Sunday, January 29, 2023

Cough With Congestive Heart Failure

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What Is Heart Failure In Children

An 8-year-old Pomeranian coughs and coughs at night – congestive heart failure

The heart is a muscle that pumps oxygen-rich blood to all parts of the body. When you have heart failure, the heart is not able to pump as well as it should. Blood and fluid may back up into the lungs . Some parts of the body dont get enough oxygen-rich blood to work normally. These problems lead to the symptoms of heart failure.

Congestive Heart Failure And Cough

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Water Pills For The Heart

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Cough And Its Effect On Heart Electrophysiology

Although the primary role of the lung afferent nerve fibers is to modulate the breathing pattern , activation of some of their subpopulations also causes the reflex changes in the cardiovascular system . For example, the stimulation of the pulmonary C-fibers may result in bradycardia and systemic and pulmonary hypotension . This vagal stimulation may entail a depression of automaticity of both the sinus and atrioventricular nodes, prolongation of the refractory period of the junctional tissues and depression of sinoatrial and atrioventricular conductivity . These interactions are mainly related to parasympathetic activation, however coexisting withdrawal of sympathetic influence is also considered.

Besides the reflex bradycardia, a forceful cough may cause sinus tachycardia. Wei and Harris documented a chronotropic response to intrathoracic pressure changes generated by cough. In their study group, three forceful coughs performed over a period of 3 sec resulted in a reproducible increase in the rate of sinus rhythm . This phenomenon was found to be dependent on patients age, with an advanced age resulting in a decline in both the amplitude and rapidity of the chronotropic response of sinoatrial node to cough .

What Are Possible Complications Of Heart Failure In A Child

Coughing and Heart Failure: Cardiac Cough Explained

Heart failure can cause many complications. These include:

  • Poor growth and development

  • High blood pressure in the blood vessels between the heart and lungs

  • Irregular heartbeats

  • Blood clots. If a clot blocks the blood supply to the brain, a stroke may occur.

  • Organ damage in the kidney or liver

  • Low red blood cell count or low hemoglobin level

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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 .

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.

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Congestive Heart Failure Drugs

There are several medications that can be used to treat CHF, including ACE inhibitors, beta-blockers, and more.

ACE inhibitors

Angiotensin-converting enzyme inhibitors open up narrowed blood vessels to improve blood flow. Vasodilators are another option if you cant tolerate ACE inhibitors.

You may be prescribed one of the following:

voluntary recall of 5 lots of the drug Accupril due to the presence of nitrosamine. Nitrosamine, a known carcinogen with the potential to cause cancer, was found to exist in the drug at levels greater than the Acceptable Daily Intake as determined by the FDA. This recall is specific only to a handful of lot numbers and does not affect all Accupril tablets made by Pfizer. If you take Accupril tablets, talk with your pharmacist or doctor and they will help you determine if your medication has been impacted by the recall.

ACE inhibitors shouldnt be taken with the following medications without consulting a doctor, because they may cause an adverse reaction:

  • Potassium-sparing diuretics and potassium supplements. These diuretics can cause potassium buildup in the blood, which may lead to abnormal heart rhythms. Examples include: riamterene , eplerenone , and spironolactone .
  • Nonsteroidal anti-inflammatory drugs .NSAIDs such as ibuprofen, aspirin, and naproxen, can cause sodium and water retention. This may reduce the ACE inhibitors effect on your blood pressure.

Beta-blockers

This may be achieved with:

Diuretics

Your doctor may recommend:

Similarities Between Kennel Cough And Heart Failure In Dogs

Congestive heart failure in pets
  • A harsh, persistent cough
  • Pulmonary crackles
  • A Harsh, Persistent cough

    This is where it can get challenging to tell the difference between kennel cough and dog heart disease cough.

    Similarly, this chihuahua terrier mix suffers from congestive heart failure, yet the cough sounds almost identical.

    Difficulty Breathing

    With both kennel cough and heart failure in dogs, difficulty breathing may be apparent. Dog heart failure will often cause more extreme labored breathing like this older Shih-Tzu with heart disease.

    Intolerance To Activity

    Both kennel cough and congestive heart failure result in an aversion to activity due to difficulty breathing and lethargy. Still, heart failure comes with heart rhythm irregularities and an increased heart rate, making the activity more strenuous than it should be for your once vibrant pet.

    Pale Gums in Dogs

    A healthy doggo should have bubble gum or salmon, pink gums. If a dog has pale gums, it is indicative that something more severe like congestive heart failure.

    If your dog has pale gums, get them to the vet as soon as possible!

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    If You Notice Even One Other Sign Of Heart Failure Contact Your Doctor Immediately

    The signs of heart failure can be ambiguous because they are frequently associated with a number of other illnesses, as well. “By themselves, any one sign of heart failure may not be cause for alarm,” according to the American Heart Association. “But if you have more than one of these symptoms, even if you haven’t been diagnosed with any heart problems, report them to a healthcare professional and ask for an evaluation of your heart,” their experts advise.

    Not sure what to look out for? Shortness of breath, wheezing, swelling or fluid retention, fatigue, loss of appetite, nausea, confusion, and increased heart rate are some of the other common symptoms of heart failure, the AHA reports.

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    Cough Induced From Airways

    There is indisputable evidence on the close relationship between cough and vagal nerve function. The vagotomy or vagal nerve cooling in animals completely abolishes cough . The bodies of the neurons innervating airways are located in the nodose and jugular ganglia of the vagal nerve . Airway afferents relevant for cough are classified into mechano- and chemosensitive terminals depending on their activation profile. Airway mechanosensors are derived from the nodose ganglion and terminate in airways and lungs. These fibers have relatively fast conduction speed and their endings are classified as rapidly or slowly adapting receptors based on the adaptation pattern to the lung inflation. The main stimuli for these receptors include lung volume changes, contraction of airway smooth muscles and the airway wall edema. These fibers participate in the regulation of breathing pattern, bronchomotor response and other reflex responses in the respiratory tract . They are not sensitive to chemicals, unless these substances cause airway edema, increase mucus secretion or induce the changes in airway muscle tone. The role of RARs and SARs, as a structural elements of the cough reflex, is rather limited, they probably regulate the duration and magnitude of the inspiratory and expiratory phases of coughing but do not usually initiate the reflex itself .

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    Dog Heart Failure Cough Sound Vs The Sound Of Kennel Cough

    Dog parents can find themselves in a perplexing situation when trying to identify the specific cause of your dogs cough. Two of the most commonly confused reasons for a persistent, irritating cough in dogs are congestive heart failure and kennel cough.

    While coughing due to dog heart failure sounds similar to the sound of kennel cough, you may have guessed that one is quite a bit more severe than the other.

    Today, we will examine the difference between kennel cough and heart cough as well as dog heart failure sound versus kennel cough sound.

    Signs Your Cough Is A Symptom Of Heart Disease Doctor Warns

    Congestive Heart Failure &  Coughing

    Catching early symptoms of heart failure can mean the difference between life and deathbut the signs are often so varied and subtle that people may often miss the warning signals.

    Some of the more well-known symptoms of heart failure include shortness of breath, difficulty breathing when lying down, and a cough, according to Eva Shelton, MD, an internal medicine physician at Brigham and Women’s Hospital. “There are two major types of heart failure physiology, left-sided and right-sided heart failure,” Shelton explains. “When left-sided heart failure occurs, blood and the fluid it contains backs up into the lungs, resulting in shortness of breath and cough.”

    But since a cough can indicate the onset of many conditions, ranging from the common cold to thyroid problems, how can you tell when it’s actually a sign of heart disease? Read on to find out.

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    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.

    This Symptom Is Often Misdiagnosed As A Respiratory Problem

    Most commonly, a cough that won’t quit is the result of asthma or chronic obstructive pulmonary disease . However, as the Cleveland Clinic points out, “even with these diseases, coughing is minimized when inflammation in the lungs is kept under control.”

    Their experts say that if your cough persists after treatmenteven if you’ve been diagnosed with a respiratory ailmentyou should be evaluated for heart failure. “I have met patients who were first diagnosed as having a respiratory issue,” heart failure specialist Miriam Jacob, MD, explains via the Cleveland Clinic site. “Over time, when their symptoms did not improve with appropriate treatment, heart failure was entertained as a diagnosis.”

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    Treating And Managing Cardiac Cough

    Congestive heart failure needs prompt treatment. Doctors also recommend managing cardiac cough with lifestyle changes so that the failing heart does not have to work as hard and the medications can work better.

    Medications are recommended for reducing fluid in the body or helping the ventricle contract better. They include:

    • Diuretics to remove the fluid
    • Nitrates that open the blood vessels for easy blood flows
    • Angiotensin-converting enzyme inhibitors for normal ventricle contraction
    • Beta-blockers for slowing the heart rate
    • Medication for keeping the blood pressure level in control.

    Cardiac cough can be managed by:

    • Taking the doctors prescribed medications properly
    • Eating a healthy diet
    • Reducing the intake of salt and extra fluid in the diet
    • Avoiding tobacco and smoking
    • Avoiding taking any medicine without first consulting your heart doctor
    • Reporting worsening symptoms to the doctor.

    In some cases of heart failure, surgery is necessary to avoid further damage to the heart and improve its functions.

    Dr. Steven Reisman is an internationally recognized cardiologist and heart specialist. He is a member of the American College of Cardiology, American Heart Association, and a founding member of the American Society of Nuclear Cardiology.

    Never Try To Treat Your Cough At Home If You Suspect Heart Failure

    Cardiac cough: how can a cough be a sign of heart problems? – Online interview

    Attempting to treat your cardiac cough at home with an over-the-counter cough suppressant can be very dangerous for those with heart failure. “The active ingredients in some of thesenamely pseudoephedrine and triprolidine-pseudoephedrine can raise blood pressure and cause fluid retentionboth side effects that can exacerbate heart failure,” Richard N. Fogoros, MD, a retired cardiologist, tells Verywell Health.

    Instead, continue taking any heart medication that has been prescribed to you and reach out to your doctor for immediate evaluation.

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    Is All Coughing A Sign Of 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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    Do Dogs Have Heart Attacks

    In humans a heart attack usually refers to myocardial infarction . Myocardial infarction refers to death of the cells in an area of the heart muscle or myocardium. Cell death is usually due to oxygen deprivation caused by obstruction of the coronary blood vessels that supply blood to the heart muscles. Heart attacks are rare in dogs but unexpected and sudden death in dogs diagnosed with any form of heart disease is possible.

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    The Impact Of Cough On Heart Function

    Cough influences heart function either by its effects on intrathoracic pressure resulting in cardiovascular hemodynamic consequences or by influencing heart electrophysiology causing an arrhythmogenic effect. It is difficult to distinguish or separate these two phenomena due to their interplay .

    Possible impact of cough on heart function

    The impact of cough on the cardiovascular system has been documented in numerous previous studies, especially in the context of cough-induced arrhythmias, cough-induced conduction disorders or cough-induced syncope. However, controversies still exist on the role of cough in cardiopulmonary resuscitation. These conditions will be discussed below.

    How Do You Stop Coughing With Congestive Heart Failure

    Congestive Heart Failure

    There are a few things that can be done to stop coughing with congestive heart failure. One is to take medications prescribed by a doctor to help loosen secretions and make it easier to cough up phlegm. Another is to drink plenty of fluids, which will help thin out mucus. And finally, practicing good hygiene by regularly washing hands and avoiding contact with respiratory viruses can help reduce the risk of infection.

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    Tips For Managing Congestive Heart Failure End

    You may be asking, How can I provide comfort to my loved one as they experience the end-of-life signs of congestive heart failure? Its only natural that you as a loved one and/or caregiver will want to be as helpful as possible, and ensure that your loved one is experiencing as little pain as possible. Heres some ways you can help:

    • Communicate with the doctors and healthcare professionals: Your loved one may be too weak, or simply forget, to communicate their symptoms to the doctors and nurses. You can help by sharing this information with them in order to make sure your loved one gets what they need.
    • Provide comfort: Sometimes it is just as simple as spending time with your loved one while watching a TV show, or talking about things they love. These conversations can help in alleviating some of their depression and anxiety.
    • Help them remember to take their medicine: There will likely be various pills and medications that your loved one needs to take. You can help by assisting your loved one in staying on schedule.

    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.

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