Each time winter approaches or flu season hits, a symphony of coughs can be heard across offices, public transport, and homes.
Coughs are typically associated with colds, allergies, or the flu, but what happens when a cough won’t go away?
Coughing is normal, and while there are common culprits that frequently top the list of reasons, there’s a less commonly discussed connection to consider – the relationship between a chronic cough and the health of your heart.
In this article, we’ll explore how the heart can silently communicate its distress, making it all the more crucial not to dismiss a lingering cough as merely another cold or allergy symptom.
What is a Persistent Cough?
A persistent or chronic cough is medically defined as one that lasts more than eight weeks in adults and more than four weeks in children. According to the Canadian Lung Association, approximately 16% of Canadians aged 45 to 85 suffer from a chronic cough.
Common Non-Cardiac Causes of Chronic Cough
Here are some of the more common reasons people find themselves caught in a cycle of coughing:
- Allergies: Seasonal changes bring with them pollen, dust, and other allergens. The body’s reaction to these can include coughing as it attempts to clear out what it perceives as harmful invaders.
- Colds and Viral Infections: Often the primary suspect behind a cough, the common cold or a more severe viral infection like the flu can result in lingering coughs even after other symptoms subside.
- GERD (Gastroesophageal reflux disease): This is a condition where stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). The acid can irritate the airways leading to a chronic cough.
- Asthma: Characterized by inflamed airways, asthma can cause periodic episodes of wheezing, chest tightness, and, yes, coughing. Some people primarily have cough as their main asthma symptom, often referred to as “cough-variant asthma”.
Heart Conditions That Can Cause Chronic Cough
When the heart’s function is compromised, a lot of symptoms can manifest, including a persistent cough.
Let’s discuss some heart conditions that might be the culprit behind why a cough won’t go away.
Heart failure doesn’t mean the heart has stopped working, but rather its efficiency in pumping blood has diminished. It can be due to the heart’s inability to pump (systolic) or fill (diastolic) effectively.
When the heart doesn’t pump blood properly due to heart failure, it can lead to a backlog of blood in the pulmonary veins (veins returning blood from the lungs to the heart). This backlog causes fluid to leak into the lungs. As a result, a person might experience a persistent, often wet-sounding cough as the body attempts to clear this fluid.
Valvular Heart Diseases
The heart’s valves regulate blood flow, ensuring it moves in the right direction and preventing backflow. Valvular heart diseases occur when one or more of the heart’s valves don’t function correctly, either not opening fully (stenosis) or not closing tightly (regurgitation).
A malfunctioning valve can cause blood to pool or flow backward. This disrupted flow can increase pressure in the heart and lungs, leading to symptoms like shortness of breath and coughing, especially when a person is lying down.
Cardiac asthma is not a form of asthma in the traditional sense. Instead, it’s a set of symptoms, like wheezing and shortness of breath, resulting from fluid buildup in the lungs due to heart failure or other cardiac conditions.
While the symptoms can mimic those of bronchial asthma, the causes are different. Bronchial asthma is a respiratory condition caused by inflammation of the airways. In contrast, cardiac asthma results from the heart’s inability to function efficiently, leading to fluid in the lungs.
Pulmonary edema refers to the accumulation of fluid in the lungs, particularly in the air sacs (alveoli). This condition makes breathing difficult and can reduce the oxygen level in the bloodstream.
The most common cause of pulmonary edema is heart failure. When the heart can’t pump effectively, pressure builds in the heart’s left chamber and the adjacent blood vessels. This increased pressure pushes fluid into the lungs. As the fluid fills the air sacs, it can cause a frothy cough, often tinged with blood, and a sensation of drowning or gasping for air.
Other Symptoms to Watch Out For
While a chronic cough can be a symptom of an underlying heart condition, it’s rarely the only sign. The body often sends multiple signals when something is amiss.
Here are some accompanying symptoms that may further indicate cardiac concerns:
Shortness of Breath
Often described as feeling like you can’t catch your breath or being winded even after minimal activity. This symptom can result from the heart’s inability to pump oxygen-rich blood efficiently, leading to decreased oxygen reaching the muscles and tissues.
An overwhelming sense of tiredness, weariness, or lack of energy can be a sign of heart strain. When the heart doesn’t circulate blood effectively, the body’s cells might not receive the oxygen and nutrients they need, resulting in fatigue.
Chest Pain or Discomfort
This can manifest as a squeezing, pressure, heaviness, or even a sharp pain. It might not always be the crushing ‘elephant on the chest’ sensation often depicted. Sometimes, it’s more subtle but should never be ignored. Chest discomfort can be a sign of reduced blood flow to the heart muscle.
Swelling of Legs or Ankles
Also known as edema, this swelling occurs when excess fluid builds up in the tissues. It’s often a result of the heart not pumping blood effectively, causing blood to back up in the veins and leading to fluid leakage into the surrounding tissues.
Each of these symptoms on its own can be caused by various conditions, but when seen in conjunction with a persistent cough, they could be the body’s way of signaling deeper cardiac concerns. If your cough won’t go away, be sure to pay attention to any other symptoms and consult with your healthcare provider.
When a cough won’t go away, it’s oftentimes nothing to be overly concerned about. However, it can sometimes be more than just an annoying tickle in the throat or a lingering aftermath of a cold.
As we’ve explored, a persistent cough may be an indicator of a potential malfunction of our body, particularly the heart. Thus, if you’ve been dealing with a chronic cough, especially one that’s accompanied by other symptoms, it’s important to speak with your healthcare provider.