Coughing and Heart Failure

Why a Cough May Be an Important Sign of Heart Failure

For people with heart failure—when the heart doesn't pump blood like it should—a long-term cough may indicate that treatment isn't working as well as it needs to be. Sometimes referred to as a cardiac cough or heart cough, this condition may be a side effect of certain medications used to treat heart failure.

If you develop a cardiac cough, it's important to work with your healthcare provider to figure out what's causing it.

This article explores the symptoms and causes of a cardiac cough. It will also explain when you should reach out to your doctor.

What Are the Symptoms of a Cardiac Cough?

Symptoms of Cardiac Cough

Verywell / Laura Porter

The symptoms of a cardiac cough will vary depending on the specific cause. Symptoms may include:

  • A wet cough that produces sputum, or mucus, that may be slightly pink due to blood
  • Heavy wheezing, or a whistling sound that happens while breathing, accompanied by coughing
  • Shortness of breath while engaging in activities or lying down
  • Paroxysmal nocturnal dyspnea, a condition where you are awakened during sleep due to coughing and shortness of breath
  • A bubbling feeling in the chest due to fluid buildup in lungs
  • A long-term dry cough that doesn't get better when treated

Keep in mind, if you are showing signs of a cardiac cough, you may also have other symptoms of heart failure such as fatigue and swelling.

Why Does Heart Failure Cause a Cough?

With heart failure, sometimes called congestive heart failure, the heart is unable to pump blood efficiently. This can lead to lung congestion as fluid backs up into the alveoli, or air sacs, of the lungs.

This fluid can cause a cough as the body tries to clear it out.

Heart Failure Healthcare Provider Discussion Guide

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Doctor Discussion Guide

Fluid can build up in the lungs and lead to a cough if your prescription heart medication isn't working as effectively as it should be, or you aren't taking it as directed. Speak with your healthcare provider right away if you suspect this is happening.

A dry hacking cough without mucus is a common side effect of angiotensin-converting enzyme (ACE) inhibitors, a type of medication commonly prescribed to those with heart failure. Some may need to switch their heart medication to reduce their coughing symptoms.

Recap

With heart failure, the heart is not able to pump blood efficiently, which can lead to fluid buildup in the lungs. This can cause a cough as the body tries to remove the fluid from the lungs. Issues related to your medications can also be to blame.

When Should You See a Doctor for a Heart-Related Cough?

A cardiac cough can easily be mistaken for another cause, such as a cold or allergies. If you have heart failure and are coughing, be sure to reach out to your doctor.

You may need to take a medication that doesn't produce this side effect for you, or switch to a drug that is more effective. Never stop taking any medication you have been prescribed without your doctor's OK, even if you believe it is triggering your cough.

Do not attempt to self-treat a cough with an over-the-counter cough suppressant or other drug. The active ingredients in some of these, like pseudoephedrine, can raise blood pressure and worsen the symptoms of heart failure.

Summary

With heart failure, the heart doesn't pump blood efficiently which can lead to a buildup of fluid in the lungs. This fluid triggers a cough as the body tries to clear it out.

Certain medications, such as ACE inhibitors, as well as not taking medications as directed can also cause a cough.

Speak with your doctor if you have heart failure and develop a wet or dry cough, wheezing, shortness of breath, or a gurgling feeling in the chest.

This could mean your medication isn't working well enough for your needs.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Heart Association. Warning signs of heart failure.

  2. Penn Medicine. Pulmonary edema.

  3. Cleveland Clinic. Persistent cough? It may be a sign of heart failure.

  4. American Lung Association. Learn about cough.

  5. Michigan Medicine. Heart failure.

  6. Yılmaz İ. Angiotensin-converting enzyme inhibitors induce cough. Turk Thorac J. 2019;20(1):36-42.doi: 10.5152/TurkThoracJ.2018.18014

  7. American Heart Association. Taking medicine for a cold? Be mindful of your heart.