Despite the name, cardiac asthma isn’t a type of asthma. It refers to breathing difficulty caused by fluid buildup in the lungs as a result of heart failure.
Cardiac asthma can be potentially life threatening, and a proper diagnosis is critical. However, it can be misdiagnosed as asthma due to the similarities between the symptoms. People with either condition can experience coughing, shortness of breath, and wheezing.
Keep reading as we break down everything you need to know about cardiac asthma, including what causes it, what symptoms occur, and how it’s treated.
Cardiac asthma is a collection of asthma-like respiratory symptoms caused by congestive heart failure. The term “cardiac asthma” was first coined in medical literature in 1833 by Dr. James Hope.
People with cardiac asthma typically experience symptoms such as coughing, trouble breathing, and shortness of breath due to pulmonary congestion. This is a buildup of fluid in your lungs that impairs your ability to oxygenate your blood.
Your heart has four chambers: the left atrium, left ventricle, right atrium, and right ventricle.
In people with congestive heart failure, the heart can’t properly pump blood out of the left ventricle or the pressure in the ventricle is high. This disruption in blood flow leads to increased blood pressure in the blood vessels of the lungs, which causes leakage and accumulation of fluid.
Symptoms of cardiac asthma include:
- trouble breathing
- rapid breathing
- bloody sputum
- frothy sputum
- orthopnea (shortness of breath when lying down)
- rales (abnormal sounds heard when listening to the lung with a stethoscope)
- paroxysmal nocturnal dyspnea (waking up at night gasping for air)
Symptoms of cardiac asthma may be the initial symptoms of heart failure, or they may be present along with other signs of heart failure, such as:
- chest pain
- irregular heart rate
- skin that appears blue
- swelling in the legs, feet, or ankles
- weight gain from fluid retention
- increased need to urinate, often at night
Cardiac asthma can be difficult to diagnose due to its similarity to asthma. Misdiagnosis is common. To differentiate between the two, a doctor will likely start by looking at your medical history and risk factors to determine whether heart failure is the cause.
Tests that may be performed to help diagnose heart failure include:
- Physical exam. The doctor may look for other signs of cardiac asthma and heart failure, such as abnormal sounds in your lungs when breathing and abnormal heart rate.
- Blood tests. The doctor may recommend a blood test to help diagnose conditions that can lead to heart failure, check for markers of increased fluid, and rule out other potential causes for your symptoms.
- Electrocardiogram. An electrocardiogram monitors the electric activity of your heart and helps identify abnormalities in your heart rhythm.
- Echocardiogram. An echocardiogram is a type of ultrasound that uses sound waves to produce a picture of your heart. The picture can show the doctor how much blood your heart is pumping and screen for irregularities or abnormalities in the pumping function.
- Chest X-ray. A chest X-ray can help identify an enlarged heart or fluid in your lungs.
- Breathing tests. Your doctor may recommend breathing tests like a spirometry test or a peak flow test to screen for lung problems.
- Other imaging techniques. A CT or MRI scan may also be used to produce images to assess the health of your heart.
Tips for your medical appointment
If you think you may be experiencing cardiac asthma, it’s critical to seek medical attention immediately.
Persistent wheezing, shortness of breath, and trouble breathing are all signs that you should talk with a medical professional, especially if your symptoms get worse when you lie down.
It can help to ask yourself the following questions while you’re waiting to see a doctor to help determine whether it’s cardiac asthma:
- Has anyone in my family experienced heart failure?
- Do I have any risk factors for heart failure, such as high blood pressure or coronary artery disease?
- Does anybody in my family have asthma?
- Have I had asthma before?
- Are there other potential causes for my breathing trouble, like the flu or a respiratory infection?
- Is my breathing trouble keeping me awake?
Cardiac asthma is caused by heart failure. The most common cause of heart failure in adults is coronary artery disease. Coronary artery disease is when the arteries that supply blood to the heart become narrowed or blocked, unable to deliver blood and even closing completely due to a heart attack. It’s usually caused by atherosclerosis, or the buildup of cholesterol and plaque in the blood vessels.
Other conditions that can cause or contribute to the development of heart failure include:
Classic asthma medications like bronchodilators are thought to have
Medications traditionally used to treat an emergency case of cardiac asthma include:
- furosemide or diuretics to remove fluid
Once your symptoms stabilize, you may be given ACE inhibitors or beta-blockers or both to prevent another episode. ACE inhibitors help widen blood vessels and unload the heart, while beta-blockers slow your heart rate and lower your blood pressure.
Oxygen and ventilation
If your body isn’t receiving enough oxygen, you’ll likely be given oxygen or put on a noninvasive ventilator. In severe cases, you could need a breathing tube. However, these treatments aren’t necessary if you’re able to breathe well enough to get adequate oxygen.
Some people will need surgical interventions, such as an angioplasty or coronary bypass surgery, to improve blood flow to the heart and make the heart stronger. The final treatment option when all other treatments have failed is a heart transplant.
Lifestyle tips for cardiac asthma
Living an overall healthy lifestyle may help improve your heart failure symptoms or prevent heart failure in the first place. Some habits you can adopt include:
- exercising regularly
- avoiding smoking
- minimizing alcohol intake
- minimizing stress
- getting adequate sleep
- maintaining a healthy weight
Cardiac asthma is a secondary condition caused by heart failure. The outlook for people with heart failure improves the sooner they receive proper treatment. However, it can vary widely between people.
The life expectancy of somebody with cardiac asthma depends on how far their heart failure has progressed, the underlying cause, and their overall health.
Mortality rates at 1 year and 5 years after heart failure diagnosis are about
Cardiac asthma is a condition caused by heart failure that leads to asthma-like symptoms, such as wheezing, coughing, and trouble breathing. It’s caused by a buildup of fluid in the lungs due to the inability of the heart to effectively clear fluid from the lungs.
Cardiac asthma is often misdiagnosed as asthma, but a proper diagnosis is critical for receiving proper treatment maximizing your outlook.