Cough in heart failure: causes, diagnosis and treatment

The article discusses the symptoms and treatment of cough in heart failure.

Pathologies that lead to insufficiency of pumping cardiac function can cause a symptom, often mistaken for a sign of allergy or bronchitis. This is a persistent cough, with heart failure appearing from blood stasis in the small (pulmonary) circle of blood circulation. The attack has this mechanism: the lungs swell, the bronchial mucosa swells, the patient develops a cough reflex.

This article will explain why it occurs and what additional symptoms are accompanied by cough in heart failure, as well as therapeutic methods.

A symptom with cardiac pathologies occurs due to stagnation of blood in the pulmonary (small) circle of blood circulation. This symptom indicates a second stage of chronic heart failure and requires immediate treatment. Heart failure is understood as a set of conditions in which an organ cannot fully function, it can be caused by various diseases.

Cough in heart failure can be eliminated if the cause is eliminated. Often this can only be done with surgery.

Heart cough is characterized by certain symptoms, which will be listed below. If such signs are found, you should immediately contact a cardiologist. If you ignore this symptom and untimely treatment or the absence of changes in its tactics, cardiac asthma occurs.

What are the causes of heart cough?

Cough with heart failure appears against a background of genetic or acquired heart defects.

The presence of this symptom is characterized by the following diseases:

• Left ventricular hypertrophy.
• Insufficiency of several or one heart valve.
• Stenosis of several or one heart valve.
• Myocarditis.
• Cardiomyopathy
• Arterial chronic hypertension.
• Atherosclerosis of the coronary vessels or their thrombosis (cause insufficient supply of myocardial oxygen).
• Cardiac amyloidosis (a violation of material metabolism, in which proteins are deposited in the tissues of the heart). This is a rather rare disease, characterized by increased mortality; it cannot be completely cured.
• Defect of the septum between the ventricles.

In heart failure, cough with sputum is rarely observed.

Dry cough can act as a side effect of ACE inhibitors - drugs that lower blood pressure. In this situation, if the symptom significantly reduces the patient’s quality of life (for example, interferes with normal sleep), the doctor will replace the drug with another: one that will be better tolerated by the patient’s body. The main causes of cough with heart failure were considered above, perhaps.

Symptomatology

So, there is a dry cough with heart failure. Only at the last stage of the pathology can it be accompanied by bleeding. Other symptoms of chronic pathology supplement it:

• shortness of breath (with little physical exertion at stage 2A, at rest - at stage 2B);
• a feeling of lack of air and the inability to stay in stuffy rooms;
• swelling
• dizziness, in some cases fainting;
• rhythm disturbances;
• heart attacks

Symptoms of coughing in heart failure are important to recognize in a timely manner.

Differences between colds and heart

Heart cough:

• mostly dry;
• always occurs simultaneously with the symptoms of heart failure described above;
• amplified at night, with physical activity and in a supine position, it becomes not so intense if the patient is sitting;
• the character is chronic, does not go away without treatment of heart pathology.

Cold cough:

• quickly passes from dry to wet;
• always accompanied by fever, runny nose, sore throat and other symptoms of respiratory diseases;
• evenly manifests itself throughout the day and does not depend on the position of the patient's body;
• passes within two to three weeks.

How does a cough manifest in heart failure in an elderly person?

Cough in adults and seniors

An annoying cough at night continually torments a patient with heart failure, forcing him to sit down. Medicine connects attacks of suffocation at night, the difficulty of expectoration in people with a complex form of pathology.

A cough in heart failure in an elderly person is very painful.

Pain in the chest area and a barking sound help determine rheumatism, and with sputum with blood due to coughing, repeated heart attack and coronary heart disease are suspected. An elderly person with cough and heart failure may have brown sputum - this is a symptom of the breakdown of red blood cells, as well as acquired heart disease.

In children

In a child, specialists associate heart cough with CHD, a congenital heart disease that turns into heart failure. In CHD, Eisenmenger's syndrome indicates a violation of the septum between the ventricles and increased pressure of the lungs with an additional discharge of blood to the right side on the left side. Cough in heart failure in childhood allows you to establish the severity of congenital heart disease.

Diagnostics

Diagnostic measures are required to determine therapeutic tactics. It is carried out in several stages:

• pulmonary x-ray - allows you to find stagnation;
• ECG, or ultrasound of the heart - through this method, the heart structure is examined and the immediate cause of the failure is established;
• ECG - detects heart rhythm disturbances;
• transesophageal echocardiography - contributes to a more detailed assessment of the heart structure compared to a simple ECG, determines blood clots inside the heart (a common symptom in heart failure of a chronic nature);
• coronarography - used for suspected presence of coronary atherosclerosis.

In addition to instrumental methods, biochemical methods are also used to study the patient's body:

• blood tests (for thyroid hormones, for serum creatinine, total);
• urine analysis - makes it possible to diagnose hypertension due to kidney disease.

How to get rid of shortness of breath and cough with heart failure?

How to eliminate heart cough?

Therapy is to combat the underlying pathology that led to heart failure.

Cardiac cough itself as a sign in some cases requires the use of antitussive drugs with anesthetic effect. They are used in a situation where this symptom is expressed significantly and is not relieved with the help of the main treatment course.

Drug treatment

With decompensation of the heart and blood vessels, drugs are prescribed in combination.

Diuretics (diuretics) eliminate excess fluid, help reduce pressure. Vasodilators contribute to vasodilatation. Coughing attacks with heart failure are eliminated with antitussive drugs with anesthetic effect, if such a symptom torments the patient, and it comes to a state of fainting.

So, the diuretics that are prescribed most often:

1. "Indapamide" is a long-acting diuretic thiazide-like drug that inhibits the entry of hydrogen, chlorine, sodium ions into the bloodstream, and has a weak vasodilating effect. The medicine for heart failure is taken in the morning for 2-3 months in an amount of 1.25 to 2.5 milligrams.
2. Veroshpiron is a hormonal potassium-sparing diuretic that stimulates the elimination of water and sodium from the body, reduces the leaching of potassium ions, and reduces the acidity of urine. With heart cough, the medicine is taken for fifteen days at 100 milligrams per day.

As for vasodilators, then among them they are most often used:

1. "Losartan." Reduces pressure in heart failure in the pulmonary circulation, prevents the retention of water and sodium in the body. It is advisable to take the drug from three to six weeks at 50 milligrams per day.
2. "Atakand." It allows you to lower blood pressure, inhibits the hormone angiotensin II, and also stimulates the pathogenesis of diseases of the cardiovascular system. With heart failure, the medicine is taken daily for two to three months once a day, eight milligrams, regardless of diet.

Separately, patients are prescribed cough medications. Among them, the most popular are:

1. Codeine is a cough suppressant with anesthetic effect. It has a narcotic effect, very quickly eliminates irritation of the cough center and reduces pain, however, it can cause dependence on drugs and bronchospasm. The drug is taken once in an amount from 15 to 60 milligrams, the next dosage is drunk after three hours, the duration of the course is determined by a specialist.
2. Glaucin. It produces an anesthetic local effect, provides assistance with heart cough, carefully calms the nervous autonomic system, and to some extent lowers blood pressure. If the patient has heart failure and cough, the drug is taken from a week to ten days at 40 milligrams 2-3 times a day.

So, what else does cough treatment for heart failure suggest?

Surgical intervention

With the help of surgical intervention, the primary source of heart failure is eliminated, in connection with which it is more effective compared to conservative medical methods. However, surgery can cause dangerous complications, especially in old age. Before deciding on an operative measure, the specialist will definitely weigh the pros and cons.

For various heart defects, the following operations are required:

• In case of insufficiency or stenosis of the valves (valve), a prosthesis is performed by a biological or mechanical artificial valve.
• During coronary thrombosis or atherosclerosis, coronary artery bypass grafting, stenting, rotational ablation, balloon angioplasty, etc. are performed.
• With cardiomyopathy, a heart transplant is performed.

Physiotherapy

It is contraindicated for patients with heart failure to lead a sedentary lifestyle.

Aerobic exercise and breathing exercises (walking, special therapeutic exercises, light running) are recommended. When prescribing, the doctor takes into account the following indicators:

• respiratory rate not higher than 30 for a minute;
• lack of dyspnea at rest;
• slight fatigue during exercise.

Diet. In the absence of dietary adjustments, therapy will not be as effective. Be sure to give up salt, drink no more than one and a half liters of water per day. It is forbidden to eat fried and greasy. If the patient is overweight, only low-calorie foods are allowed. The diet should include more herbs, vegetables, fruits and oils. Take trace elements and vitamins required for normal cardiac activity (requires prior consultation with a specialist).

Dog cough in heart failure

Heart failure is a disease that occurs in animals, including dogs. The body is deficient in oxygen and nutrients.

The disease almost always causes other heart problems, pathologies of other organs, or infection. Groups of breeds with a natural predisposition to failure are distinguished: dwarf breeds, boxers, English bulldogs, poodles, schnauzers, Samoyeds, German shepherds and Dobermans. The problem in large dogs appears due to lack of physical activity or their excess. The disease is often diagnosed in animals in old age, when the heart works worse and worse due to age-related changes.

Pathological changes appear at different rates, and failure due to this is divided into chronic and acute. The latter form is more often manifested during the course of the underlying disease, after treatment the problem is successfully solved. If adequate therapy is not available, then the pet may die due to cardiogenic pulmonary edema. Chronic heart failure in dogs is characterized by periods of worsening condition and remission. The main symptom is persistent cough. The main causes of pathology are as follows:

• heart defects and diseases, for example, ischemia, pericarditis, myocarditis;
• pressure problems
• immoderate loads;
• cardiomyopathy;
• parasitic infestation;
• myocardial infarction.

It is important to know that the sooner you go to the vet to identify problems in the animal, the higher the chances of saving his life.

Animal treatment

After a comprehensive examination is carried out, the specialist will prescribe the necessary treatment course. It is important to know that in the first place, the underlying disease that provokes heart failure is treated. Therapy of acute form includes:

• strict dog pressure control;
• elimination of arrhythmia;
• reduced load on the heart muscle;
• ensuring proper liver function;
• manipulations to exclude pulmonary edema or stop it.

The choice of drugs depends on the specifics of the body of a particular dog. Check out:

• ACE inhibitors - Ramipril, Enalapril;
• diuretics to reduce swelling;
• digoxin - a group of glycosides;
• beta-blockers - Metorolol, Bisporolol.

In an animal with a heart attack, an injection of "Caffeine" subcutaneously and "Cordiamine" is used intramuscularly. The treatment of heart failure in a dog in a chronic form is almost no different from acute. In addition to drug therapy, you need to ensure peace for the pet: reduce the duration of walks and reduce physical activity. Salt and water are also limited. It is necessary to carefully monitor the pulse of the animal. Do not self-medicate, otherwise you can harm the pet.