After a heart attack, shortness of breath and cough appeared: why and what to do?

Author's rating

Author of the article

Green Elena Stanislavovna

Otolaryngologist of the second category

Articles written

665

about the author

Cardiac cough is a special symptom that occurs due to a violation of the contraction of the ventricles of the heart. Many of us do not know that this disease can appear not only from a cold, but also as a result of heart pathologies. Chest pain and coughing during a heart attack may be the main complaint that the patient voices to the doctor. Cough after a heart attack or with myocardial disease is most often a consequence of heart disease, damage to the respiratory organs, especially catarrhal inflammation, to which people with heart disease are prone.

What is a cough like after a heart attack?

Myocardial infarction is an ischemic heart disease accompanied by the death of myocardial cells. During an attack, a person usually feels a strong cough, sometimes with a sore throat. The signs of such an illness are difficult to diagnose, since it comes in different types and can be caused by a number of diseases.

• viral or infectious diseases;
• stomach diseases;
• cardiac pathology.

Symptoms of cardiac cough are more pronounced during physical activity, stress, and poor lifestyle.

Myocardial infarction has a number of side symptoms. Some of them cause serious harm to human health; if they are present, you should consult a doctor. Cardiogenic shock is one of the side effects of myocardial infarction. It is triggered by heart failure and low blood pressure. This symptom continues for 3 or 10 hours, is accompanied by pain in the chest area, and requires emergency medical care.

Among the common causes of cough during a heart attack is shortness of breath. It is felt in the initial stages of heart disease. This deviation occurs due to disruption of the heart muscle and lungs. This disease most often affects athletes and smokers. In an advanced state, the disease can cause pulmonary edema, which can be fatal.

Addition of a cold or ARVI

A patient who has had a myocardial infarction may catch a cold. Sometimes such patients become infected with a viral infection from visitors or roommates. ARVI is characterized by hyperthermia, copious nasal discharge, sneezing, and coughing.

A carefully collected anamnesis helps in establishing the correct diagnosis. An indication of contact with a sick person confirms a possible viral infection. There will be no focal changes on the x-ray. A general blood test may show an acceleration of ESR, relative or absolute lymphocytosis.

Cold treatment

How to treat ARVI? Treatment of colds and viral infections does not require the use of antiviral drugs. It is enough to fight fever and cough. But the doctor should take into account that the capabilities of the cardiovascular system in such patients are limited.

They more often develop stagnation in the pulmonary circulation due to a cold or pneumonia. Special monitoring of patients with impaired coronary blood flow and associated ARVI is required. Treatment of cough after myocardial infarction requires establishing its cause, since for different pathologies the patient requires different therapy.

Cold treatment

Heart Cough Clinic

Most people suffering from heart disease are wondering how to distinguish bronchial asthma from a cardiac cough. Both of these diseases are similar to each other and can be confused during diagnosis. The following symptoms may be characteristic signs of cough against the background of heart pathologies:

• No sputum.
• Lips turn blue.
• Breathing is frequent and heavy.
• Shortness of breath appears.
• Chest pain.
• Swelling of veins in the neck.
• General weakness in the body.
• Profuse sweating.
• Swelling of the ankle area.

In severe cases, loss of consciousness may occur. Cough during myocardial infarction occurs quite often. It is not accompanied by a runny nose or headaches.

You need to know the difference between an attack of angina and a myocardial infarction. These conditions are similar in characteristics. An attack of angina occurs when the heart muscle is deprived of oxygen due to a lack of blood due to narrowing of the coronary arteries. After the attack stops, the pain goes away. During a myocardial infarction, the blood supply to the heart muscle is completely stopped due to blockage of the coronary artery by thrombosis. Myocardial infarction entails severe pain and prolonged pain in the chest area. An attack of angina is considered an alarming signal. If it lasts longer than usual, there is a risk of myocardial infarction.

Causes and symptoms of pulmonary edema during myocardial infarction

Pulmonary edema during myocardial infarction is a pathological process that accompanies heart failure. In this case, the cells of the affected area of ​​the myocardium (heart muscle) die, since due to a failure of the blood flow of the coronary arteries, the supply of oxygen and nutrients to the heart is stopped.

This may be accompanied by the development of edema in the lungs, which is caused by the accumulation of blood plasma released from the vessels in the lung tissues and alveoli. Thus, a heart attack is complicated by problems with the patient’s breathing; this is an extremely dangerous condition that can lead to the death of the patient and requires an immediate response.

According to ICD-10, the disease is assigned a code of 121, and its complication in the form of pulmonary edema is assigned a code of 150.1.

Cardiologists associate the development of this complex of pathologies with two factors:

1. Blockage of the coronary artery as a result of atherosclerosis, or significant narrowing of the lumen.
2. Too high pressure in the ventricle due to certain heart pathologies.

As you know, the job of the heart is to pump blood. The heart contracts in cycles, while the myocardium either relaxes or contracts again. When the heart relaxes (the so-called diastole), the ventricle is filled with blood, and during systole (contraction), it is pumped by the heart into the vessels.

When a patient develops a heart attack, the ventricles lose the ability to completely relax. This occurs due to the death of some muscle cells - necrosis.

Myocardial infarction is a serious complication of diseases of the cardiovascular system. But even after treatment, patients sometimes experience a cough. What is it connected with?

A patient’s cough may appear at the time of a cardiovascular accident and be a symptom of overload of the pulmonary circulation. With the development of blood stagnation in the pulmonary vessels, breathing is impaired and shortness of breath occurs.

Cough during a heart attack requires emergency treatment in a cardiology hospital or intensive care unit, as it may indicate the onset of pulmonary edema. This is a serious complication that often leads to death.

Why does cough occur when the threat to the patient’s life has already been stopped? The reasons for this condition are as follows:

• Inadequate therapy during the recovery period.
• Taking ACE inhibitors.
• Development of pneumonia.
• Concomitant cold or acute respiratory viral infection.

After relief of the acute condition and restoration of coronary circulation, the patient is prescribed maintenance therapy - beta blockers, ACE inhibitors, diuretics.

If the selected doses of drugs do not correspond to the severity of the patient’s condition, stagnation in the pulmonary circulation may develop again. The same happens with transmural myocardial infarction and a large area of ​​damage to the heart muscle, after which the heart cannot cope with normal load.

In this case, the patient will experience the following symptoms:

• Shortness of breath with any exertion and at rest.
• Difficulty breathing.
• First dry and then wet cough.
• The appearance of swelling in the legs.

A cardiac cough often bothers the patient in a horizontal position at night during sleep.

When auscultating the patient, the doctor first hears scattered dry rales, and then wet ones in the lower parts of the lungs.

If post-infarction cough is of cardiac origin, adjustment of therapy is required. Diuretics are usually prescribed to remove excess fluid and medications that improve the functioning of the heart muscle.

If such a symptom appears after discharge from the hospital, the patient should contact a cardiologist. A cough should not be ignored, as it may indicate incorrect or insufficient treatment.

Angiotensin-converting enzyme inhibitors are drugs that are prescribed to combat high blood pressure and heart failure, to improve myocardial function. These include the following drugs:

However, all ACE inhibitors, to one degree or another, are characterized by the development of a dry cough. This side effect does not occur in all patients, but it is quite common. It is not accompanied by sputum production, but is intrusive and worsens the patient’s quality of life.

Therapy adjustment

Dry cough while taking ACE inhibitors does not require specific treatment. In such a situation, the drug is discontinued. Preference is given to drugs from the group of beta blockers (Concor, Nebilet) or sartans (Lozap, Lorista).

When a cough appears after a heart attack, it is first necessary to exclude the side effects of medications.

Development of pneumonia

If the patient is hospitalized for a long time, he may develop congestive pneumonia. This is especially typical for bedridden patients, because myocardial infarction in most cases requires bed rest.

The risk of congestive pneumonia increases in the following patients:

• Elderly and frail.
• Smokers.
• With accompanying obesity.

When pneumonia occurs, the patient experiences the following symptoms:

• Moist cough.
• Dyspnea.
• Chest pain.
• Fever.

The diagnosis is confirmed by identifying foci of infiltration in the lung tissue.

Treatment

Pneumonia that develops in a hospital is called nosocomial or hospital-acquired. It is caused by microflora that are resistant to most antibiotics, so treating such a pathology is difficult for the doctor.

Often it is necessary to prescribe several drugs from different groups. The parenteral route of administration is usually used - intramuscular or intravenous drip.

To prevent this complication in people who have had a heart attack, it is necessary to perform breathing exercises and take an elevated position in bed.

A patient who has had a myocardial infarction may catch a cold. Sometimes such patients become infected with a viral infection from visitors or roommates.

ARVI is characterized by hyperthermia, profuse nasal discharge, sneezing, and coughing. A carefully collected anamnesis helps in establishing the correct diagnosis. An indication of contact with a sick person confirms a possible viral infection.

There will be no focal changes on the radiograph. A general blood test may show an acceleration of ESR, relative or absolute lymphocytosis.

Cold treatment

How to treat ARVI? Treatment of colds and viral infections does not require the use of antiviral drugs. It is enough to fight fever and cough.

But the doctor should take into account that the capabilities of the cardiovascular system in such patients are limited. They more often develop stagnation in the pulmonary circulation during a cold or develop pneumonia.

Special monitoring of patients with impaired coronary blood flow and associated ARVI is required.

Treatment of cough after myocardial infarction requires establishing its cause, since for different pathologies the patient requires different therapy.

Some people still believe that a developing cough indicates pathologies of the respiratory system.

In fact, the lungs closely interact with the blood vessels and the heart, so coughing after a heart attack also occurs due to a deterioration in the pumping function of the heart, when the ventricles do not have time to pump out the required amount of blood.

This process provokes stagnation in the pulmonary system, so blood plasma leaves the lungs and contributes to the formation of edema. The swelling affects the nerve endings in the bronchi, thereby contributing to coughing.

Cough associated with heart attack

Causes of cough

A cough can occur during a heart attack and be a symptom of overstrain in the pulmonary circulation. When blood stagnates in the lungs, breathing becomes impaired and shortness of breath develops.

Coughing during a heart attack requires urgent help. Treatment is carried out only in cardiology conditions or in intensive care. This symptom may indicate incipient edema in the lungs. This is a dangerous complication that can lead to death. When the threat to life has passed, a cough may manifest itself under the influence of the following reasons:

• incorrect recovery;
• use of ACE inhibitors for treatment;
• development of inflammation in the lungs;
• concomitant colds;
• increased pressure, which increases the load on the heart, depleting its walls and impairing blood pumping.

The problem is also caused by impaired integrity of the tubular bones. Because of this injury, blood clots penetrate into the vessels of the lungs and cause a heart attack. When exposed to infectious agents, pneumonia develops.

After collecting complete information about the nature of the cough, the doctor selects effective treatment tactics.

Coughing after a heart attack has its own characteristics, which make it possible to differentiate it from bronchial and colds:

• the cough is dry - there is no sputum, there is no suppuration or mucus, and in an acute attack blood may appear;
• during an attack, the lips, nasolabial triangle, fingers and earlobes turn blue;
• breathing quickens, and as symptoms progress, even normal conversation provokes suffocating attacks of coughing;
• heart pain, increased heart rate due to severe blood overload of the heart;
• presyncope, loss of consciousness due to increased pressure in the chest and decreased blood flow to the heart;
• enlarged veins in the neck;
• increased in a supine position due to increased load on the left ventricle in this position;
• the attack is accompanied by profuse sweating, weakness and dizziness, subsequently developing swelling in the ankles in the evenings.

Symptoms accompanying cough

The listed symptoms can progress with varying severity. The severity correlates with the cause and severity of the primary heart pathology.

Cough after a heart attack occurs:

• dry, irritating;
• dry, developing in paroxysms, with difficulty breathing;
• evening - it is loud, exhausting, develops in a supine position;
• with expectoration of blood - manifests itself in the case of severe congestion in the lungs.

Timely relief of coughing will help to quickly restore health and slow down the progression of the primary disease.

Diagnostics

To choose the right method to combat the disorder, the doctor first thoroughly studies the patient’s condition, confirms the symptom and its danger. For this purpose, diagnostics are organized. By contacting a specialist in a timely manner, many dangerous consequences can be prevented.

Diagnosis of the problem, methods

To confirm that this disorder is a consequence of a heart attack, the following are prescribed:

• electrocardiogram - to identify hypertrophy and ischemia in the heart;
• echo-CG - to study the contractility of the ventricle and a detailed study of the cardiac system;
• X-ray - to detect congestion in the lungs;
• tomography – for a full study of the capabilities of the heart.

• Organizing a proper daily routine.

What do we have to do

If symptoms of myocardial infarction appear, you should call an ambulance immediately. You should ask that the cardiology team respond to the call. Before the doctors arrive, the person can be given one nitroglycerin tablet. This medicine stops a heart attack and reduces heart pain. In order not to confuse an attack of angina and myocardial infarction, you need to know certain nuances. During an angina attack, after taking nitroglycerin, the pain goes away, but during a heart attack, it does not. You should not take more than one tablet of this medication, as it can lower blood pressure, which can worsen the patient's condition. If a person does not have stomach problems, you can give him acetylsalicylic acid 500 mg.

We recommend reading - What to do if a cough appears after anesthesia?

How it manifests itself

Cough during myocardial infarction and coughing after it have specific symptoms that make it possible to distinguish them from manifestations of a cold and bronchial disease. There are the following signs that accompany coughing after a heart attack:

• tingling or burning pain in the heart;
• increased heart rate, increased pressure in the pulmonary artery;
• enlarged neck veins;
• blueness of lips, earlobes, fingertips;
• rapid intermittent breathing;
• gradual intensification of attacks, they are suffocating and long;
• dry cough (without phlegm or other mucus), possibly containing blood;
• lightheadedness or loss of consciousness;
• increased attacks in a supine position as a result of increased load on the left ventricle;
• attacks are accompanied by weakness, dizziness, increased sweating;
• swelling of the lower extremities in the evenings;
• increased attacks in the evening and at night.

Etiotropic therapy

Etiotropic therapy is a treatment method aimed at eliminating the cause of the disease. If you have a cardiac cough, you need to strengthen the muscles of the heart and normalize its function. Drug treatment will be prescribed by a cardiologist after the examination results. As a preventive measure or at the first disturbances in the functioning of the heart, you can use traditional medicine recipes.

Recipe No. 1. To treat cough during a heart attack, use the following medicine: take 10 ripe lemons, scald them with boiling water and leave for 10 minutes. Squeeze the juice out of these fruits, throw in a kilogram of linden honey and ten heads of garlic. The mixture must be mixed and poured into a suitable container. The drug should be infused in a cold place for about ten days. Take the medicine one teaspoon before meals, four times a day. This therapy should be used for several months until all signs of the disease go away. This medicine helps with arrhythmia at an early stage.

Useful - Cough with arrhythmia.

Recipe No. 2. A mixture of herbs and honey. This recipe was created by Carpathian healers to eliminate a hearty cough. You should take a glass of dill seeds, grind them in a coffee grinder and mix with two tablespoons of grated valerian root. Add a spoonful of honey to the mixture and mix again, pouring in a liter of boiling water. The medicine must be infused for a week. The medicine should be taken 3 times a day before meals.

An attack of myocardial infarction should only be treated in a hospital setting. The main thing in therapy is:

• Restoring blood circulation. This point is the most important in the treatment of heart disease.
• Thrombolic treatment. The effectiveness of this treatment method depends on the timeliness of assistance.
• Surgical intervention. This treatment method is used for acute attacks of heart attack.

Etiotropic therapy is prescribed to each patient after undergoing a full examination by a doctor. You cannot treat heart problems on your own; you can only use traditional methods as a supplement to the main treatment.

Diagnosis of cardiac cough

Cardiac cough most often occurs in older people. Young people often suffer from this symptom. If such signs of cough are detected, consultation with a doctor is necessary. For a detailed diagnosis, you will be prescribed several measures that you will need to undergo. Methods such as ECG, EchoCG, CT, MRI and chest radiography will help to thoroughly examine the heart and analyze the functionality of the myocardium, as well as identify congestive diseases in the lungs. After the examination, the doctor will prescribe appropriate therapy for you.