Cardiac Asthma

What is cardiac asthma?

Unlike bronchial asthma, cardiac asthma is difficulty breathing because of pulmonary edema or fluid in your lungs. This fluid comes from pulmonary hypertension, which happens in left-sided heart failure. Heart failure doesn’t mean your heart isn’t working. It means it can’t keep up with your body’s demand for blood.

What is the difference between bronchial and cardiac asthma?

Bronchial asthma is a long-term disease in your lungs. Inflamed, narrow airways make you wheeze and cough. This may sound similar to cardiac asthma symptoms. However, with cardiac asthma, the cause is fluid buildup in your lungs.

With bronchial asthma, symptoms can happen after breathing in:

• Dust.
• Air pollution.
• Other irritants.

Who does cardiac asthma affect?

Cardiac asthma affects people with congestive heart failure, a heart condition that gets worse when blood flow through your veins increases. As heart failure gets worse, it takes very little exertion to bring on difficult breathing.

Cardiac asthma risk factors

• High blood pressure.
• Diabetes.
• Diseased heart valves.
• Angina (chest pain).
• Heart attack.

How does cardiac asthma affect my body?

Fluid in your lungs makes it hard to breathe, especially when you’re lying down. You may breathe better when you sit or stand up.

What are the symptoms?

Cardiac asthma symptoms include:

• Waking up with difficulty breathing after several hours of sleep at night.
• Wheezing.
• Coughing (may be dry or with mucus or sometimes blood).

What causes cardiac asthma?

Heart failure causes pulmonary hypertension (high blood pressure in your lungs), which leads to pulmonary edema (fluid in your lungs). This fluid makes it hard for you to breathe (cardiac asthma).

How is cardiac asthma diagnosed?

Your healthcare provider can make a diagnosis from:

• Your medical history.
• A physical exam.
• Testing.

What tests will be done to diagnose cardiac asthma?

Your healthcare provider can use a number of tests to diagnose cardiac asthma, including:

• Blood tests.
• Urine (pee) tests.
• Electrocardiogram (EKG).
• Echocardiogram.
• Chest X-ray.
• Cardiopulmonary stress test.
• Cardiac catheterization.
• Cardiac CT (computed tomography).
• Magnetic resonance imaging (MRI).

How is cardiac asthma treated?

Cardiac asthma treatments are different from treatments for bronchial asthma. Cardiac asthma treatments include:

• Exercise.
• Medications.
• Cardiac rehabilitation.
• Implantable cardioverter defibrillator (ICD).
• Biventricular pacemaker.
• Left ventricular assist device.
• Heart transplant.

What medications are used?

Medicines for cardiac asthma include:

• ACE inhibitors.
• Beta blockers.
• Diuretics.
• SNRIs (serotonin-norepinephrine reuptake inhibitors).
• Aldosterone blockers.
• SGLT2 inhibitors.

Side effects of the treatment

Side effects vary by medication, although some may be similar.

ACE inhibitor side effects may include:

• Dry cough.
• Dizziness.
• Tiredness.
• Headache.

Beta blocker side effects may include:

• Nausea.
• Sleepiness.
• Dizziness.
• Depression.

How can I reduce my risk of cardiac asthma?

Since heart failure causes cardiac asthma, lowering your risk of heart failure cuts your risk of cardiac asthma, too.

To reduce your risk of both:

• Care for your other conditions, like high blood pressure and diabetes.
• Stay at a healthy weight.
• Manage your stress.
• Exercise regularly.
• Eat foods that are good for your heart, like fruits and vegetables.
• Don’t use tobacco products.
• Avoid or limit alcohol.
• Don’t use recreational drugs.

What can I expect if I have cardiac asthma?

Heart failure, which causes cardiac asthma, keeps getting worse with time. Symptoms can get worse without warning. You can manage heart failure with lifestyle changes and medicines for a while.

However, you may come to a point when you feel short of breath when you’re not exerting yourself at all. This is called advanced heart failure.

Before you get to this point, it’s good to let your family and healthcare provider know what kind of care you want. For example, if you’re having a lot of trouble breathing, would you want a breathing tube in your throat?

How long does cardiac asthma last?

Cardiac asthma lasts as long as you have the condition that’s causing it. Usually, that condition is heart failure, which doesn’t have a cure. Be sure to explore your treatment options to get the best care available.

How do I take care of myself?

To make your symptoms better and improve your quality of life, follow your healthcare provider’s advice:

• Treat other conditions that make heart failure worse.
• Make lifestyle changes, such as eating less salt.
• Keep taking medicines your provider prescribes.

When should I see my healthcare provider?

Contact your healthcare provider if you start to get new symptoms or your symptoms get worse.

Tell your provider if you have:

• Worse shortness of breath.
• Swollen ankles.
• Sudden weight gain.
• Difficulty sleeping.
• Loss of appetite.

When should I go to the ER?

Call 911 if you’re having an allergic reaction to your medicine, such as a swollen tongue or lips. You should go to the ER if you’re having trouble breathing and nothing you try makes it better.

What questions should I ask my doctor?

• What treatments would you recommend for my specific situation?
• What kinds of exercise would you recommend?
• How often do I need follow-up appointments?

A note from Cleveland Clinic

Cardiac asthma is a sign of a larger condition: heart failure. Although there’s no cure for heart failure, medicines and treatments are available. Your healthcare provider can work with you to find a treatment that makes sense for you. Because heart failure gets worse with time, it’s important to keep your provider updated on your symptoms. You’ll also want to let them know which treatments you’re comfortable with if your heart disease gets worse.