Coughing Up the Truth: Is Congestive Heart Failure Causing Your Persistent Cough?

Imagine a bustling courier service on a particularly chaotic day. Parcels are piling up in every corner, with more and more deliveries coming in faster than they can be sorted and dispatched. The overwhelmed system begins to falter — deliveries are delayed, packages go missing, and the whole operation slows to a crawl. Now, think of this scene as your heart in congestive heart failure. The heart doesn’t come to a stop but struggles to pump blood effectively, slowing the entire flow through the body. About 26 million individuals worldwide live with congestive heart failure, which can lead to higher healthcare expenses and impact daily activities and overall quality of life.

In an attempt to keep up, the heart makes adjustments. The chambers stretch to hold more blood, or the muscle thickens and stiffens to push blood forward. But these efforts come at a cost. Over time, this extra work causes strain, leading to the death of some heart cells, weakening the heart muscle, and reducing its pumping power even further. Just like that overwhelmed courier service, the system can’t keep up, leading to backups and, eventually, a breakdown.

Symptoms of congestive heart failure

Congestive heart failure develops gradually, often without noticeable symptoms in the early stages. On occasion, the symptoms may be difficult to detect and easily mistaken for other common ailments. Moreover, these symptoms may not be constant, appearing and disappearing until they worsen.

Some early warning signs of congestive heart failure are:

• Fatigue
• Swelling in the lower legs
• Sudden weight gain
• Frequent urination, particularly at night

As the condition progresses, more chronic symptoms may indicate a worsening state, such as:

• A persistent cough that won't go away
• Breathlessness
• Rapid or irregular heartbeats
• Wheezing

In severe cases, congestive heart failure may present with more alarming symptoms that include:

• Fainting
• Bluish skin tone
• Rapid breathing
• Chest pain

Types of congestive heart failure

CHF is commonly classified based on which side of the heart is affected and how well the heart muscle pumps or relaxes.

• Left-sided heart failure
  This is the most common type and occurs when the left ventricle cannot pump blood efficiently to the body, leading to fluid build-up in the lungs and symptoms such as breathlessness and fatigue.

• Right-sided heart failure
  Right-sided heart failure develops when the right ventricle fails to pump blood effectively to the lungs, causing fluid accumulation in the legs, ankles, abdomen, and sometimes the liver.
• Biventricular heart failure
  This type involves failure of both the left and right sides of the heart, resulting in a combination of pulmonary congestion and systemic fluid retention.

• Systolic heart failure (heart failure with reduced ejection fraction)
  In systolic heart failure, the heart muscle is weak and cannot contract properly, reducing the amount of blood pumped out of the heart with each beat.

• Diastolic heart failure (heart failure with preserved ejection fraction)
  Diastolic heart failure occurs when the heart muscle becomes stiff and cannot relax adequately, limiting the heart’s ability to fill with blood despite a normal pumping function.

Chronic cough and congestive heart failure: What’s the connection?

In people with congestive heart failure, as the heart's pumping ability declines, fluid begins to accumulate in the body. When this fluid builds up in the lungs, it often triggers a cough reflex as the body tries to clear the congestion. This cough worsens as the condition progresses and may be wet, sometimes producing blood-streaked, pink, or white mucus. Additionally, some medications used to treat heart failure can cause a persistent, dry cough, which can be another source of discomfort for those managing the condition.

Understand the causes

Prevention is better than a cure. The same goes for congestive heart failure. Learning about the causes of congestive heart failure is the first step towards prevention:

• Conditions that overburden the heart: High blood pressure, heart valve disease, or congenital heart disease are risk factors for congestive heart failure and should be monitored.
• Diseases affecting other body organs: Thyroid disease, kidney disease, diabetes, and obesity may increase the risk and should be monitored.
• Coronary artery disease: A buildup of sticky plaque in the arteries impedes blood flow to the heart. The lack of blood gradually damages the heart tissue. Adopt heart-healthy habits to prevent plaque buildup in the arteries.
• Heart attack: A sudden obstruction in the arteries cuts off blood supply to the heart and damages the heart tissue. It's important to control blood pressure, manage diabetes, and maintain a healthy weight.
• Cardiomyopathy: The heart muscle can become inflamed due to infections, genetic changes, or alcohol and drug use.
• Medication: Certain drugs used for treating cancer may also cause congestive heart failure.

Get help

Get your symptoms checked right away. You may be referred to a heart specialist who will recommend some tests to pinpoint the diagnosis. Heart failure is an irreversible condition, so the primary goal is to prevent its progression and alleviate symptoms. Managing existing medical conditions through medication and lifestyle changes is a key treatment strategy for congestive heart failure. Your doctor will detail the different treatment alternatives that are available — medical and surgical — and help you choose the plan most suitable for you.

Shield your heart: Simple steps to prevent congestive heart failure

Even if you have a genetic predisposition to congestive heart failure, maintaining a healthy lifestyle can help prevent it in the long run. Here are some of the steps that you can take to keep your heart healthy and happy:

• Eat a low-fat and low-sodium diet. A dietitian can help customise a diet specific to your health needs.
• Smoking or exposure to second-hand smoke can negatively affect your heart and overall health.
• Exercise consistently or participate in any physical activity that you find enjoyable. Being active is essential for promoting heart health and controlling your weight.
• If you are living with other conditions like hypertension or diabetes, you must get them treated and monitor your health regularly.
• Stress is your heart’s enemy. Manage your stress by indulging in activities that bring you peace, be it gardening, painting, or yoga.

Dr Amit Malik, Director and Coordinator of Interventional Cardiology and Electrophysiology, Uttar Pradesh, suggests, “Embrace a heart-healthy lifestyle by incorporating a balanced diet, regular exercise, and stress management to minimise the risk of congestive heart failure.”

Empower your heart with knowledge and action

Congestive heart failure happens when the heart struggles to pump blood effectively. Chronic coughing is one of its main symptoms due to fluid retention in the lungs. Apart from genetics, other health conditions and an unhealthy lifestyle may lead to congestive heart failure. Medical attention should be immediately sought if symptoms arise. A low-sodium diet, regular exercise, and stress management are essential to prevent congestive heart failure.

Frequently Asked Questions

1. Can you live with congestive heart failure?

Yes, many people live for years with congestive heart failure with appropriate treatment, lifestyle changes, and regular medical follow-up.

2. What is the main cause of congestive heart failure?

The most common cause is coronary artery disease, which reduces blood flow to the heart muscle and weakens its pumping ability.

3. What are the four stages of congestive heart failure?

The four stages (A–D) range from being at risk with no symptoms (Stage A) to advanced heart failure with severe symptoms at rest (Stage D). The following are the stages:

• Stage A: At risk for heart failure
• Stage B: Pre-heart failure
• Stage C: Symptomatic heart failure
• Stage D: Advanced heart failure

4. What is the difference between heart failure and congestive heart failure?

Heart failure refers to the heart’s inability to pump effectively, while congestive heart failure specifically describes heart failure accompanied by fluid build-up in the lungs or body tissues.

5. Can the heart repair itself after congestive heart failure?

The heart usually cannot fully repair itself, but treatment can improve heart function, slow disease progression, and significantly improve quality of life.