Cardiac Asthma

Cardiac asthma is a condition that produces classic wheezing and coughing but from a source other than bronchial constriction.  The term cardiac asthma refers to wheezing associated with heart failure.  Depending upon how severe the symptoms are, this wheezing can be a medical emergency.

In true asthma the lungs are the original source of the problem.  Asthma triggers create inflammation in the bronchioles, pathways through which air passes through out the lungs.  This inflammation causes a constriction of the pathways as well and as a release of mast cells to the area.  These cells increase the amount of mucus produced in the bronchioles which also decreases the amount of air allowed to pass through to the lungs.

In the case of true asthma, treatment is directed at the lungs and bronchioles to reduce the inflammation and improve airflow.  An individual who suffers from true asthma should also work to reduce their exposure to triggers that increase their risk of an asthma attack.  These things can include smoke, chemicals, allergens, pet dander, exercise or upper respiratory infections.

An individual who suffers from cardiac asthma will experience a buildup of fluid in the lungs and airways as a result of heart failure.  The signs and symptoms, shortness of breath, coughing and wheezing  –  will mimic the signs of asthma.  However, while true asthma is a chronic condition caused by inflammation in the airways, cardiac asthma is a symptom indicative of a failing heart.

Physicians will look at the pattern of shortness of breath and the age of the individual as well as the overall health to help determine which type of asthma and individual actually suffers from.  People with bronchial asthma, true asthma, tend to experience shortness of breath early in the morning and coughing through the night.  Individuals who have cardiac asthma will often wake up breathless a few hours after going to bed and have to sit upright to catch their breath.  This is because as individuals who suffer from heart failure lie down for a prolonged period of time the fluid will accumulate in the lungs and lead to a shortness of breath.

In both cases an individual will find they are short of breath during exertion or exercise but in bronchial asthma the symptoms are usually brought on by vigorous exercise and tend to be worse after the exercise then during it.  On the other hand and individual with cardiac asthma will have shortness of breath during less vigorous exertion and may find themselves short of breath while climbing stairs or even getting dressed.

The distinction is very important to make because the treatment is significantly different.  If  the possibility of heart failure is overlooked it can likely lead to death while attempting to treat inflammation in the bronchioles.  Treatments for heart failure will include medications that will help reduce the symptoms of both the heart failure and the cardiac asthma by increasing the pumping ability of the heart.  In fact, overusing rescue inhalers for two through asthma may actually worsen the symptoms of cardiac asthma.

While both bronchial asthma and cardiac asthma can lead to life-threatening situations it is much more likely that an individual who is suffering from shortness of breath is secondary to cardiac asthma will experienced a life-threatening situation much more quickly.  For this reason it is very important that an individual consult with their physician to determine if they have cardiac asthma or bronchial asthma and if cardiac asthma is diagnosed it is very important that the individuals maintain appropriate medication and supervision by their primary care physicians.