Persistent Heart Cough In Congestive Heart Failure
What is chronic or persistent cough?
Is persistent or chronic coughing normal?
Everyone coughs and no one worries about an occasional cough. Many acute illnesses ranging from hay fever and the common cold to pneumonia and bronchitis create recurrent coughs. Coughing is a common condition that's mostly associated with our own body trying to eliminate some irritants trapped within the lungs. Coughing can also be observed through a disease wherein our body is trying to push the bacteria trapped in the mucus. However, the cough that accompanies acute illnesses resolves in a few days to a couple of weeks. By comparison, a chronic cough is defined as one which lingers for at least three to eight months, sometimes lasting for months or even years.
Chronic coughing is common, so it rates among the most frequent reasons for seeing a physician. Along with being concerned about the cause of the cough, patients experience anxiety and frustration, especially when diagnosis and therapy stretch out over weeks, which is frequently the case. Coughing interrupts sleep, producing fatigue and impairing concentration and work performance. In this time of frightening new viruses, social interactions may endure. Coughing may also have significant physical consequences, ranging from urinary incontinence to fainting and broken ribs. Between clinical tests, lost productivity at work, remedies which don't help, and remedies that do, coughing can become costly.
What causes chronic coughing?
Smoking is a significant cause. Most cigarette smokers develop a chronic "smoker's cough." Chemical irritation is responsible, but the same toxic chemicals that cause the easy smoker's cough may result in far more severe conditions, such as bronchitis, emphysema, pneumonia, and lung cancer. Chronic cough is a cause of concern for smokers.
A lingering cough can be a worry for nonsmokers. Fortunately, benign issues are responsible for many chronic coughs in nonsmokers. Benign or not, persistent coughing can lead to worry, embarrassment, fatigue, and much more. That is why chronic coughs should be diagnosed and treated until they linger too long.
Dozens of conditions can result in a recurrent, lingering cough. The lion's share is due to only five: postnasal drip, asthma, gastroesophageal reflux disease (GERD), chronic bronchitis, and therapy with ACE inhibitors, used for hypertension. Many individuals have several of those conditions, but in nonsmokers, the first three, independently or in combination, account for almost all chronic coughs. The significant causes of long-term coughing are given below.
Major causes of persistent cough
There are many possible common causes of chronic cough:
Gastroesophageal reflux disease
Chronic bronchitis; bronchiectasis
Treatment with ACE inhibitors
Less common causes of a nagging cough
Airborne environmental irritants
Aspiration during swallowing
Pertussis (whooping cough)
Other lung diseases
Frequent in smokers
Persistent coughing is mostly caused by long-term diseases of the lungs, such as asthma or chronic obstructive pulmonary disease. Keeping the disease in check with good treatment can help reduce the coughing. If the coughing persists along with various other signs or symptoms, you could be suffering from congestive heart failure (CHF).
Congestive heart failure (CHF)
What is Congestive heart failure (CHF)?
Congestive heart failure refers to a medical condition where your heart muscles are weak or not flexible. Because of this, the heart can't pump enough blood throughout the body. CHF occurs when the lower left chamber of the heart is affected. In a healthy heart, this room pumps out 50 percent of the blood it receives throughout every heartbeat. However, in the majority of patients with CHF, it pushes out less than 40 percent of the blood, which fills it.
The usual causes of CHF include existing health conditions (such as diabetes and high blood pressure), which may impact the heart's functioning. Additionally, it results in some lifestyle habits like smoking, consuming foods full of fat and cholesterol, lack of physical activity rather than keeping a healthy weight.
Since the heart loses the power to pump the blood through the body, it begins backing up in various body tissues. This buildup of fluid in the cells is the main reason this problem is known as 'congestive heart failure.'
Heart disease can disguise as lung disease if coughing and breathlessness are its most important symptoms. It's a frequent occurrence in patients with heart failure (HF). Their cough is most conspicuous when they are lying flat, so they frequently resort to sleeping propped up on cushions. The cough of HF may be sterile, or it could create thin, frothy white sputum. Leg swelling, fatigue, and exercise intolerance are other common symptoms of HF. Congestive heart failure happens when the heart can not pump enough blood to meet your body's needs. This disability can result from several preexisting cardiac disorders, which can lead to the symptoms:
Fatigue and weakness
Shortness of breath (dyspnea)
Wheezing or chronic coughing
Because of the heart's inability to pump blood, any returning flow from the heart to the lungs can get backed up. This may result in nasal congestion; hence, the title "congestive heart failure" and the principal reason for chronic coughing.
Can CHF cause heart coughing?
How can CHF cause coughing?
Coughing is a symptom that receives much less attention in heart-related ailments than the definitive symptoms like shortness of breath and chest discomfort. CHF leads to the buildup of fluids in the lungs, which is a condition called pulmonary edema. The body attempts and coughs persistently to eliminate the additional fluids in the lungs.
With proper treatment for CHF, the cough must subside. But if it reappears, then your remedies may require some adjustments.
Cough induced by medications for congestive heart failure: Like the disease that can cause coughing, the medication used to treat it may also cause similar side effects. Angiotensin-converting enzyme (ACE) inhibitors are a frequent class of medications prescribed for CHF. Regrettably, ACE inhibitors activate the growth of dry and persistent cough. About 5-35percent of those people undergoing therapy with ACE inhibitors reported coughing. The only solution for this problem is to substitute ACE inhibitors with a different class of medicines.
Other symptoms commonly associated with CHF are exhaustion, limitations in doing normal activities, swelling in the ankles, and shortness of breath. These signs may be warning signs of CHF and don't necessarily confirm its identification; however, an individual should not take these signs lightly. For those who have any such symptoms, a prompt visit to the doctor is suggested.
1. American Heart Association. Medications used to treat heart failure [Internet]. [updated 2017 May 31; cited 2019 Dec 9]. Available from: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/medications-used-to-treat-heart-failure.
2. Wyskida K, Jura-Szołtys E, Smertka M, Owczarek A, Chudek J. Factors that favor the occurrence of cough in patients treated with ramipril–a pharmacoepidemiological study. Med Sci Monit. 2012 Sep;18(9):PI21-8.
3. Harvard Health Publishing. 5 warning signs of early heart failure [Internet]. [updated 2019 Sep 25; cited 2019 Dec 9]. Available from: https://www.health.harvard.edu/heart-health/5-warning-signs-of-early-heart-failure.
4. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993;328:246–52.
5. Cupp MJ. Herbal remedies: adverse effects and drug interactions. Am Fam Physician. 1999;59:1239–45.
6. Munkholm H, Hansen HH, Rasmussen K. Coenzyme Q10 treatment in serious heart failure. Biofactors. 1999;9:285–9.
7. Watson PS, Scalia GM, Galbraith A, Burstow DJ, Bett N, Aroney CN. Lack of effect of coenzyme Q on left ventricular function in patients with congestive heart failure. J Am Coll Cardiol. 1999;33:1549–52.
8. Hofman-Bang C, Rehnqvist N, Swedberg K, Wiklund I, Astrom H. Coenzyme Q10 as an adjunctive in the treatment of chronic congestive heart failure. The Q10 Study Group. J Card Fail. 1995;1:101–7.
9. Currens JH, White PD. Cough as a symptom of cardiovascular disease. Ann Intern Med. 1949;30(3):528-43. doi: 10.7326/0003-4819-30-3-528.
10. Cleveland Clinic. Persistent cough? It may be a sign of heart failure [Internet]. [updated 2018 Dec 28; cited 2019 Dec 9]. Available from: https://health.clevelandclinic.org/persistent-cough-it-may-be-a-sign-of-heart-failure/.
11. NCBI. Types of heart failure [Internet]. [updated 2018 Jan 25; cited 2019 Dec 12]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK481485/.
12. Cedars Sinai. Heart failure [Internet]. [cited 2019 Dec 09]. Available from: https://www.cedars-sinai.edu/Patients/Health-Conditions/Heart-Failure.aspx.
13. American Heart Association. Causes of heart failure [Internet]. [updated 2017 May 31; cited 2019 Dec 09]. Available from: https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure.
14. Heart Rhythm Society. Heart failure [Internet]. [cited 2019 Dec 09]. Available from: https://www.hrsonline.org/patient-resources/heart-failure.
15. American Heart Association. Warning signs of heart failure [Internet]. [updated 2017 May 31; cited 2019 Dec 9]. Available from: https://www.heart.org/en/health-topics/heart-failure/warning-signs-of-heart-failure.
16. American Lung Association. Chronic cough [Internet]. [cited 2019 Dec 9]. Available from: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/chronic-cough/.
17. Zink T, Chaffin J. Herbal ‘health’ products: what family physicians need to know. Am Fam Physician. 1998;58:1133–40 [Published erratum appears in Am Fam Physician. 1999;59:540]
18. Ernster L, Dallner G. Biochemical, physiological and medical aspects of ubiquinone function. Biochim Biophys Acta. 1995;1271:195–204.
19. Soja AM, Mortensen SA. Treatment of congestive heart failure with coenzyme Q10 illuminated by meta-analyses of clinical trials. Mol Aspects Med. 1997;18(suppl):S159–68.