Heart Health Heart Failure Coughing and Heart Failure Why a Cough May Be an Important Sign of Heart Failure By Richard N. Fogoros, MD Richard N. Fogoros, MD Facebook LinkedIn Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our editorial process Updated on August 25, 2022 Medically reviewed by Anisha Shah, MD Medically reviewed by Anisha Shah, MD LinkedIn Anisha Shah, MD, is board-certified in internal medicine and cardiology. She served as a Medical Advisor at Cigna, Physician Editor at MCG Health, and is currently a Physician Clinician Reviewer at Magellan Health. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Causes Lung Disease When to Get Help If you have a long-term cough with congestive heart failure, that cough is something to pay attention to. It's called a cardiac cough and it may indicate that: Your heart condition is getting worseTreatment isn't working as well as it needs to beYou're having side effects from your heart-failure medicationYou have undiagnosed heart failure This article explores the symptoms and causes of a cardiac cough and when to get medical help for it. Verywell / Laura Porter What Are the Symptoms of a Cardiac Cough? The symptoms of a cardiac cough vary depending on the specific cause. Possible symptoms include: A wet cough that produces sputum (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 (waking up due to coughing and shortness of breath) A bubbling feeling in the chest due to fluid buildup in the lungs A long-term dry cough that doesn't get better when treated If you're showing signs of a cardiac cough, you may also have other symptoms of heart failure such as fatigue and swelling. Causes of Cardiac Coughing Congestive heart failure causes excess fluid (congestion) to build up in your body. That adds to your blood volume and can ease the strain on your heart. When this fluid builds up in the alveoli (air sacs) in your lungs, it's called lung congestion. The cardiac cough is your body's attempt to clear out the fluid. Causes of lung congestion include: Worsening heart failure Your prescription heart medication not working as effectively as it should (possibly due to worsening heart failure) Not taking your heart medication as prescribed A side effect of angiotensin-converting enzyme (ACE) inhibitors, a type of medication commonly prescribed for heart failure The cough from ACE inhibitors tends to be a dry, hacking cough. If it's bad enough, you may need to switch to a different heart medication. If you suspect this side effect, let your healthcare provider know right away. Don't stop taking your heart medication without their approval, even if you think it's triggering your cough. Heart Failure and Lung Disease Sometimes, a cough is mistaken for a symptom of lung disease when it's actually a heart problem triggered by lung disease. A type of right-sided heart disease called cor pulmonale is always caused by lung disease. Potential causes include: Chronic obstructive pulmonary disease (COPD) Pulmonary hypertension (high blood pressure in the arteries of the lung) Autoimmune diseases that damage the lungs, such as lupus, rheumatoid arthritis, or scleroderma Cystic fibrosis Severe bronchiectasis (widening of the airways) Scars in the lung tissues (interstitial lung disease) Obstructive sleep apnea Because of the threat to your heart, don't assume a new or different type of cough is because of your respiratory condition. Why COPD and Heart Failure Go Hand-in-Hand Heart Failure Healthcare Provider Discussion Guide Get our printable guide for your next healthcare provider's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. When to See a Healthcare Provider You should contact your healthcare provider if: You have heart failure and are coughingYou start coughing soon after a change in heart-failure medications or dosage adjustmentYou aren't diagnosed with heart disease but have a cough and other symptoms that could point to heart failureYou have lung disease and develop a new type of cough or worsening cough A cardiac cough can easily be mistaken for a cough with a different cause, such as a cold or allergies. It's safest not to make assumptions about the cause and to it get checked out. 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 In heart failure, the heart doesn't pump blood efficiently. It's often tied to a cardiac cough. Heart failure causes fluid retention, which can lead to a buildup of fluid in the lungs. This fluid triggers a cough as the body tries to clear it out. It can also be caused by medicine that's ineffective or not taken properly, and medications like ACE inhibitors. Contact your healthcare provider if you suspect a cardiac cough. Don't stop taking your medications with their approval and don't try to treat the cough yourself. Types of Heart Failure 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. American Heart Association. Warning signs of heart failure. University of Pennsylvania: Penn Medicine. Pulmonary edema. Yılmaz İ. Angiotensin-converting enzyme inhibitors induce cough. Turk Thorac J. 2019;20(1):36-42. doi:10.5152/TurkThoracJ.2018.18014 University of Michigan Medical School: Michigan Medicine. Heart failure. American Lung Association. Learn about cough. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Cor pulmonale. American Heart Association. Taking medicine for a cold? Be mindful of your heart. By Richard N. Fogoros, MD Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit