Cardiac Asthma Treatment

Introduction

Cardiac asthma is not a true form of asthma but rather a condition caused by congestive heart failure (CHF). It results from fluid accumulation in the lungs due to poor heart function, leading to wheezing, coughing, and shortness of breath.

Causes of Cardiac Asthma

The primary cause is left-sided heart failure, where the heart cannot pump blood efficiently, leading to fluid buildup in the lungs (pulmonary congestion). Common causes include: - Hypertension (high blood pressure) - Coronary artery disease - Valvular heart disease - Cardiomyopathy

Symptoms

  • Shortness of breath (dyspnea), especially at night
  • Wheezing (similar to bronchial asthma)
  • Cough producing frothy sputum
  • Rapid breathing (tachypnea)
  • Chest discomfort

Differences Between Cardiac and Bronchial Asthma

  • Cardiac Asthma is caused by heart failure, while Bronchial Asthma is due to airway inflammation.
  • Cardiac Asthma worsens with lying down (orthopnea), while Bronchial Asthma is usually triggered by allergens.

Treatment Strategies

1. Acute Management (Emergency Treatment)

  • Oxygen therapy to improve blood oxygen levels.
  • Diuretics (e.g., furosemide) to remove excess fluid.
  • Vasodilators (e.g., nitroglycerin) to reduce heart workload.
  • Morphine (in some cases) to relieve anxiety and breathing difficulty.
  • Positive pressure ventilation (CPAP or BiPAP) in severe cases.

2. Long-term Management

  • Treat Underlying Heart Failure:
    • ACE inhibitors or ARBs (to reduce heart strain)
    • Beta-blockers (to improve heart function)
    • Diuretics (to prevent fluid buildup)
    • Aldosterone antagonists (to control fluid retention)
  • Lifestyle Modifications:
    • Salt restriction in diet
    • Regular physical activity (as per doctor’s advice)
    • Weight management
  • Avoid Triggers:
    • Minimize stress and physical overexertion
    • Control high blood pressure and diabetes

Conclusion

Cardiac asthma is a serious condition that requires immediate and ongoing management. By controlling heart failure and lifestyle modifications, patients can prevent recurrent episodes and improve their quality of life.

Source recommendations

1. European Society of Cardiology (ESC) Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure
  2. https://pubmed.ncbi.nlm.nih.gov/34447992/
  3. https://academic.oup.com/eurheartj/article/42/36/3599/6358045
  4. https://pubmed.ncbi.nlm.nih.gov/22611136/
  5. https://academic.oup.com/eurheartj/article/44/37/3627/7246292

2. American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines for the Management of Heart Failure

  1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063
  2. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2022/03/29/19/53/2022-AHA-ACC-HFSA-Heart-Failure-Guideline-gl-hf
  3. https://professional.heart.org/en/science-news/-/media/832EA0F4E73948848612F228F7FA2D35.ashx
  4. https://pubmed.ncbi.nlm.nih.gov/35363499/
  5. https://www.sciencedirect.com/science/article/pii/S0735109721083959

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