Cardiac asthma is wheezing due to congestive heart failure and in the true sense it is not asthma. Clinically it is a condition caused by severe reflexive blocking and or by edema of the lungs. It is an asthmatic-type breathing caused by sudden blockage of the pulmonary circulation. The bronchial spasm in cardiac asthma is caused by back pressure from the left side of the heart to the lungs. Symptomatically cardiac asthma is quite similar to lung asthma.
Patients with heart failure or heart valves that do not open properly experience shortness of breath not necessarily accompanied by wheezing, coughing, increased rapid and superficial breathing, increased blood pressure and heart beat rate and a feeling of uneasiness. Symptoms usually occur with exercise or at night after going to bed. Cardiac asthma is usually due to a major mechanical fault of the heart. The reduced pumping efficacy of the heart leads to a build up of fluid in the lungs. This build up of the fluid causes the air passages to narrow up and eventually cause wheezing and other related symptoms. It is a life-threatening condition and one must seek medical advice immediately on experiencing any symptoms.
The key to effective management of cardiac asthma is right diagnosis, which includes differentiation between patients who wheeze only due to acute heart failure and those who wheeze from other disorders, such as asthma, chronic obstructive pulmonary disease, pneumonia or acute respiratory distress syndrome. Treatment is directed at improving the pump function of the heart along with medications.
Treatments mainly focus on controlling the night coughs, control of the edema, control of inflow load and the amount of residual blood in the left ventricle. Diuretics (water pills) free the lungs of excess fluid and other medications such as morphines, nitrates help the heart muscles pump more effectively. The wheezing gradually stops when the heart failure has been well controlled.
In some patients who suffer from asthma and heart failure simultaneously, treatment is required for both conditions. A combination of bronchodilators, supplementary oxygen is generally effective in controlling the asthmatic symptoms in addition to treating heart failure in such patients. Corticosteroids are prescribed only when the patient with acute cardiac asthma has not responded well to initial therapy. Corticosteroids usually take long hours to give peak effect. If the asthma is caused by a heart valve that is not working properly or a hole between the heart chambers, surgery or other procedures may be suggested.