Tuesday, November 29, 2022

Congestive Heart Failure And Coughing

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What Is A Heart Cough

Congestive heart failure in pets

In heart failure, your heart muscle has dysfunction that might be due to weak contraction or stiffness. This can allow fluid to back up in yout lungs, creating a condition called pulmonary edema. Your body coughs persistently in an effort to eliminate the excess fluid.

  • Shortness of breath that worsens with exercise or while lying down.
  • Heavy wheezing.
  • A bubbling feeling in your chest.
  • A wet cough with white or pink sputum, or mucus.

Ive had patients who come to me after months of being treated with antibiotics or steroids for a persistent cough, says Dr. Jacob. Understandably, their physicians treated common medical problems like an upper respiratory infection. When a patient also tells me about weight gain, swelling in the legs or belly and shortness of breath I am suspicious of heart failure. Even vague symptoms of fatigue, nausea or getting full quickly can be signs of heart failure.

What Are Heart Failure Symptoms

If you have heart failure, you may not have any symptoms, or the symptoms may range from mild to severe. Symptoms can be constant or can come and go. Heart failure symptoms are related to the changes that occur to your heart and body, and the severity depends on how weak your heart is. The symptoms can include:

  • Congested lungs. A weak heart causes fluid to back up in the lungs. This can cause shortness of breath with exercise or difficulty breathing at rest or when lying flat in bed. Lung congestion can also cause a dry, hacking cough or wheezing.
  • Fluid and water retention. A weak heart pumps less blood to your kidneys and causes fluid and water retention, resulting in swollen ankles, legs, and abdomen and weight gain. This can also cause an increased need to urinate during the night as your body attempts to get rid of this excess fluid. Bloating in your stomach may cause a loss of appetite or nausea.
  • Dizziness, fatigue, andweakness. Less blood to your major organs and muscles makes you feel tired and weak. Less blood to the brain can cause dizziness or confusion.
  • Rapid or irregular heartbeats. The heart beats faster to pump enough blood to the body. This can cause a fast or irregular heartbeat. Irregular heartbeats also can become more common as the heart weakens.

What Is Heart Failure In Dogs

Heart failure is a complex condition that can develop from congenital or acquired heart disease in dogs. Depending on the specific disease process, it can affect the left and right sides of the heart, manifesting in respiratory signs and weakness due to:

  • Fluid retention: Congestion sometimes called backward failure
  • Pump failure: Low cardiac output sometimes called forward failure.

While the underlying heart disease can vary depending on age and breed, chronic heart failure management for degenerative mitral valve disease and dilated cardiomyopathy initially relies on a combination of a diuretic, angiotensin-converting enzyme inhibitor, and pimobendan, with additional medications added as necessary.

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Copd And Congestive Heart Failure

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COPD and Congestive Heart Failure are two of the most common chronic health conditions and also among the top 3 leading causes of death in the U.S. Heres the scoop they are often connected. Thats right. People who have COPD have a 20% or greater risk for developing CHF and CHF is a leading cause of death in people with COPD.1 Its also important to note that the two conditions often have very similar signs and symptoms, so it can be hard to tell them apart.

What Are Treatment Options

Congestive Heart Failure

If you take your dog in for treatment there are many different options depending on your pets particular diagnosis. Your dog will get a treatment plan from a veterinary cardiologist.

The most common treatments for congestive heart failure in dogs available are:

  • Symptomatic support and care
  • Removal of fluids, from the chest or from the abdomen

With quality care, many dogs do well with medications and treatment. Treatment, however, is about keeping your dog in a good quality of life, not about keeping your emotions intact.

There is no cure for heart disease. As an owner, you have to be aware of your dogs feelings and abilities and be prepared for when it comes time for humane euthanasia if necessary.

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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 thats 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 dont help, and remedies that do, coughing can become costly.

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What To Do When Experiencing Cardiac Coughing

If you cough every time you take a deep breath or find yourself getting quickly winded at the end of a long speech, then you understand the frustrations of dealing with a chronic cough. And, while there are treatment options available for those with a cardiac cough, it can take a while to find the most suitable treatment for your unique needs. So, what should you do in the meantime? If you are experiencing cardiac coughing, you first need to note the symptoms and review them with your healthcare provider. However, if you find youre consistently experiencing unmanageable episodes of cardiac coughing, you should seek medical attention immediately. This is especially important if youve already been diagnosed with CHF or chronic obstructive pulmonary disease , as a chronic cough could exacerbate the existing conditions.

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Can It Be Inherited

Your dog can in fact have inherited his congenital heart disease diagnosis, and it can be prevalent in some breeds.

Sometimes dogs can live with these types of heart disease for many years or it may show up late in life.

It can be discovered during a physical if the veterinarian hears a loud heart murmur through a stethoscope. Common congenital defects that your vet may discover are:

  • Subaortic stenosis
  • Ventricular septal defects
  • Persistent ductus arteriosis

Dogs that have congestive heart failure and are diagnosed with one of these congenital heart defects veterinarians will suggest that they be spayed or neutered to prevent spreading the defect within the breed population.

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Is All Coughing A Sign Of Heart Failure

Congestive Heart Failure

No. Theres a host of reasons you may have a cough.

Irritants or allergens like smoke, mold, dust and pollen can cause you to cough. Certain medical conditions like a cold, flu, pneumonia, acid reflux and sinusitis can also make you cough.

But if youre experiencing heart cough symptoms or have been diagnosed with asthma or bronchitis and your cough doesnt improve with treatment, you should talk to your doctor about heart failure.

Its important to check in with your doctor if your symptoms of cough arent improving after the treatment youve been recommended, says Dr. Jacob. You should be your own advocate. If you feel that you continue to have a cough that isnt resolving you could ask to be referred to a pulmonologist or cardiologist to get another opinion.

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Be A Detective: Ask Detailed Questions

Take time to gather information from the patients history and physical examination, including details that may help determine whether the dog has heart failure and why it may have occurred.

Does the history support heart disease and heart failure?

  • Is there a history of heart disease in a relative or littermate?
  • Is congenital or acquired heart disease more likely? For instance, in a middle-aged to older dog, is the murmur a relatively new finding, suggesting an acquired disease, or has it been present since the dog was a puppy, suggesting undiagnosed congenital heart disease? See Consider These Cases .
  • Does the history of clinical sign progression support heart failure? Findings from the history that support heart failure are listed in Table 1. These findings, while not specific for heart failure, suggest that pulmonary edema may be present, especially when combined with signalment and abnormal findings on physical examination.

Does the physical examination support heart disease and heart failure?

  • A left apical systolic murmur is a characteristic finding in dogs with mitral regurgitation from DMVD, and a loud murmur is more likely with advanced disease. See Consider These Cases .

FIGURE 2. Lead II electrocardiogram demonstrating sinus tachycardia with a regular rhythm and heart rate of 175 beats/min in a dog with CHF .

What Is Kennel Cough

Kennel Cough or Infectious Tracheobronchitis is an all-encompassing term for upper respiratory illness in dogs and is the number one reason for coughing in dogs.

Frequently a dogs immune system has already been affected by a virus such as:

  • Canine influenza,

The kennel cough bacteria Bordetella loves to latch on to one of these viruses for a free ride to the upper respiratory system, causing a persistent and prolonged cough.

Kennel cough can spread quickly despite the most valiant sanitation efforts due to its ability to infect through aerosol or droplets in the air.

Here are the most common ways dogs contract and transmit kennel cough:

  • Aerosol from sneezes and saliva
  • Sharing contaminated water & food bowls
  • Sharing dog toys & bedding
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    Make Recommendations For Home Care That Considers The Pets And Care Takers Quality Of Life

    Involve owners in monitoring their dogs heart disease:

    Set up a recheck schedule to monitor disease progression, potential adverse effects of medications, patient quality of life, and any challenges faced by the owner. Recheck evaluations for a dog in heart failure are often recommended every 2 to 4 months, or sooner, if medications are adjusted or clinical decompensation occurs.

    Educate owners about clinical signs that indicate their dogs need medical attention, including cough , breathing difficulty, anorexia or vomiting, and lethargy or collapse.

    Encourage owners to record resting or sleeping breathing rates at home. Many dogs have a resting breathing rate of less than 35 breaths/minute, often in the mid-teens to mid-twenties. An elevated breathing rate that is repeatable within the hour, especially if the dog has breathing difficulty or a decrease in appetite or activity level, should prompt medical attention.

    Additional points to consider:

    • Ensure the dog is eating and taking its medications. Make recommendations for a palatable diet and advise the owner to avoid high-salt foods and treats when possible.
    • Set activity level expectations, which varies for each dog. Light activity is acceptable and encouraged, especially if it enhances quality of life, but strenuous activity needs to be avoided.
    • Consider the owners lifestyle when making treatment recommendations. For instance, therapy given more than twice daily may be difficult for some owners.

    Things You Should Do To Manage Chf Symptoms

    Coughing and Heart Failure: Cardiac Cough Explained

    There are many dogs that live long lives with CHF and another congenital heart disease.

    Successful living with heart disease is much like it is with humans, it takes care, medications, quality nutrition, and exercise.

    Below is a list of 10 things you should do to manage symptoms of congestive heart failure in dogs to ensure your pet lives a quality life.

    1. Coughing

    If coughing becomes severe, contact your veterinarian. If already diagnosed with CHF and on furosemide, your vet may recommend an additional dose to alleviate any extra accumulation of fluids.

    Watch your dog carefully, time coughing, and take notes for the next visit.

    2. Difficulty Breathing

    With CHF, difficulty breathing indicates fluid build-up in the lungs. Your vet may prescribe additional diuretics like furosemide.

    If the difficulty breathing worsens call your veterinarian immediately.

    3. Difficulty Sleeping

    Dogs may try to sleep on their chest instead of their sides. You may observe your dog trying to sleep quietly sitting up.

    This is due to the fluid build-up in the lungs when your dog lies on its side making it uncomfortable. Its a sign to get a check-up.

    4. Exercise

    Dogs with CHF should be allowed the amount of exercise they want to enjoy life. If they become tired or weak, it’s best to take a break.

    Pushing your dog beyond its limits can cause irregular heartbeats .

    5. Expensive Medications

    There may also be a less expensive alternative treatment that your vet may be aware of. Call your vet first.

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    Cough And Its Hemodynamic Impact

    The deep and vigorous cough results in significant fluctuations in both intrathoracic and intraabdominal pressure, up to 250450 mmHg and 100 mmHg, respectively. It may activate both thoracic pump mechanism and abdominal pump, that enhances venous return and moves blood to other organs . A decreased intrathoracic inspiratory pressure in the inspiratory phase leads to an increase in the right ventricle filling. It is worth mentioning, however, that excessively negative pressure in the thoracic cavity may yield in large vein collapse . During an expulsive phase of coughing, increased intrathoracic pressure compresses the heart and the large vessels and acts as an additional factor of blood ejection from the heart and its shift to the peripheral vessels . In healthy subjects, the voluntary cough may cause a shift of a significant amount of blood thus increasing the blood pressure. However, the situation changes shortly after cough termination.

    During continuous coughing, the circulatory effects are similar to Valsalva maneuver. Termination of the coughing bout is associated with the period of acute hypotension accompanied by peripheral vasoconstriction . The best characterized clinical entity caused by the hemodynamic consequences of cough is a cough-induced syncope.

    Coughing In Dogs With Heart Disease

    by | Feb 16, 2018 | Blog Post, Cardiology

    When dogs have a heart murmur, their hearts can become enlarged and lose the ability to pump blood into their lungs and the rest of their body. Known as heart failure, the symptoms show up as coughing and difficulty in breathing due to both the accumulation of fluid in the lungs and the enlarged heart pushing on and irritating the trachea.

    Other symptoms of heart failure include lethargy, persistent loss of appetite, a swollen belly and pale/bluish gums.

    Because coughing is a symptom of multiple other conditions, it is vital to differentiate the cause. Dogs in heart failure need immediate evaluation and medications, while dogs that are coughing but not in heart failure are less likely to need urgent care.

    An easy and useful way to distinguish a cough due to heart failure versus another cause is to monitor the sleeping respiratory rate.

    Sleeping respiratory rate is the rate, or times per minute, that your dog breathes in one minute while in a complete state of rest, meaning he or she is completely relaxed or even asleep. Research shows that dogs in heart failure have elevated sleeping respiratory rates, while dogs that are not in heart failure have normal respiratory rates.

    For assistance in accuracy, we recommend using an app such as this one.

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    Congestive Heart Failure 101

    Congestive heart failure occurs when the heart cant pump enough blood to meet the demands of your body. This impairment can result from a number of preexisting cardiac disorders, which can lead to the following symptoms:

    • Fatigue and weakness
    • Wheezing or chronic coughing

    Due to the hearts inability to effectively pump blood, any returning circulation from the heart to the lungs can get backed up. This can lead to pulmonary congestion hence, the name congestive heart failure. Its also the primary reason behind chronic coughing.

    How Is Chf Diagnosed

    Congestive Heart Failure: Symptoms, Causes, and Treatment Options – St. Mark’s Hospital

    After reporting your symptoms to your doctor, they may refer you to a heart specialist, or cardiologist.

    The cardiologist will perform a physical exam, which will involve listening to your heart with a stethoscope to detect abnormal heart rhythms.

    To confirm an initial diagnosis, a cardiologist might order certain diagnostic tests to examine your hearts valves, blood vessels, and chambers.

    There are a variety of tests used to diagnose heart conditions. Because these tests measure different things, your doctor may recommend a few to get a full picture of your current condition.

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    How Is Hf Diagnosed

    A physical examination will show changes, such as swelling in the legs or crackling breath sounds, indicating excess fluid in the lungs.

    A chest x-ray can show an enlarged heart and signs of fluid accumulation into the lungs. An echocardiogram can also reveal heart size and disease of the heart muscle or valve problems.

    Side Effects Of Ace Inhibitors

    While ACE inhibitors are usually tolerated quite well, certain side effects may occur, including:

    • Cough: The most prominent side effect of ACE inhibitors is a dry, hacking cough, which may be seen in up to 20% of people given these drugs. While not a dangerous problem, this side effect can be bothersome and usually requires discontinuation of the drug.
    • Hypotension : ACE inhibitors may reduce blood pressure too much, producing symptoms of weakness, dizziness, or syncope . This problem can usually be avoided by starting with a low dose and gradually building up to higher doses.
    • Impaired kidney function: Especially in people who have underlying kidney disease, the use of ACE inhibitors can further reduce kidney function. For this reason, kidney function should be monitored in people who have kidney disease and are beginning ACE inhibitors.
    • High blood potassium : ACE inhibitors can increase blood potassium levels. While this effect is usually very modest and not medically significant, in about 3% of people, potassium levels can become too high.
    • Angioedema: Very rarely, people taking ACE inhibitors can experience angioedema, a severe allergic-like reaction that can become quite dangerous.

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