Don’t confuse cardiac asthma with bronchial asthma: Know the difference

Despite its name, cardiac asthma is not bronchial asthma. It is a disorder that results in asthma-like symptoms such as wheezing, coughing, and breathing difficulties. It is a type of coughing that occurs with left heart failure, not asthma. This World Asthma Day, let’s learn more about cardiac asthma.

Health Shots asked Dr Kaushal Chhatrapati, Interventional Cardiologist, to share all about the disease and how one should not confuse it with asthma.

What is cardiac asthma?

Cardiac asthma is often confused with bronchial asthma because of its symptoms which closely resemble asthma. It is usually characterised by breathlessness, wheezing, and extreme discomfort. But that’s where the resemblance ends. Cardiac asthma is breathlessness from cardiac causes, generally, heart failure, says Dr Chhatrapati.

When the heart muscles become weak, secondary to any cause (heart attack is the most common cause), they become inefficient in pumping blood the way they should. The decrease in the heart’s ejection fraction (the measurement of the percentage of blood leaving the heart each time it squeezes) serves as evidence of this. Normal Ejection Fraction is expressed as a percentage is 65 percent. Whenever this falls to 40 percent or less, heart failure can occur, explains the heart.

He adds that the blood that your heart is unable to pump pools in the lungs and leaks into the minute air sacs where respiration occurs. This then hampers the exchange of gases, and oxygen level in the blood falls. Thus, the patient experiences coughing, difficulty in breathing, and wheezing. This is known as “Cardiac Asthma.”

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Cardiac asthma vs bronchial asthma

If you are still confused between the two conditions, here are some differences pointed out by Dr Chhatrapati.

1. Someone at risk of bronchial asthma would have a history of allergy and a tendency to have asthma attacks from young age, favouring a diagnosis of the condition. In cardiac asthma, the patient might have a history of heart disease, blood pressure, and diabetes.

2. Quantity and quality of phlegm also differ in both conditions. Bronchial asthma patients may bring out sticky, viscid sputum, whereas, pink frothy sputum indicates cardiac asthma.

3. Rapid and dramatic response to inhalers or nebulization of Asthma medications favors Bronchial Asthma. Cardiac Asthma generally doesn’t respond to bronchodilators alone, though they may help a little. IV urine-making drugs(“Diuretics”) bring about rapid symptomatic relief in Cardiac Asthma

4. As for diagnosis, bronchial asthma is diagnosed by checking the history, and pulmonary function tests help. Whereas, ECG may give a clue about underlying heart disease in cardiac asthma. 2D echocardiography is one test used to diagnose cardiac asthma, along with some blood tests.

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How to reduce the risk of cardiac asthma?

Since cardiac asthma is brought on by heart failure, reducing your risk of heart failure also lowers your risk of developing cardiac asthma. Here are some ways to reduce the risk as suggested by the cardiologist:

• Talk to your doctor and take medicines for underlying risk factors such as high blood pressure, diabetes, and heart disease regularly.
• If the patient has a low ejection fraction (low EF), he or she should limit salt and water intake as per the advice of the doctor.
• Both cardiac and bronchial asthma are triggered by infection of the lungs, so patients should get inoculated against problems like seasonal influenza and pneumococcal.

If left untreated, cardiac asthma can be a dangerous disease that can lead to several complications. However, if treated properly, the patient may be able to live a healthy and fruitful life.