should be prescribed only by a cardiologist.

To get rid of cardiac cough, in addition to treating the underlying disease, the doctor will recommend a whole range of measures.

Daily regime

Compliance with the work and rest regime for pathologies of the cardiovascular system allows you to avoid overload and has a beneficial effect on the functioning of the heart. Such patients are recommended to sleep at least 8 hours a day.

Rejection of bad habits

Smoking and alcohol put a serious strain on the heart, and quitting them should happen as soon as possible.

Stress prevention

Stressful situations pose a serious threat to people with heart pathologies, and the patient should learn to cope with them correctly and not get upset over trifles. If necessary, your doctor may recommend taking sedatives.

Frequent walks in the fresh air

With a cardiac cough, tissues are starved of oxygen, and walking in the fresh air will help saturate them with oxygen. This oxygen therapy will not only help eliminate palpitations and shortness of breath, but also normalize mood and sleep.

Healthy eating

For diseases of the cardiovascular system, the doctor may prescribe a special diet or recommend reducing the amount of salt consumed and giving up unhealthy foods (fatty meat, fast food, smoked meats, pickles, soda, strong tea and coffee). All patients are advised not to overeat and monitor their weight, as these factors can provoke and aggravate cardiac cough. Patients should not drink large amounts of liquid (the amount of liquid consumed is determined individually).

Physical activity

Sufficient physical activity helps normalize blood circulation and eliminate congestion. Their intensity should be individual and determined only by the general condition of the patient. At first they should be minimal, and as the condition improves, they should gradually increase.

Drug therapy

To eliminate cardiac cough, the following drugs may be prescribed:

• diuretics: Indapamide, Trifas, Veroshpiron, etc.;
• vasodilators: Atacand, Losartan, Candecor;
• antitussives with an anesthetic effect: prescribed only in cases where coughing attacks significantly aggravate the patient’s condition, causing fainting and severe weakness.

The choice of drugs to eliminate cardiac cough, their dosage and duration of use are determined only by the doctor. Depending on the patient’s condition, the doctor can adjust the treatment regimen.

Folk remedies

Most cardiologists do not recommend using folk remedies to eliminate cardiac cough. You can use some folk recipes only after consulting a doctor and diagnosing the underlying disease that caused the appearance of this unpleasant symptom.

A cardiac cough is the “first warning sign” of many pathologies of the cardiovascular system and a good reason to consult a cardiologist. Not all people who are not involved in medicine can recognize it on their own.

Our article will help you suspect the appearance of a cardiac cough in time and take correct and timely measures. Do not self-medicate this alarming and unpleasant symptom and do not put off visiting a doctor, because...

it can be caused by many dangerous diseases and complicated by cardiac asthma and pulmonary edema. Remember this and be healthy!

Channel One, the program “Live Healthy” with Elena Malysheva on the topic “Why do we cough? Unusual causes of cough" (for cardiac cough see 11:17):

Source: https://doctor-cardiologist.ru/serdechnyj-kashel-simptomy-lechenie

What is cardiac cough and how to treat it

Cardiac cough occurs during decompensation of chronic coronary insufficiency. It is a specific symptom of interstitial, and after alveolar pulmonary edema. According to 2015 data, the risk group in the Russian Federation is 7.

9 million people suffer from cardiac diseases. The annual mortality rate is about 12% of the total number of patients seeking help.

The main difference from a cold or bronchial cough is the mechanism of formation and methods of therapy.

What is cardiac cough

Doctors associate the origin of the disease with a decrease in the contractility of the left ventricle. Stroke volume and cardiac output decrease.

At the same time, venous return remains at the same level, which leads to the accumulation of blood in the pulmonary vessels, sweating of fluid into the interstitial space and alveoli. Cough at the initial stage develops due to reflex reactions leading to the appearance of bronchial spasm.

Further, foam forms in the lungs, which enters the upper respiratory tract, irritates the receptor apparatus, and contributes to increased symptoms.

A cardiac cough is fundamentally different from that occurring in infectious diseases and asthma of allergic origin . However, it can be difficult for an untrained person to differentiate it in the initial stages of development.

Signs and symptoms

The disease begins with a slight cough, which later develops into a severe dry cough. At the stage of alveolar edema, there are moist fine bubbling rales that can be heard at a distance, without the use of a phonendoscope.

White or pinkish foam is released. Its color is due to the presence of erythrocytes in the proliferation, sweating through the vascular wall with permeability changed as a result of overstretching. Dyspnea in cardiac asthma is often inspiratory; inhalation is difficult.

Mixed options are possible. The patient complains of a feeling of suffocation and lack of air. Pain is characteristic of attacks that develop against the background of acute ischemic myocardial damage, including infarction. Painless forms are observed in cardiosclerosis.

An objective examination of the patient reveals the following signs:

• Hypoxia (diffuse cyanosis, tachycardia, inclusion of auxiliary muscles in the respiratory process).
• Heart failure (swelling of the legs, bluish tint of the nasolabial triangle, earlobes, lips).
• The position is forced, half-sitting, with hands resting on the bed. This placement of the body in space allows you to deposit a certain volume of blood in the lower extremities and partially relieve the small circle.
• Heart sounds are muffled due to a large number of moist rales, an accent appears over the pulmonary artery.
• Blood pressure initially rises, followed by a drop down to shock levels.

How to distinguish a cardiac cough from a regular cough

Differential diagnosis in the later stages of the disease is not difficult. The patient exhibits a typical clinical picture consistent with pulmonary edema. You can recognize a cardiac cough immediately after its appearance by the presence of the following signs :

• Heartache.
• Existing cardiac history (AMI, congenital defect).
• The patient assumes a forced sitting position with his legs down.
• No signs of inflammation of the upper respiratory tract.

Debut against the background of physical activity, psycho-emotional arousal, stress. Symptoms of general intoxication are not detected. The disease is rare in young people and children.

In case of an infectious lesion of the respiratory system, the connection with the load is not traced. In the recent past there has been an episode of hypothermia or exposure to a draft. There are other relevant symptoms:

• Hyperthermia.
• Myalgia.
• Discharge from the nasal passages.
• A sore throat.
• Hyperemia of the mucous membranes.

It is diagnosed with equal frequency in adult patients, adolescents, and preschoolers. Rarely accompanied by shortness of breath.

Classic asthma occurs after contact with an allergen or a non-biological trigger (frost air, strong odors). Expiratory shortness of breath, due to bronchospasm, exhalation is difficult. Whistling wheezes, audible at a distance, dry.

Sputum is coughed up in small quantities and has a glassy consistency. No foaming occurs.

Accurate diagnosis

Pathology at the stage of pulmonary edema is determined by the presence of corresponding symptoms. As a rule, there is no time left for additional examinations. The initial stage allows the use of hardware and laboratory methods. The main method is electrocardiography.

The film reveals cicatricial changes in the myocardium, conduction blockade, AMI (depression or ST elevation). The absence of signs of illness reduces the likelihood of a cardiac origin of cough to 10–14%.

EchoCG is used to determine the boundaries of the heart, valve apparatus, diastolic and systolic function.

During colds, characteristic changes occur in the internal environment (increased ESR, leukocytosis).

They also determine the concentration of natriuretic hormones - specific peptides, the production of which increases with increased hemodynamic load and organic lesions of the heart.

How to treat cardiac cough

Therapy is primarily aimed at unloading the pulmonary circulation, relieving spasm of the coronary arteries, if any, dehydration of the lungs, reducing preload on the heart, then the patient is transported to the ICU.

Treatment in the elderly, adults and pediatric patients differs only in the dosages of the drugs. Planned recovery and secondary prevention of attacks is determined by the underlying disease that caused cardiac asthma.

Medicines

Reducing blood flow from peripheral vessels into the pulmonary circle is achieved by introducing vasodilators. Sublingual or parenteral forms of nitroglycerin are used. Take 1 tablet, under the tongue. Injection 1% solution is diluted 0.

9% sodium chloride to obtain 0.01% concentration. The infusion rate is selected individually. A parameter of treatment effectiveness is considered to be a reduction in blood pressure by 10–25% from initial values.

An absolute contraindication to the use of nitrates is systolic blood pressure below 90 mmHg. Art.

To reduce the volume of circulating blood and reduce the degree of hydration of the lungs, the patient is prescribed loop diuretics. The drug of choice is Furosemide or Lasix at a dose of 60–90 mg. It is administered intravenously, in a stream. When used in this manner, the diuretic effect is achieved within 2–5 minutes after infusion.

Morphine (1–2 ml of 1% solution) is considered an effective drug for relieving edema. It reduces the excitability of the respiratory center and reduces blood flow to the pulmonary vessels. The medication is used with caution as it has the ability to cause respiratory depression.

Alternative remedies - Arfonad, Gigroniy.

It is better to administer drugs in small doses. Part of the drug is infused intravenously, the rest - intramuscularly or subcutaneously. This allows you to reduce the risk of respiratory arrest and make the effect of Morphine softer and longer lasting.

Oxygen passed through 70–80% ethyl alcohol is used as an antifoam for alveolar pulmonary edema. Higher concentrations can cause burns to the mucous membrane of the respiratory tract.

In order to increase the contractility of the heart, cardiotonics (Dopamine) are administered through a syringe pump or infusion system.

With successful relief of cardiac cough, wheezing subsides , there is an increase in saturation, and normalization of skin color. After stabilization of the patient's condition, the patient is hospitalized for examination and supportive care. Patients are routinely prescribed medications:

• Angiotensin-converting enzyme inhibitors (Enalapril, Captopril, Fosinopril).
• Potassium-sparing diuretics (Spironolactone, Veroshpiron).
• Angiotensin II antagonists (Candesartan, Losartan).
• Neprilysin inhibitors (Sacubitril).
• Beta-adrenergic receptor blockers (Nebivolol, Carvedilol, Bisoprolol).
• Combined agents (Uperio).

Treatment for older people is carried out taking into account their general condition and the presence of contraindications to taking a particular drug. If the function of the excretion systems (kidneys, liver) decreases, adjustment of drug dosages may be required. Therapy is carried out for life, under the control of the cardiovascular system.

Surgery

Surgical restoration of cardiac function is required in severe cases when medication does not stabilize the patient’s condition. The intervention is carried out in a specialized clinic, under general anesthesia, usually in a planned manner. The list of indications includes the severe course of the following pathological conditions:

• Angina pectoris.
• Cardiomyopathy.
• Coronary aneurysm.
• Congenital or acquired damage to the valve apparatus.
• AMI.

A heart transplant is considered a radical method of surgical treatment. It is performed for decompensated or critically acute HF stages IIB-III. Contraindications to intervention include age ≥ 65 years, impaired liver and kidney function, severe atherosclerosis, acute viral infections, and cancer with a poor prognosis for life.

Folk remedies

Medicines from the arsenal of alternative medicine can be used in both adult patients and children. It should be remembered that such techniques are auxiliary and are beneficial only in the chronic course of the disease, in combination with basic drug support.

Before starting to take herbal substances, you should consult your doctor. Traditional medicine is drunk in the form of water decoctions and infusions. Herbs such as St. John's wort, immortelle, nettle, hawthorn, thyme, and rose hips are used as raw materials.

They can reduce the degree of atherosclerotic damage to the intima of blood vessels, increase the capacity and elasticity of the circulatory system.

Diet

Patients with chronic heart failure should limit calorie intake (to normalize body weight if it is excess). The amount of table salt should not exceed 5–6 grams per day.

It is necessary to take into account not only the pure product, but also the amount of NaCl included in the dishes. The daily volume of fluid should be kept within 1.5–2 liters. Its reduction is possible only with decompensation of the condition, which increases the risk of developing internal edema.

In addition to the above, the patient should adhere to the general principles of a healthy diet:

• Limit the consumption of spicy, fatty, fried, overly sour foods, and alcohol.
• Eat fractionally, 5-6 times a day, in small portions.

Prevention

Secondary prevention of cardiac cough in diagnosed CHF is to comply with a therapeutic and protective regimen.

You need to follow your doctor’s orders exactly, undergo regular medical examinations, adhere to the principles of dietary nutrition, and lead a moderately active lifestyle (daily walking, acceptable physical exercise). Primary prevention coincides with the well-known requirements of a healthy lifestyle:

• Quitting smoking and drinking alcohol.
• Hardening.
• Regular exercise in dynamic sports.
• Fractional balanced nutrition.
• Annual medical examinations as part of general medical examination.

Doctor's report

Cardiac cough is one of the first manifestations of a life-threatening condition - pulmonary edema against the background of decompensation of chronic heart failure.

Therefore, every elderly person suffering from cardiac diseases should be able to distinguish a cough of cardiogenic origin from a cold.

Such skills will allow you to seek medical help in time, prevent the transition of interstitial edema to alveolar edema, and save your own life.

Source: https://wiki-farm.ru/kardiologiya/serdechnyj-kashel

What does a cough tell you about heart disease?

Heart disease may be accompanied by a cough. It can be dry or with a slight discharge of viscous sputum.

Most often it occurs against the background of heart failure, and can also be a complication of drug therapy. Additional examination is required to determine the cause.

To get rid of a cough, you need to improve the contractility of the left ventricle and eliminate pulmonary hypertension.

What heart problems cause a cough?

The occurrence of a cough reflex in cardiac patients is usually caused by circulatory failure. She appears in the background:

One common cause is coughing when taking medications to treat hypertension and heart failure.

These may be ACE inhibitors - Capoten, Enap, Lisinopril and other medications in this group.

The cough begins after a few days or months of regular use, first appears as a soreness or scratching in the throat, then turns into a dry, painful, annoying cough.

It is associated with an increase in the content of biologically active compounds, which ACE destroys. After discontinuation of the medication, cough cessation can be expected within 2 to 3 weeks, but there are cases of this complication that lasted more than six months.

Reasons for appearance

The occurrence of cough in heart disease is associated with myocardial weakness. Due to ineffective cardiac output, it is difficult for blood to flow from the lungs to the left side of the heart. This leads to an increase in pressure in the pulmonary vessels (veins and capillaries), sweating of the liquid part of the blood, the appearance of edema and a decrease in air exchange function.

As the disease progresses, the walls of blood vessels and airways become denser, the lungs become rigid (inelastic), and the mobility of the chest during breathing decreases. Congestive bronchitis appears, which is characterized by insufficient cleansing of the bronchi from accumulated mucus, which causes a cough reflex.

Acute decompensation of the heart is accompanied by attacks of suffocation similar to cardiac asthma, and an extremely severe form causes the formation of foamy, bloody sputum - pulmonary edema develops. This condition is life-threatening for patients, and without treatment it leads to death.

Symptoms of cough in cardiovascular diseases

Unlike the cough reflex, which is associated with diseases of the bronchi or lungs, a cardiac cough is accompanied by the following symptoms:

• cyanosis of the skin, aggravated by physical stress, is localized in the area of ​​the nasolabial triangle and fingertips;
• swelling in the lower extremities, increasing in the evening;
• rapid breathing, shortness of breath, first during exercise, and then at rest or with little physical activity;
• pain in the heart area, rapid heartbeat;
• absence of sputum, except for an extremely severe form of acute left ventricular failure;
• severe weakness, dizziness, fainting;
• dilatation and congestion of the neck veins;
• Symptoms worsen when lying down and at night.

Skin cyanosis

Which cough is considered cardiac in children, adults, and the elderly?

A dry paroxysmal cough, which appears against the background of difficulty breathing, arrhythmia, intensifies with exercise, is a symptom of mitral stenosis. With this disease, asthmatic attacks at night, sweating, hemoptysis are often observed, and when the rheumatic process is activated, the body temperature rises.

Cough due to heart failure associated with cardiomyopathy in older adults is usually:

• loud;
• worries patients more in the evening;
• becomes stronger when lying down, which makes you sleep half-sitting;
• may intensify paroxysmally several times during the night;
• sputum appears mixed with dark streaks of blood during decompensation.

In a child, a cardiac cough often occurs due to cardiac malformations with the discharge of blood from the left half of the heart to the right. These children often suffer from colds, which can make diagnosis difficult.

Complications of valvular and combined congenital defects also include chronic recurrent pneumonia and bronchiectasis.

Constant pain in the chest with a dry, sharp cough is characteristic of rheumatic carditis, inflammation of the pericardial sac. The inflammatory process leads to fluid leaking between the pericardial layers, which compresses the heart and leads to the formation of heart failure.

Patients experience severe malaise, chills, shortness of breath, rapid heartbeat, and pain becomes stronger when inhaling. The accumulation of a large volume of exudate disrupts the movement of blood through the venous network, causing swelling of the face and swelling of the veins of the neck.

Attacks of nighttime dry and persistent cough that appear immediately after assuming a horizontal position are characteristic of bacterial inflammation of the inner lining of the heart.

Throughout the day, the cough with endocarditis is less intense and is accompanied by coughing up a small amount of sputum, which makes the patient’s condition easier.

Diagnosis of the patient's condition

To make a diagnosis, the patient's medical history is taken into account - hypertension, heart defects, myocardial ischemia, cardiomyopathy, heart attack or rheumatism.

Cardiac cough in most cases means a decompensated course of circulatory failure, therefore, before its occurrence, there is pain in the heart, shortness of breath, rapid heartbeat, and rhythm disturbances.

When listening to the lungs in patients with cardiac pathology, one can detect:

• weakened or harsh breathing;
• wet small wheezing;
• crepitus, which is similar to the sounds of a tuft of hair rubbing near the ear (associated with stagnation of blood, swelling of the bronchial mucosa).

Upon examination, it is possible to detect swelling of the legs and enlarged liver.

Ultrasound of the heart

To clarify the cause of heart failure and exclude or confirm lung diseases, instrumental and laboratory diagnostics are indicated. Patients are prescribed:

• general blood test, biochemical, electrolytes, gas composition, liver and kidney tests, cardio-specific enzymes, sugar, cholesterol;
• sputum analysis and culture are informative in the presence of an infectious process in the bronchi;
• ECG - can detect ischemia, myocardial hypertrophy and rhythm disturbances. Exercise tests and Holter monitoring are used;
• Ultrasound in duplex scanning mode - evaluate contractile function, valve defects, size of the myocardium and heart cavities;
• MRI – helps to detect cardiomyopathy, structural anomalies, coronary disease, cardiosclerosis;
• X-ray of the chest organs shows the degree of congestion in the lungs and the presence of respiratory tract pathology.

Treatment of cough in heart disease

Since cough with circulatory failure is a reaction of the lung tissue to congestive processes, bronchodilators and drugs that suppress the cough reflex are not prescribed to eliminate it.

At best, they are useless, and at worst, they have a negative effect on the heart muscle and blood pressure.

Therefore, the main directions of therapy are increasing myocardial contractility, reducing the load on the heart, stimulating the removal of fluid from tissues, and improving exercise tolerance. For these purposes it is recommended:

• bed or semi-bed rest, limitation of physical and mental stress;
• reducing salt content (up to 2 - 3 g) and water (up to 0.7 - 1 liter), light meals in fractional portions;
• oxygen inhalation;
• cardiac glycosides (Strophanthin, Digoxin);
• nitrates (Kardiket, Perlinganite);
• diuretics (Trifas, Veroshpiron);
• antiplatelet agents (Curantil, Plavix);
• stimulants of metabolic processes (Preductal, Riboxin).

Cough in heart disease is most often caused by congestion in the lung tissue. It occurs when the contractility of the ventricles decreases and is accompanied by heart pain, shortness of breath, palpitations, and edema.

We recommend reading the article about hidden heart failure. From it you will learn about the classification, causes of development and clinical picture of latent heart failure, as well as the diagnosis and prevention of heart failure.

And here is more information about cardiac asthma and pulmonary edema.

To carry out differential diagnosis with lung diseases, the presence of heart defects, myocardial ischemia, cardiomyopathy, pericarditis, endocarditis is taken into account, and laboratory and instrumental examination methods are also prescribed. Treatment is aimed at increasing myocardial contractility and removing excess fluid from the body.

Source: http://CardioBook.ru/kashel-pri-serdechnyx-zabolevaniyax/

Cough with heart failure - symptoms and treatment

A survey of the population showed: 97% of people consider cough not a disease itself, but a symptom of a respiratory tract disease. But there are many more reasons for this, in fact. One of them is heart failure, in which a cardiac cough manifests itself; it is very similar to the symptom of bronchitis, but has its own characteristics in etiology and treatment.

What is cardiac cough

A symptom that occurs with a disease of the cardiovascular system (cardiovascular system). It is characterized by special symptoms and begins due to poor circulation in the lungs.

Often, a cough occurs in heart failure, during which the heart rate decreases and leads to oxygen starvation of the lungs, which causes an inflammatory process.

Important! In severe heart disease, coughing may be accompanied by blood clots instead of phlegm.

Symptoms and causes of its occurrence

Poor functioning of the heart and the occurrence of a number of pathologies leads to stagnation of blood in the lungs - this is the main cause of cardiac cough. However, depending on the disease, cardiac cough varies in symptoms, pain level and the presence or absence of expectorated blood.

The main heart pathologies that cause cough are:

• cardiosclerosis;
• myocarditis;
• arrhythmia;
• ischemic disease;
• heart attack;
• alcoholic myocardiopathy;
• paroxysmal tachycardia;
• damage to heart valves.

Another characteristic cause of heart failure is physical overload. If a person has a predisposition to heart disease, then the stress placed on the myocardium and blood vessels can lead to heart failure and accompanying symptoms. Most of these symptoms occur in adults, starting at age 30.

Video about the symptoms and treatment of cardiac cough.

Cough in heart failure is accompanied by symptoms:

• Dry cough. If the blood supply is disrupted, there is no discharge of pus or sputum. In severe cases of pathology, expectoration of blood may occur.
• Pain when lying down. As soon as the patient assumes a horizontal position, a severe cough immediately occurs, accompanied by pain. Because of this, people suffering from this pathology sleep in a semi-sitting position.
• Swelling of veins. When coughing, venous compaction in the neck is characteristic, associated with poor blood circulation.
• Pain and increased heart rate (heart rate). Attacks of cardiac cough are accompanied by a characteristic pain sensation and rapid heartbeat.
• Headache and loss of consciousness. Poor blood supply during coughing can cause dizziness and, in more severe cases, lead to fainting.
• Swelling. Occurs in the ankle area. As the disease worsens, the swelling becomes more pronounced and does not disappear by the morning.
• Increased breathing rate. Along with the cough, shortness of breath appears, the person begins to choke and cannot normalize breathing.

These symptoms of cardiac cough are quite individual and in some cases may not appear. The degree of severity depends on the nature and form of the disease.

How to distinguish a cardiac cough from a regular cough

• To distinguish a cough in heart disease from a normal one, you need to pay attention to the symptoms and characteristic signs present.
• The type of symptom can be determined by the following features:
• Table of differences between the signs of cardiac and pulmonary cough.

Is there phlegm with a heart cough? This question is one of the most frequently asked.

The cough is characterized as dry, and the discharge of mucus or pus means that it is associated with a disease of the respiratory system, rather than the cardiovascular system.

If you do not know how to recognize a cardiac cough, and comparing the above signs did not help, consult a doctor and undergo a complete diagnosis of the body to identify the cause of the disease.

In children

1. The symptom in children with congenital heart disease (CHD) is similar in symptoms to adult diseases.
2. This type of cough occurs if congenital heart disease causes blood stagnation in the pulmonary circulation.

3. Symptoms of cardiac cough in children:

1. dry cough;
2. fatigue, depressed mood;
3. pain in the heart area;
4. severe coughing in the morning and at night;
5. swelling of the veins in the neck;
6. dyspnea.

If these symptoms occur, you should consult a doctor and undergo a full course of examination.

Treatment

To decide how to treat cardiac cough, you need to know the disease that causes it. Treatment is based on the nature and form of the disease, and can be:

1. medicinal;
2. surgical;
3. using folk remedies.

Each type of treatment has its own advantages and disadvantages, which your doctor will prescribe for treating cardiac cough in your case. He will draw up a treatment plan and help you select the necessary medications or prescribe procedures to promote recovery.

A cardiac cough can be cured only after the disease causing it is completely eliminated. Treatment is often prescribed not to eliminate side symptoms, but to restore normal blood circulation.

Drug therapy

This form of treatment is considered the most effective in case of cardiovascular disease (cardiovascular system).

The drugs are prescribed as directed by the doctor after an examination and tests: ultrasound, cardiogram, tomography and blood test.

Medicines help normalize heart function, relieve muscle spasms and improve blood circulation. The heart will independently pump out stagnant blood from the lungs and restore the breathing process.

Cardiac cough is treated by using the following drugs:

• Vasodilators. A popular medicine of this type is Nitroglycerin in tablet form. This remedy relieves heart spasms by dilating the walls of blood vessels. This helps improve blood circulation.
• Diuretics. Help eliminate swelling in any form. Furosemide is considered a popular diuretic prescribed by most doctors. If the kidneys have poor functioning, the use of the drug is contraindicated.
• Beta blockers. When the functioning of the heart is weakened, the body secretes a hormone - adrenaline, to start its work. But constant exposure to the hormone negatively affects the functioning of the cardiovascular system and can worsen the patient’s condition. Beta blockers help slow the heart rate and normalize blood pressure, thereby reducing the load on the heart.
• Antitussives. Used to relieve acute coughing attacks.

Important! Antitussive drugs are a temporary measure. To completely eliminate the symptom, it is necessary to treat the underlying disease.

Surgery

If drug treatment does not have the desired effect for heart defects or other diseases, surgical intervention may be prescribed.

Developments in the field of surgery make it possible to perform minimally invasive operations, thereby reducing subsequent rehabilitation time.

It must be remembered that heart surgery is a complex and dangerous process. 10% of such procedures end in complications and death, and in other cases there is no absolute guarantee that heart surgery will relieve cough symptoms. Therefore, it is recommended not to resort to surgical intervention unless necessary.

ethnoscience

If a cough of cardiac origin occurs, the use of traditional medicine is highly discouraged by doctors. Heart disease is a very dangerous process that requires monitoring by a specialist and taking medications.

As a rule, folk remedies do not have sufficient impact and require regular use over several months or years. In this case, the slightest non-compliance with the dosage or incorrect selection of components can cause complications or side symptoms of the disease.

What should a patient do with a heart cough?

At the first symptoms of cardiac cough during illness, it is necessary to normalize your schedule, diet and physical activity. Together with taking medications, this will avoid further complications of the disease.

For a heart cough you need to:

• Maintain a daily routine. A properly constructed schedule allows you to avoid unnecessary stress on the heart. Patients are recommended to sleep at least 8 hours.
• Dosed physical activity. Sports can improve blood circulation and strengthen the heart muscle. However, the loads must be dosed and selected individually for each case. Before starting exercise, consult your doctor.

• Do not drink alcohol and tobacco, avoid stressful situations. Try not to participate in conflict situations and minimize stress factors.
• Follow a diet. For some diseases, the doctor prescribes a diet individually for each patient. The basis for any diet is the rejection of fatty and salty foods.

If you follow these recommendations, you can get rid of most diseases of the cardiovascular system within a few weeks.

Prevention measures

Cough in heart failure occurs when the standard rules of a healthy lifestyle are not followed. To avoid cough disorders with heart disease, you need to follow simple recommendations:

• regularly undergo dosed physical activity;
• to refuse from bad habits;
• adhere to a proper diet;
• normalize sleep patterns.

It is enough to follow these tips and the chance of heart problems will be reduced to a minimum.

Conclusion

Cough of cardiac origin is a severe and dangerous symptom of heart failure. However, proper treatment from a specialist and adherence to a healthy lifestyle will help get rid of the disease in the shortest possible time without the use of surgical intervention.

Source: https://MyKashel.ru/vidy/serdechnyj-kashel.html