How left heart failure shows up in heart cough

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The breathing problems in left heart failure only come indirectly from the lungs, because water accumulates in them. The reason for this, however, is the deteriorating performance of the heart, which can no longer pump blood completely into the body. This causes it to build up back into the pulmonary circulation, which can lead to water in the lungs. That is why the resulting symptoms are colloquially called heart cough, which sounds cute, but is anything but harmless.

With these warning signs you should therefore always see your general practitioner, who can refer you to a cardiologist:

• Difficulty breathing during exertion
• Decrease in performance (climbing stairs, climbing, running fast)
• Swelling of the ankles and lower legs (fluid retention: edema)
• Coughing, rattling noises when breathing

In addition to the symptoms mentioned, the following symptoms may occur:

• Accelerated pulse, especially during exertion (“palpitations”)
• Quickened breath
• Cold fingers, feet and legs
• Nocturnal urge to urinate
• Dizziness

Pump Problems: What Exactly Is Left Heart Failure?

The human heart consists of two chambers, with the left ventricle having the task of pumping “fresh”, oxygen-rich blood into the body’s circulation. This function is limited in left heart failure. In addition to the backlog of blood in the lungs, the consequence is that less oxygen-rich blood reaches muscles and organs and they are undersupplied. Left heart failure can take two forms:

This is called when the heart muscle is weakened and the heart can therefore pump less blood to the body systolic heart failure.

This is called when the heart’s pumping power is maintained, but the heart muscle is not (no longer) elastic enough to take in sufficient blood diastolic heart failure.

Left heart failure has two main causes

According to Prof. Voigtländer, the vast majority of heart failure – whether left or right – can be traced back to two previous illnesses: coronary artery disease (CHD) and high blood pressure. CHD is a circulatory disorder due to constricted coronary arteries (“hardening of the arteries”) and the underlying disease of myocardial infarction. CHD is particularly often responsible for left heart failure. When the tiny coronary arteries are blocked, they cannot (temporarily) supply part of the heart muscle with oxygen. This can cause heart muscle cells to die. As a result, this part of the heart muscle loses its pumping power, resulting in cardiac insufficiency.

Diastolic heart failure as a special form of left heart failure often occurs in older people. It becomes particularly dangerous for them when CHD and high blood pressure occur together with diabetes. “In the case of diabetics, there is also the risk of silent heart attack. Diabetes can reduce the pain sensation for typical heart attack symptoms to such an extent that the heart attack is noticed too late and given emergency medical care. The heart muscle dies,” warns the expert.

However, younger, apparently healthy people can also be affected by heart failure. Defective heart valves, atrial fibrillation, congenital heart defects, inflammatory heart muscle diseases (myocarditis) or alcohol and drug abuse are responsible for around 20 to 30 percent of cases.

Can Left Heart Failure Be Cured?

No, but once the cause has been identified, it can be targeted, stopped and monitored. In addition, various drugs to lower blood pressure (e.g. ACE inhibitors and beta blockers) and dehydrating drugs (so-called diuretics) are used. Another important component of therapy is regular exercise or moderate training.

If the heart’s pumping performance is already severely reduced, cardiologists recommend implanting an ICD (internal cardioverter / defibrillator) – i.e. a pacemaker. It automatically delivers electric shocks when life-threatening cardiac arrhythmias occur, thus preventing sudden cardiac death. In rare extreme cases, the heart is so permanently damaged that the last option is a heart transplant or the use of a cardiac support system (artificial heart). But it doesn’t have to get that far!

Attention! Just don’t let the weak heart go off the rails

A derailment of cardiac insufficiency (cardiac decompensation) is one of the most common reasons for hospital admission, explains Prof. Voigtländer: “For the therapy of cardiac insufficiency, an active role of the patient is extremely important in order not to let the heart disease worsen in the first place.”

A derailment occurs when, for example, drugs are omitted, incorrectly dosed or combined. Or when a healthy lifestyle is not observed. “Body weight deserves special attention because an increase of more than two kilograms in three days indicates a tendency towards fluid retention, called edema. Those affected should therefore weigh themselves daily,” advises the heart specialist.

Because of the intake of water drains (diuretics), heart failure patients should avoid excessive salt consumption in food and excessive amounts of fluids (over 2 liters per day). It is also important to avoid overloading the already weakened heart with bacterial or virus infections. The German Heart Foundation therefore advises heart patients to be vaccinated against influenza and pneumococci, and of course, as soon as available, against the coronavirus. The German Heart Foundation clearly recommends the corona vaccination to all heart patients.

Other symptoms or factors for worsening heart failure that patients should look out for include:

• Pneumonia – more common in heart failure (overloaded, weakened heart)
• Accelerated pulse, palpitations on exertion
• Sudden respiratory distress with fear of death (due to congestion in the lungs as a result of a high blood pressure crisis)
• Foamy cough, rattling noises when breathing

Covid-19 also poses a risk of worsening heart failure. Those affected should keep these tips in mind: Heart failure patient? How to protect yourself from Corona

So that left heart failure does not progress – get active!

Doctors and medication can only take over part of the treatment in the case of a heart failure, the rest is the responsibility of the patients themselves , high cholesterol and lifestyle measures such as reducing excess weight, quitting smoking and regular exercise, “says Prof. Voigtländer.

Whereas in the past it was advised to take care of people with a weak heart, today we know that physical activities with a lot of movement with comparatively little effort – such as walking, hiking, Nordic walking or cycling – must be an integral part of heart failure therapy. However, the resilience must be tested with the family doctor or the cardiologist beforehand. Research has shown that regular endurance training can improve performance by 10 to 25 percent, reduce hospital stays, and lower mortality.