How Your Heart Works
Your heart has a right side and a left side, separated by a wall. Each side has a small collecting chamber , which leads into a large pumping chamber . There are four chambers the left atrium and right atrium , and the left ventricle and right ventricle .
Normally, the upper chambers of your heart contract first and push blood into the lower chambers . The ventricles then contract the right ventricle pumping blood to your lungs and the left ventricle pumping blood to the rest of your body.
In a healthy heart, heartbeats are set off by tiny electrical signals that come from your hearts natural pacemaker a small area of your heart called the sinus node, located in the top of the right atrium. These signals travel rapidly throughout the atria to make sure that all the hearts muscle fibres contract at the same time, pushing blood into the ventricles.
These same electrical signals are passed on to the ventricles via the atrioventricular node and cause the ventricles to contract a short time later, after they have been filled with blood from the atria. This normal heart rhythm is called the sinus rhythm, because it is controlled by the sinus node.
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Assessment Of The Body
People with both conditions may appear to be working hard to breathe. Those experiencing heart failure may have a hard time breathing while lying flat. Their feet and ankles may be swollen. Their stomachs may appear bloated. Asthma usually does not present with a bloated stomach or feet or ankle swelling.7-8
Cardiac Asthma: Not Your Typical Asthma
Clinical Instructor of Pharmacy PracticeSchool of PharmacyPhiladelphia College of Osteopathic MedicineGeorgiaSuwanee, Georgia
Ramon Cereceres, Jr., PharmD
Ashley N. Feik, PharmD Candidate
Katherine E. Iltis, PharmD
University of the Incarnate WordFeik School of Pharmacy
Katelyn E. Horne, PharmD CandidateLoma Linda University
Monica Litzinger BSc, BSc Pharm, RPhOutpatient PharmacistSuwanee, Georgia
ABSTRACT: Cardiac asthma is a condition secondary to heart failurethat is marked by dyspnea, wheezing, cough, frothy or bloody sputum,and rales.1 These symptoms usually occur at night and aremore prevalent in the elderly population. Because its symptoms aresimilar to those of bronchial asthma, cardiac asthma is oftenmisdiagnosed. However, an accurate diagnosis is imperative becausetreatments for the two conditions differ, and incorrect treatment canexacerbate cardiac asthma.2 IV furosemide, nitroglycerin, and morphine are used for the acute treatment of cardiac asthma.3 If the patient is hypoxic, supplemental oxygen also may be used.3 Outpatient medication regimens focus on treating heart failure.
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Lab Tests And Procedures
Based on initial findings, your healthcare provider will order tests to investigate further. If asthma is suspected, you would generally be referred to a pulmonologist or pulmonology lab for evaluation with in-office spirometry and other pulmonary function tests .
If heart failure is suspected, a number of common lab tests, imaging studies, and procedures can be performed to confirm the diagnosis. You may get these initially or only after pulmonary tests have been conducted and reviewed:
- B-type natriuretic peptide , a blood test that detects a hormone released with increased ventricular pressure
- Echocardiogram, a non-invasive ultrasound test that can visualize how well your heart is pumping
- Electrocardiogram , used to measure the electrical impulses during heartbeats to detect irregularities
- Stress testing, in which your ECG and respiratory function are evaluated while exercising on a treadmill or stationary bike
- Cardiac magnetic resonance imaging , a detailed imaging study of the heart using powerful magnetic and radio waves
- Computed tomography angiography, a 3-D imaging study using a series of X-rays to map the structure of the heart
- Chest X-ray, generally less useful in diagnosis but that may help exclude other causes of heart dysfunction
It is important to seek a full and proper diagnosis of your condition whether heart failure or asthma is suspected.
Am I Having A Heart Attack
Someone having a heart attack is more likely to feel a pain or tightening across the chest rather than the feeling of a skipped heartbeat, explains Lucy Martin, senior cardiac nurse at the British Heart Foundation. Other common symptoms are sweating, shortness of breath and feeling sick or a pain that radiates along the arm or up to the jaw.
If you are experiencing any of the above symptoms, its important to seek urgent medical care.
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The Connection Between Lungs And Heart
The lungs and the heart work very closely and are heavily dependent on each other. One of the primary functions of the heart is to supply oxygen to other parts of the body. And oxygen enters the body through lungs. So if theres any issue with the health of your lungs, the heart has to work harder to circulate oxygen throughout the body. All of this means that healthy lungs play a critical role in heart health.
How Is Asthma Linked To Heart Disease
- The symptoms of both asthma and heart failure include shortness of breath, severe chest pains and coughing. It is difficult to distinguish between the two at first glance.
- Both asthma and heart disease are caused by inflammation in the body.
- In the event of an asthma attack, the patient is also bound to show symptoms of severe chest pains because the flow of blood is compromised when the body is inflamed.
- Patients with active asthma are more likely to get a heart failure than those who have not had an asthma attack recently.
- Most cases of asthma linked to heart diseases were found in patients who had developed asthma as adults.
- Researchers found that patients with asthma had about a 70 percent higher risk of heart diseases than those without asthma.
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What Can I Do To Prevent Palpitations
Depending on the cause of your palpitations, these tips can help you have them less often:
- Reduce your stress level or biofeedback techniques.
- Avoid or limit the amount of alcohol you drink.
- Avoid or limit the amount of caffeine in your diet.
- Do not smoke or use tobacco/nicotine products
- Exercise on a regular basis .
- Avoid foods and activities that trigger palpitations.
- Control your blood pressure and cholesterol levels.
What Are The Symptoms Of Atrial Fibrillation
You might notice your heartbeat feels strange and sometimes very fast, even when youre not exercising. Other symptoms of AF can include:
finding it harder to exercise
shortness of breath
dizziness or feeling faint.
Sometimes people don’t experience any symptoms and AF gets detected when having an exam or check up. This is common in older people.
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What Can I Expect If I Have Cardiac Asthma
Heart failure, which causes cardiac asthma, keeps getting worse with time. Symptoms can get worse without warning. You can manage heart failure with lifestyle changes and medicines for a while.
However, you may come to a point when you feel short of breath when youre not exerting yourself at all. This is called advanced heart failure.
Before you get to this point, its good to let your family and healthcare provider know what kind of care you want. For example, if youre having a lot of trouble breathing, would you want a breathing tube in your throat?
How long does cardiac asthma last?
Cardiac asthma lasts as long as you have the condition thats causing it. Usually, that condition is heart failure, which doesnt have a cure. Be sure to explore your treatment options to get the best care available.
Heart Palpitations And Asthma
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Caffeinated Foods / Beverages
The research around caffeine is a little less definitive since a study released at the start of 2016 found no relationship between caffeine consumption and palpitations. However, those results dont change the fact that caffeine revs up your sympathetic nervous system and spikes your levels of stress hormones , raising your blood pressure and increasing your heart rate. Caffeine also acts as a diuretic, which can wash away your potassium and magnesium stores, creating an electrolyte imbalance that disrupts the heart rhythm.
In my experience, placing extra stress on the heartas caffeine doescan aggravate existing arrhythmias or cause new ones. One of the reasons beta blockers are prescribed to heart attack patients is that they help control heart rate and prevent sudden changes in heart rate and rhythm by blunting the effect of the stress hormone adrenaline.
For those of you with healthy hearts, your daily dose of coffee, tea, or chocolate probably wont cause any harm. Beware, though, of caffeine-containing energy drinks, which are particularly popular with young people. These drinks, which combine caffeine with large amounts of sugar, have been linked with heart palpitations, arrhythmia, heart attack, and sudden cardiac death in adolescents and young adults.
Increased Excitability Or Hyperactivity
Sudden, noticeable excitement after beginning albuterol therapy is a less common side effect, occurring in less than 1 in 10 patients. Its more common in children and adolescents 2 to 14 years old than in older patients. In children, hyperactivity may show up as nervousness or jitters. Fortunately, this side effect tends to resolve within a few days or weeks after starting the medication.
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What Do Heart Palpitations Feel Like
Heart palpitations can cause a fluttering sensation in the chest or a feeling that your heart has skipped a beat. You may also feel like your heart is beating too fast or is pumping harder than normal.
If you have GERD, you may sometimes feel tightness in your chest, but this isnt the same as having heart palpitations. Some symptoms of GERD, such as air being trapped in the esophagus, may cause palpitations.
A Recent Study By Cepelis And Colleagues Investigated A Potential Association Between Asthma And Atrial Fibrillation Which Is A Condition Characterized By An Irregular Heartbeat
Atrial fibrillation is a common heart problem characterized by an irregular heartbeat. Studies have shown that irregular heartbeats are associated with an increased risk of blood clots, stroke, and worsened cardiovascular outcomes.
In 2014 Chan and colleagues demonstrated that atrial fibrillation may be associated with asthma, a seemingly unrelated medical condition. Asthma is a long-term inflammatory disease that narrows the airway and makes breathing difficult. Besides this initial study in 2014, there had been no other studies investigating the link between asthma and irregular heartbeats in a larger sample of individuals, until now.
In a recent study, in JAMA Cardiology, Cepelis and colleagues investigated the association between asthma and the risk of developing AF using data of 54,567 participants from the Nord-Trøndelag Health Study . The study found that following adjustments for confounding factors, including sex and age, participants with asthma had a higher risk of developing atrial fibrillation, compared with non-asthmatic patients.
Furthermore, the study found that patients who had their asthma under control were at a slightly lower risk of having atrial fibrillation when compared to patients with uncontrolled asthma. Collectively, in consensus with Chan and colleagues, the current study suggests that asthma may be a risk factor for atrial fibrillation.
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The 411 On Heart Palpitations
From everyday stress to watching your favorite sports team, heart palpitations can be caused by a wide-range of situations. Although they may seem minor at the time youre experiencing them, prolonged palpitations may be a symptom of a more serious health concern, such as a cardiac arrhythmia. Defining the source of palpitations is key to developing a course of action to treat future occurrences.
Cardiac and non-cardiac causes of palpitations
A heart palpitation is a perceptible unpleasant forcible pulsation of the heart, usually with an increase in frequency or force, with or without irregularity in rhythm. Dr. Ajith Nair, assistant professor of cardiology at Baylor College of Medicine, says heart palpitations can occur as a result of both cardiac and non-cardiac causes.
Cardiac causes include:
Nair says certain medication can also play a role.
If youre taking albuterol for asthma, it can sometimes cause palpitations, for example, he said. Other medications that have potential to cause palpitations are sympathomimetic drugs, vasodilators and anticholinergics.
Always be mindful of some of the things that you take, whether they are prescription-based or over-the-counter, Nair said.
Types of arrhythmias
When To Evaluate Heart Palpitations
Palpitations are symptoms of everything from short or long-term stress to a variety of arrhythmias . They may feel alarming, but do not always reflect a serious heart condition. Joseph Marine, M.D., vice-director of the Division of Cardiology at Johns Hopkins, starts his evaluation by asking his patients what they hear.
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Impact Of Copd On Af Risk
A total of 12 included studies assessed the association of COPD with AF risk . Grymonprez et al. reported the relationship between the frequency of COPD and AF incidence, and also the association of different systemic inflammatory levels and AF risk. Knuiman et al. reported the race- and sex-specific association of COPD with AF incidence, separately. We combined the separate data of these 2 studies as the final effect estimates in the pooled analysis.
In the pooled analysis using the random-effects model, the effect estimate of COPD on AF risk was 2.24 . In the sensitivity analysis, the pooled results were stable after exclusion one study at a time. In addition, the pooled RRs were not significantly changed when we re-performed the analyses using the fixed-effects model .
Figure 2. Forest plot for the relationship between chronic obstructive pulmonary disease and the development of atrial fibrillation.
Can Respiratory Problems Cause Heart Palpitations
Chances are youve experienced a racing heartbeat at some point in your life. More commonly known as palpitations, this symptom is underlined by a very spasmodic heart rhythm. Palpitations, like chest pain, result from the heart not pumping sufficient blood to the body. If you have palpitations that began after a specific event, like a stressful situation, you should probably visit a physician to evaluate for serious heart conditions such as arrhythmia..
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Why Foods Cause Heart Palpitations
Feeling palpitations after eating is a relatively common experience, which tends to occur when a substance in your food or drinkor your bodys natural biochemical response to that substancejolts the hearts electrical system and causes fluttering sensations, skipped beats, or a feeling that your heart is beating too hard or too fast.
Coffee drinkers, think about the last time you drank one cup too many. You know what I mean!
If your heart is healthy and you have no history of arrhythmia or heart diseaseand youre not experiencing any other symptomstheres little need to worry about an occasional episode of these irregular beats. For people who do have arrhythmias or cardiac issues, however, its a different story. Palpitations caused by food can cause an existing disruption in your hearts rhythm to escalate, and potentially lead to a major event.
So What Can You Do If You Currently Have Asthma
Patients with more severe forms of asthma should be aware that there is an increased risk for atrial fibrillation, and that they should talk with their doctor about how diet and exercise might help minimize that risk, says Tattersall.
There has been a lot of data that has come out that suggests there are modifiable risk factors in developing atrial fibrillation, according to Tattersall. One of the largest modifiable risk factors that can make the biggest difference was exercise and weight loss, he says.
Tattersall references the ARREST AF Cohort Study, published in December 2014 in the Journal of the American College of Cardiology , and another trial known as the LEGACY study, published in May 2015 in JACC. In both those studies, people who lost weight and exercised actually improved their atrial fibrillation, notes Tattersall. Combined with that, we know that in certain forms of asthma, maintaining an ideal body weight can also help improve symptoms, he says.
According to the American Lung Association, extra weight increases the risk of asthma and of more severe asthma thats harder to control with medication.
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Atrial Fibrillation : Causes Symptoms And Treatments
Atrial fibrillation is a common abnormal heart rhythm or arrhythmia. It causes your heart to beat abnormally, which might feel like your heart is fluttering.
We answer the top 7 most common questions about AF, read on to find out more.
Smoking And/or Alcohol Consumption
Smoking can lead to damages in just about every single part of the body, including the heart. According to the American Heart Association, cigarettes contain around 4,000 chemical ingredients, with at least 250 of these being harmful to the body. For example, nicotine found in cigarettes can cause your heart rate and blood pressure to soar.
Heavy alcohol use can also have severe adverse effects on the body. Research shows that even moderate consumption can increase the risk of developing AFib. Even if you only drink on special occasions, holiday heart syndrome can cause an irregular heartbeat due to excess drinking at one time .
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