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Cardiac asthma is not a form of asthma. It's a type of coughing or wheezing that's a
New Delhi to
symptomofheartfailure.Dependingonhowsevereyoursymptomsare,thiswheezingcan
beamedicalemergency.
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Whenitcomestocardiacasthma,theheartisusuallytherootoftheproblem,astheorgan
hastosignificantlymalfunctioninorderfortheconditiontooccur.Thecollectionoffluidis
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caused by the hearts inability to pump blood powerfully and effectively, and the fluid
buildup,inturn,leadstothenarrowingofairpassages.Pressureexertedbytheleftsideof
the heart, due to the unnatural disparity between its work load and capacity, is also
responsibleforcardiacasthma. CATEGORY
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Cardiac asthma is historically most prevalent in elderly ChildrenHealth EyeDisease


people, but the condition is not exclusive to this Treatments
demographic by any means. Cardiac asthma can and
HairTips Healthnews
does appear in people of all ages, especially those with
other ailments of the heart and a natural tendency for HealthyDiet HeartDiseases
unhealthy fluid accumulation. For example, those with Preventing
leaky heart valves and/or gaps between the hearts
ImmuneSystem KneeProblems
chambersareknowntobeespeciallypronetocardiacasthma,evenatayoungage.
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Asaresultofheartfailure,fluidcanbuildupinthelungs(pulmonaryedema)andinand Researching
MenHealth
around your airways. This causes signs and symptoms such as shortness of breath,
coughingandwheezingthatmaymimicasthma.Asthmaisachronicconditioncausedby PregnantWomen SleepStatus
inflammationoftheairways,whichcannarrowthem,leadingtobreathingdifficulties.True
asthmahasnothingtodowithfluidinthelungsorheartdisease. TipsFood Vitamin

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Whilecardiacasthmaismostlycausedbyinternalfactors,externalinfluenceplaysalarger Instructions
roleintrueasthma,whichisbroughtonbytightnessinthechest,inadditiontoshortness
ofbreath,wheezingandcoughing.Trueasthmacanbetriggeredbythingssuchasweather, WomenHealthy
smokeandpollution.
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6/11/2017 Cardiacasthma:Causes,Symptoms,DiagnosisandTreatment|TipsCuringDisease
Since cardiac asthma and true asthma are two distinct medical problems, the common
treatmentsfortrueasthmacanhavethereverseeffectwhencardiacasthmaisconcerned.
Inhalers and therapies medications meant for asthmatics can make the symptoms of
cardiac asthma worse and even cause irregular heartbeats. Thus, it is important to
approach cardiac asthma from the correct angle in order to alleviate the symptoms and
properlymanagethesickness.

SignsandSymptomsofCardiacAsthma
Thesignsandsymptomsofcardiacasthmavaryintheirintensityfrompersontopersonbut
the surface especially after exercise or while sleeping. The main symptoms of cardiac
asthma are shortness of breath, rapid shallow breathing or chest pain, accelerated heart
rate, high blood pressure or swelling of the ankles. Symptoms can worsen over time and
canwakeyouinthemiddleofthenightbecauseofshortnessofbreath.Swollenanklesare
characteristicofcardiacasthmathatyoumightseeinanormalconditionofasthma.

Both cardiac asthma and pulmonary edema are


symptoms of coming heart failure. It is a life
threateningconditionandonemustseekmedical
advice immediately on experiencing any
symptoms.

Someofthemainsymptomsare:

Shortness of breath, not necessarily


accompaniedbywheezing.

Increasedrapidandsuperficialbreathing.

Increasedbloodpressureandheartbeatrate.

Afeelingofuneasiness.

Cardiac asthmatic people wake up breathless a few hours after sleeping, and have to sit
uprighttoagainproperlybreathe.Thisisduetolyingdowntoolong.

Swollenankleswhichworsenrapidlyduringthestretchoftheday.

CausesofCardiacAsthma:
Usually, cardiac asthma is due to major mechanical heart failure. This may be a life
threatening situation, if not checked properly and at right time. In this, heart pumping
efficacyisreducedandbuildsupfluidinlungs.Thisleadstonarrowingofairpassagesand
hence,causeswheezingandotherproblems.

HeartValves
Pulmonary edema can result from problems with
the valves in the heart. If the mitral opening
narrowsa condition called mitral stenosisthe
amount of blood reaching the left ventricle
diminishes,resultinginabackupinthepulmonary
veins. The mitral opening separates the left atrium
andventricle.Thisoccurs,mostoften,asaresultof
rheumaticheartdisease,inwhichthemitralvalves
andchordaetendineaethickenandstiffen.Chordae
tendineae keep the mitral valve from backing up
into the atrium, a condition called mitral valve
prolapse. After blood reaches the left ventricle, the
aorta carries it on to the rest of the body. If the aortic valve narrows (aortic stenosis), a
diminished amount of blood can leave the ventricle. Also, in a condition called aortic
regurgitation,bloodthatreachestheaortaflowsbackintotheventricleduetodysfunction
of the aortic valves. These aortic valve problems can cause the backup that results in
pulmonaryedema.

CardiacMuscleDysfunction

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Pulmonary edema can occur as a result of several heart muscle problems. The most
common cause is abnormal systolic functionproblems with the heart during the
contractionphaseofapatient'sheartbeat.Diseasesthatcausesystolicdysfunctioninclude
coronaryarterydisease(CAD),atoxinpresentinthebloodstream,andmyocarditis,which
is inflammation of the heart muscle. Systolic dysfunction causes increases in pulmonary
venouspressurebecausethevolumeofbloodbeingpushedfromtheheartislessthanthe
amount being sent to the heart, causing a backup in the pulmonary vessels. Diastolic
dysfunction can also cause pulmonary edema. Causes of dysfunction during diastole, the
relaxation and filling phase of hearbeat, include heart muscle diseases, lack of blood flow
andhighbloodpressure.

PulmonaryVenousPressure
The immediate cause of pulmonary edema is simply an increase in pulmonary venous
pressure,meaningthatmorebloodthanusualisintheveinsthatrunbetweenthelungs
and the heart. This is known as backward failure. With the rise in pressure, there is little
time to compensate for the increased vascular volume the layer of cells that allows only
gasestopermeatebeginsallowingfluidtopass.Thisfluidbuildsupinthelungs'spaces,and
breathingbecomesrestrictedanddifficult.

OtherCausesofCardiacAsthma
Theothercausesofcardiacasthmaarelesscommon,butworthnoting.Narrowingofthe
renal artery, or renal artery stenosis (RAS), can cause pulmonary edema. In some cases,
edema has been the only symptom by which RAS was diagnosed. A benign tumor of the
atrialwall,calledatrialmyxoma,andabloodclotinsidetheheart,knownasanintracardiac
thrombus,mayalsopresentpulmonaryedemaasasymptom.

DiagnosisofCardiacAsthma
Cardiacasthmamustbedifferentiatedfromthevariousprimarydiseasesofthelungswhich
cause paroxysms of wheezing or panting. The differentiation is usually readily made by
simpleclinicalmeasuresindoubtfulinstancesmeasurementsofcirculationtimemaybeof
crucialvalue.

The management of cardiac asthma


involveschieflythreetherapeuticprinciples:
Control of precipitating factors (and
especially treatment of latent edema and
controlofnocturnalcough)
Measuresaimedatreducingtheinflowload
(sitting position, morphine, venesection,
tourniquets on extremities, positive
pressurebreathing)
Attempts to reduce the amount of residual
blood in the left ventricle (rapid
digitalization, use of oxygen, and
aminophyllin).

A severe attack of cardiac asthma associated with rapidly developing pulmonary edema
constitutes one of the commonest and gravest of all medical emergencies. There are few
conditionsinthebroaddomainofinternalmedicineinwhichpromptandenergetictherapy,
basedonanunderstandingofthemechanismofthedisorder,canproducesuchimmediate
andgratifyingbenefit.

A chest xray usually reveals the presence of fluid in your lungs that indicates your
symptomsarecausedbycardiacasthmaratherthanlungorbronchialasthma.Todiagnose
heart failure, doctors rely on EKG, cardiac stress tests and imaging techniques like
echocardiogramsandCTscans,explainstheNationalLibraryofMedicine.

CardiacAsthmaTreatment
The key to effective management of cardiac asthma is right diagnosis, which includes
differentiationbetweenpatientswhowheezeonlyduetoacuteheartfailurevsthosewho
wheeze from other disorders, such as asthma, chronic obstructive pulmonary disease,
pneumoniaoracuterespiratorydistresssyndrome.

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Treatmentisdirectedatimprovingthepumpfunctionoftheheartalongwithmedications.
Iftheasthmaiscausedbyaheartvalvethatisnotworkingproperlyoraholebetweenthe
heartchambers,surgeryorotherproceduresmaybesuggested.

Treatmentsmainlyfocusoncontrollingthenight
coughs, control of the edema, control of inflow
loadandtheamountofresidualbloodintheleft
ventricle.

Treatmentofheartfailureinvolvesusingdiuretics
(waterpills)tofreethelungsofexcessfluidand
medications to help the heart muscles pump
moreeffectively.Whentheheartfailurehasbeen
wellcontrolled,thewheezingwillgraduallystop.Somepeoplemaysufferfromasthmaand
heartfailuresimultaneously,andthusrequiretreatmentforbothconditions.

Patients suffering from cardiac asthma generally respond well to a combination of


bronchodilators,supplementaryoxygen,andtreatmentoftheheartfailure.

Corticosteroids are prescribed only when the patient with acute cardiac asthma has not
respondedwelltoinitialtherapy.Corticosteroidsusuallytakelonghourstogivepeakeffect.
Iftheasthmaiscausedbyaheartvalvethatisnotworkingproperlyoraholebetweenthe
heartchambers,surgeryorotherproceduresmaybesuggested.

Whoarepronetocardiacasthma?
Cardiacasthmausuallyoccursinelderlypeoplewhohavewheezingandshortnessofbreath
thatareduetoheartfailure.Whentheheartistooweaktopumpbloodeffectively,fluidwill
accumulateinthelungs.Fluidinthelungscausesshortnessofbreathandwheezing.

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