Cardiac asthma isn’t a type of asthma, it refers to breathing difficulty caused due to fluid build-up in the lungs because of heart failure. It is a potentially fatal disorder and proper diagnosis, and treatment is critical. But it can be misdiagnosed as asthma due to the similarities between the symptoms, where people suffering from either condition can experience coughing, shortness of breath and wheezing.
Man suffering from cardiac asthma

What Is Cardiac Asthma?

Cardiac asthma is a group of asthma-like respiratory symptoms caused by congestive heart failure. It was first coined in medical literature by Dr James Hope in 1833. People suffering from this condition generally exhibit symptoms like coughing, trouble breathing, and shortness of breath due to pulmonary congestion. Where the fluid is accumulated in the lungs that hinder the ability to purify the blood.

In people with congestive heart failure, the heart cannot efficiently pump blood out of the left ventricle. This interruption in blood flow leads to increase blood pressure in the blood vessels of the lungs, which causes leakage and fluid build-up.

Also Read: Heart Failure: Symptoms, Causes, Types And Treatment

Symptoms

Wheezing

Breathing difficulty

Rapid heartbeat

Coughing

Bloody and foamy sputum

Shortness of breath when lying down

Nocturnal dyspnoea

Symptoms of cardiac asthma may be initial symptoms of heart failure such as:

Chest pain

Fainting

Fatigue

Irregular heart rate

Skin that appears blue

Swelling in the lower extremities

Weight gain

Frequent urination, often at night

Causes

Cardiac asthma is caused by heart failure, while the common cause of heart failure in adults is coronary artery disease. It is a condition where the arteries that supply blood to the heart become narrowed leading to improper blood flow and heart attack. Other conditions that contribute to the development of heart failure include:

Past heart attacks

Abnormal heart rhythm

Uncontrolled hypertension

Heart valve disorders

Cardiomyopathy

Hyperthyroidism

Myocarditis

Heart defects present from birth

Diabetes

Lung disease

Obesity

Kidney failure

Severe anaemia

Sleep apnea

Also Read: Heart Valve Disease: Causes, Symptoms And Treatment

Diagnosis

Cardiac asthma may be difficult to diagnose as the symptoms are quite similar to asthma, thus misdiagnosis is common. To distinguish between the two, the healthcare provider will collect the patient's medical history and risk factors to evaluate whether heart failure is the root cause.

Some of the tests recommended by a doctor to confirm the diagnosis include:

Physical exam: The doctor will thoroughly assess the patient for any signs of cardiac asthma and heart failure, like abnormal sounds in the lungs while breathing and abnormal heart rate.

Blood tests: The doctor may suggest blood works to diagnose conditions that lead to heart failure, check for markers of fluid retention, and rule out any other possible causes for symptoms.

Electrocardiogram: An ECG evaluates the electrical activity of the heart and identifies any abnormalities in the heart rhythm

Echocardiogram: An echocardiogram is an imaging test that uses sound waves to produce a picture of the heart. This show how efficiently the heart is pumping blood.

Chest X-ray: A chest X-ray can help identify an enlarged heart or fluid in your lungs.

Breathing tests: A spirometry test or a peak flow test is done to monitor lung function and any lung problems.

Furthermore, the doctor may also suggest a CT or MRI scan assess the health of the heart.

Treatment

The main mode of the treatment plan is to correct the underlying heart failure and fluid build-ups in the lungs.

The doctor may prescribe medications to treat an emergency case of cardiac asthma. Once the symptoms stabilize, then the patient is put on ACE inhibitors or beta-blockers or both to avert another episode. ACE inhibitors help widen blood vessels, while beta-blockers slow heart rate and lower blood pressure.

Oxygen And Ventilation

If the patient is not getting enough oxygen, then they may be given oxygen or put on a non-invasive ventilator.

Surgery

Some patients may need surgery such as an angioplasty or coronary bypass surgery to improve blood flow to the heart and augment heart health.

Lifestyle Modification

Leading a disciplined lifestyle may help improve heart failure symptoms or prevent heart failure, some of the lifestyle changes one should adopt include:

Engaging in regular exercise

Quitting smoking

Restricting alcohol intake

Managing stress

Getting sound sleep

Maintaining healthy weight