Persistent Cough? It May Be a Sign of Heart Failure

When to be evaluated for a cough that won't improve
persistent cough

When something is irritating our lungs, or our body is trying to get rid of bacteria trapped in mucus, we understand the coughing will stop as soon as the irritant or infection is gone.

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Persistent cough is another matter. The most common causes are asthma or chronic obstructive pulmonary disease. But even with these diseases, coughing is minimized when inflammation in the lungs is kept under control.

That’s why if you’ve been diagnosed with asthma or bronchitis, and your cough does not improve with treatment, you should be evaluated for heart failure.

“I have met patients who were first diagnosed as having a respiratory issue. Over time, when their symptoms did not improve with appropriate treatment, heart failure was entertained as a diagnosis,” says heart failure specialist Miriam Jacob, MD.

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What to watch out for

In heart failure, the heart contracts less forcefully than it should. This can allow fluid to back up in the lungs, creating a condition called pulmonary edema. The body coughs persistently in an effort to eliminate the excess fluid.

In these patients, cough is usually accompanied by shortness of breath and may be accompanied by worse functional capacity and exercise intolerance. Sometimes, patients are unable to lie down without becoming short of breath.

Once heart failure has been diagnosed and appropriate treatment started, the cough should go away. If it returns, your medications may need adjusting or your angiotensin-converting enzyme inhibitor changed to an angiotensin receptor blocker.

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This article originally appeared in Cleveland Clinic Heart Advisor.

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