Heart failings can lead to a persistent cough as the body attempts to rid itself of fluid buildup.
In the human body, a persistent cough accompanied by shortness of breath, swelling, fatigue, and exercise intolerance can be a potential symptom of congestive heart failure (CHF). This condition arises when the heart struggles to pump blood efficiently, leading to fluid build-up in the lungs and other tissues[1][3][5].
Causes of Congestive Heart Failure
CHF is often caused by structural or functional impairment of the heart, usually due to coronary artery disease, hypertension (high blood pressure), diabetes mellitus, or other heart conditions that impair ventricular filling or ejection of blood[2]. The heart's failure to pump effectively increases pressure in the lungs' blood vessels, causing airway compression, bronchospasm, and symptoms that can resemble asthma with wheezing and coughing[2].
Symptoms and Mechanism Behind Them
Shortness of breath occurs because fluid accumulates in the lungs and impairs oxygen exchange. Persistent cough or wheezing may be due to fluid buildup or airway irritation from congestion. Swelling (edema) in the legs, ankles, or abdomen arises because poor heart function leads to fluid retention by the kidneys[1][3][5]. Fatigue and exercise intolerance develop as the organs and muscles receive insufficient blood and oxygen.
Diagnosis and Treatment
Diagnosis usually involves an echocardiogram to assess heart function, electrocardiogram (ECG), blood tests including natriuretic peptides, chest X-rays, and possibly MRI/CT to evaluate heart and lungs[1][2]. Treatment includes lifestyle modifications such as diet, fluid restriction, quitting smoking, regular physical activity tailored to tolerance, medications like diuretics, beta blockers, ACE inhibitors or ARNI, mineralocorticoid receptor antagonists, SGLT2 inhibitors, and advanced therapies for severe cases, such as device therapy, mechanical circulatory support, or heart transplant[1][2].
Early diagnosis and intervention are crucial to improve quality of life and prevent complications. Lung congestion is the primary cause of hospitalization in people with heart failure. Fluid can build up in the air sacs in the lungs due to heart failure, which healthcare professionals refer to as pulmonary edema.
A cough from heart failure is usually persistent and produces white or pink blood-tinged mucus. People living with heart failure may also experience wheezing when lying down. Treatment for coughing due to congestive heart failure involves decreasing the excess fluid in the lungs and treating underlying heart function issues.
Individuals with symptoms of congestive heart failure should contact a healthcare professional, including if they experience swelling in the ankles, feet, or legs, cough up blood or pink-tinged mucus, gain more than 3 pounds in 24 hours, have increased shortness of breath or exercise intolerance, or develop chest pain, extreme shortness of breath, confusion, or bluish skin. Other symptoms of congestive heart failure include shortness of breath, swelling in the legs, persistent fatigue, exercise intolerance, loss of appetite, nausea, increased heart rate, and confusion.
A person may not know whether their cough is heart-related unless they have certain diagnostic tests. Doctors prescribe diuretics to reduce fluid retention in the lungs and other body areas. A cough due to congestive heart failure often sounds "wet" and may produce rales, or crackles, when listened to with a stethoscope. People with congestive heart failure may receive medication to improve heart function, which may reduce the heart rate, improve blood pressure, and help the heart beat more efficiently.
References:
[1] American Heart Association. (2020). Heart Failure. Retrieved from https://www.heart.org/en/health-topics/heart-failure
[2] Mayo Clinic. (2021). Congestive heart failure. Retrieved from https://www.mayoclinic.org/diseases-conditions/congestive-heart-failure/symptoms-causes/syc-20371456
[3] National Heart, Lung, and Blood Institute. (2020). What is Heart Failure? Retrieved from https://www.nhlbi.nih.gov/health-topics/heart-failure
[4] Cleveland Clinic. (2021). Heart Failure Symptoms. Retrieved from https://my.clevelandclinic.org/health/diseases/15753-heart-failure/symptoms
[5] Johns Hopkins Medicine. (2021). Heart Failure. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/heart-failure
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