Heart cough
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The Relationship Between Cough and Heart Conditions
Chronic Cough and Myocardial Infarction Risk
Chronic cough, often a sign of chronic lung infection or inflammation, has been linked to an increased risk of myocardial infarction (heart attack). A study from the Framingham Heart Study found that both nonproductive and productive chronic coughs were independent predictors of myocardial infarction. Specifically, individuals with chronic nonproductive cough had an odds ratio (OR) of 1.8, while those with chronic productive cough had an OR of 1.6 for developing myocardial infarction. This association remained significant even after adjusting for various confounders such as age, gender, smoking status, and lung function. Elevated plasma fibrinogen levels, an acute phase reactant, were also noted in individuals with chronic cough, suggesting a potential inflammatory pathway linking chronic cough to heart disease.
Cardiac Cough in Dogs and Humans
The concept of "cardiac cough" has been explored in both veterinary and human medicine. Historically, cough has been considered a major symptom of cardiogenic pulmonary edema in dogs, but recent evidence challenges this traditional view, suggesting that cough may not be as strongly linked to congestive heart failure as previously thought. In humans, cough can be both a cause and a consequence of heart dysfunction. For instance, arrhythmia-triggered cough is a rare but notable phenomenon where abnormal heart rhythms induce coughing, which typically resolves with successful treatment of the arrhythmia.
Cough Syncope and Cardiovascular Responses
Cough syncope, a condition where coughing leads to fainting, is associated with significant drops in blood pressure and an inappropriate heart rate response. Patients with cough syncope exhibit more pronounced hypotension and a delayed recovery of systolic pressure compared to other fainters. This suggests a neurally mediated reflex contribution to the symptomatic hypotension observed in these patients. Additionally, the heart rate response to coughing has been studied as a potential measure of autonomic nervous control, although it appears less effective than other tests like the Valsalva maneuver .
Cough as a Symptom and Diagnostic Tool
Cough is a common symptom in cardiovascular disorders and can indicate worsening disease states or side effects of medications, such as angiotensin-converting enzyme inhibitors (ACE-I). A meta-analysis of randomized placebo-controlled trials found that cough was a significant side effect of ACE-I, although a substantial number of cough cases were also reported on placebo, indicating other potential causes. Moreover, innovative diagnostic tools like TussisWatch, a smartphone-based system, have been developed to identify cough episodes indicative of chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF), highlighting the diagnostic potential of cough monitoring in chronic heart conditions.
Conclusion
Cough, while often associated with respiratory issues, has significant implications for heart health. Chronic cough can be an indicator of increased myocardial infarction risk, and specific types of cough, such as those triggered by arrhythmias, can provide insights into underlying cardiac conditions. Understanding the complex relationship between cough and heart dysfunction is crucial for accurate diagnosis and effective treatment of cardiovascular diseases.
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