Cardiac Asthma - Causes, Symptoms, Diagnosis, and Treatments

Introduction:

Cardiac asthma is a condition that occurs when fluid accumulates in the lungs as a result of heart failure. It is different from bronchial asthma, which is caused by shrinkage of the airway passage due to inflammation . This condition is marked by difficulty breathing, wheezing, and the presence of blood in coughs.

What Are the Causes of Cardiac Asthma?

Cardiac asthma arises from heart failure, a condition where the heart fails to adequately pump blood to satisfy the body's requirements. Various factors can contribute to this, such as:

• Coronary Artery Disease: This shows features like narrowing or blockage of the arteries responsible for supplying blood to the heart due to the buildup of plaque.

• Hypertension: Failure to address high blood pressure can result in progressive damage to the heart muscle and ultimately lead to the development of heart failure.

• Heart Valve Disease: Damage to the valves in the heart can cause the heart to work harder to pump blood, which can eventually lead to heart failure.

• Cardiomyopathy: A cardiac condition characterized by a weakened heart muscle that impairs its ability to effectively pump blood.

• Arrhythmia: Irregular heart rhythms can impose excessive workload on the heart, resulting in heart failure.

What Happens in Cardiac Asthma?

In situations where the heart struggles to efficiently pump blood, there is a possibility of blood backing up into the lungs, resulting in the accumulation of fluid within the air sacs, a condition known as pulmonary congestion. This buildup of fluid can create breathing difficulties, giving rise to the symptoms associated with cardiac asthma.

What Are the Symptoms of Cardiac Asthma?

The symptoms of cardiac asthma can be similar to those of bronchial asthma, but there are some key differences. The most common symptoms of cardiac asthma include:

• Shortness of Breath: Dyspnoea is a hallmark symptom of cardiac asthma. Severe shortness of breath occurs when the person is lying down (supine position).

• Wheezing: Coughing or wheezing occurs especially at night or early morning. This may be mistaken for bronchial asthma, but the wheezing in cardiac asthma is usually caused by fluid buildup in the lungs.

• Rapid or Shallow Breathing: The person may be breathing more quickly than usual or taking shallow breaths.

• Chest Discomfort: The person may feel pressure or tightness in their chest.

• Fatigue: Weakness is a common symptom of heart failure, which is the underlying cause of cardiac asthma.

• Swelling in the Legs or Ankles: This is another common symptom of heart failure and can be a sign that fluid is backing up in the body.

How Is Cardiac Asthma Diagnosed?

Cardiac asthma is diagnosed by a comprehensive evaluation of medical history, physical examination, and investigations. Some of the investigations done to diagnose cardiac asthma include:

• Chest X-ray: This radiograph shows buildup of fluid in the lungs.

• Echocardiogram: This uses sound waves to create images of the heart and can help to identify any issues affecting the cardiac muscle or valves.

• Electrocardiogram (ECG): This shows the electrical conduction of the heart and helps in identifying any abnormal heart rhythms (arrhythmia).

• Hematological Studies: Performing blood tests can aid in the detection of any underlying medical conditions that could be contributing to the development of cardiac asthma.

It is also necessary to differentiate bronchial asthma from cardiac asthma. This is done using lung function tests like spirometry or a bronchodilator test. Spirometry measures the volume of air inhaled and exhaled, while a bronchodilator test measures how well the lungs respond to medication.

How Is Cardiac Asthma Treated?

The treatment for cardiac asthma depends on the underlying cause and severity of the condition. In general, the objective of the treatment is to enhance heart function and diminish the accumulation of fluid in the lungs. Here are some of the ways to treat cardiac asthma:

• Medications: Medications can improve heart function and reduce fluid buildup in the lungs. This includes diuretics to help the body get rid of excess fluid, ACE inhibitors or angiotensin receptor blockers that expand the blood vessels to reduce the cardiac workload and improve blood flow, and beta blockers to help slow the heart rate and reduce the workload on the heart.

• Oxygen Therapy: If the person is having difficulty breathing, oxygen therapy may be used to help them get more oxygen.

• Lifestyle Changes: Lifestyle changes help improve heart health, such as reducing salt intake, losing weight, quitting smoking, and exercising regularly. Individuals with cardiac asthma are recommended for an active lifestyle and balanced diet to improve their overall well-being.

• Surgery: In some cases, surgery may be necessary to treat the underlying cause of cardiac asthma. Surgery may be used to repair or replace damaged heart valves or treat narrowed arteries.

What Are the Complications of Cardiac Asthma?

If left untreated, cardiac asthma can lead to several complications, including:

• Pulmonary Edema: This is a critical condition characterized by the accumulation of fluid in the lungs, resulting in respiratory difficulties. Symptoms may include severe shortness of breath, wheezing, coughing, and frothy, pink-tinged sputum.

• Respiratory Failure: If cardiac asthma is not treated promptly and effectively, it can lead to respiratory failure, a condition where the lungs fail to deliver sufficient oxygen to the body.

• Arrhythmia: The stress on the heart caused by cardiac asthma can lead to abnormal heart rhythms or arrhythmias. This can be dangerous, especially if it leads to a sudden cardiac arrest.

• Kidney Damage: The use of diuretics to treat cardiac asthma can put a strain on the kidneys, causing damage or failure.

• Cognitive Impairment: Reduced oxygen supply to the brain can cause cognitive impairment, such as confusion, disorientation, and transient memory loss.

How to Prevent Cardiac Asthma?

Cardiac asthma can be prevented by the following:

• Managing Underlying Conditions: Proper management of underlying conditions like hypertension, diabetes mellitus, and hypercholesterolemia is essential. This is done by comprehensive management by medical professionals and individuals.

• Quitting Habits Like Smoking and Alcoholism: Smoking is a major risk factor for cardiac asthma. Hence, it is recommended to quit the habit.

• Exercises: Adapting to a healthy lifestyle by regular exercising can improve cardiac health.

• Balanced Diet: Proper diet and nutrition are necessary to prevent diseases. Intake of excess salt, added sugars, and oil should be reduced and nutritious foods like fruits, vegetables, pulses, or rains should be consumed.

• Management of Stress: Chronic stress can increase the risk of heart disease. Practice stress-reducing activities such as yoga, meditation, or deep breathing exercises.

• Periodic Medical Check-Up: Regular check-ups and screenings can help to identify any potential issues early and prevent complications of cardiac asthma.

Conclusion:

Overall, prompt identification of underlying medical conditions through blood tests and appropriate treatment aimed at improving heart function and reducing pulmonary congestion are crucial in managing this serious condition. By addressing the root causes and managing symptoms effectively, individuals with cardiac asthma can experience improved respiratory function and overall well-being.