Cardiac asthma is severe breathlessness (dyspnea) caused by heart failure, leading to fluid buildup in the lungs (pulmonary edema).
Cause: Left heart failure → Increased pulmonary capillary pressure → Fluid leaks into lungs → Difficulty in breathing.
Synonyms:
- Acute Left Heart Failure
- Pulmonary Edema
Mnemonic: "C.A.R.D.I.A.C. A.S.T.H.M.A." (Cardiac Attack, Rapid Dyspnea, Immediate And Critical – Always Severe Trouble, Heart Malfunctioning Attack)
CAUSES OF CARDIAC
ASTHMA
1. Cardiac Causes
(Most Common)
• Mitral Valve Disease → Stenosis, Regurgitation.
• Aortic Valve Disease → Stenosis, Regurgitation.
• Acute Myocardial Infarction (Heart Attack).
• Uncontrolled Hypertension (High BP).
2. Other Causes
• High-Altitude Pulmonary Edema (HAPE) → Seen above 2700
meters.
• Tachyarrhythmias (Fast Irregular Heartbeat).
• Fluid Overload (IV Fluids in Elderly).
Mnemonic: "M.A.H.T." (Mitral, Aortic, Heart Attack, Tachyarrhythmia)
PATHOPHYSIOLOGY
OF CARDIAC ASTHMA
• High Pressure in Pulmonary Veins → Fluid leaks into lungs.
• Interstitial Edema (Mild Stage) → Causes breathlessness.
• Alveolar Edema (Severe Stage) → Frothy Sputum, Hypoxia, Cyanosis.
• Severe Hypoxia → Weakens Heart Further → Worsening of Condition.
Mnemonic: "L.I.F.E." (Leakage of Fluid → Interstitial Stage → Full Edema → Emergency)
SYMPTOMS OF
CARDIAC ASTHMA
• Severe breathlessness (Worse at Night & Lying Flat).
• Restlessness, Anxiety, Sweating.
• Pink Frothy Sputum (Pulmonary Edema).
• Fast Heart Rate (Pulsus Alternans).
• Blood Pressure Raised (Except in Shock Cases).
Mnemonic: "B.R.E.A.T.H." (Breathless, Restless, Edema in Lungs, Alternans Pulse, Tachycardia, Hypertension)
DIAGNOSIS OF
CARDIAC ASTHMA
Chest X-ray:
- "Butterfly Appearance"
(Classic Sign of Pulmonary Edema).
- Kerley B Lines (Fluid in Lungs).
ECG:
- Shows
Heart Disease (MI, Arrhythmia, LVH).
ECHO (Echocardiography – Best Test!)
- Checks
Heart Function & Valve Disease.
Mnemonic: "X.E.E." (X-ray, ECG, Echo)
DIFFERENCE
BETWEEN CARDIAC ASTHMA & BRONCHIAL ASTHMA
|
Feature |
Cardiac Asthma |
Bronchial Asthma |
|
Cause |
Heart Failure |
Airway Narrowing |
|
Cough |
Frothy Pink Sputum |
Dry or Mucous Cough |
|
Wheezing |
Fine Crackles &
Rhonchi |
Loud Wheeze |
|
Position |
Worse on Lying Down |
No Effect of
Position |
|
Response to
Bronchodilators? |
NO |
YES |
Mnemonic: "C.B.A." (Cardiac = Breathless + Edema, Bronchial = Airway Tightness)
TREATMENT OF
CARDIAC ASTHMA (EMERGENCY MANAGEMENT)
1. IMMEDIATE TREATMENT
- Sit Patient Upright (Reduces Lung
Congestion).
- Give 100% Oxygen (6-10 L/min).
2. DRUGS FOR RELIEF (M.F.A.D.)
- Morphine
(3-8 mg IV) → Reduces Anxiety & Breathing Effort.
- Furosemide
(40-80 mg IV) → Removes Excess Fluid (Diuretic).
- Aminophylline
(250 mg IV) → Improves Heart Function.
- Digitalis
(If Atrial Fibrillation Present) → Controls Heart Rate.
3. SEVERE CASES (Need Vasodilators & Ventilation)
- Nitroglycerin (Sublingual) → Reduces
BP & Heart Load.
- Sodium Nitroprusside (IV) → For Severe
Hypertension.
- Mechanical Ventilation (If Oxygen Not
Helping).
Mnemonic: "S.O.S. M.F.A.D." (Sit Up, Oxygen, Support + Morphine, Furosemide, Aminophylline, Digitalis)
PREVENTION OF
CARDIAC ASTHMA
- Treat Underlying Heart Disease (Valves, Hypertension, MI).
- Avoid Excess Fluid Intake (Elderly & Heart Patients).
- Regular Medication (Diuretics, Beta-Blockers, ACE Inhibitors).
- Lifestyle Changes (Salt Restriction, Low-Fat Diet, Exercise).
Mnemonic: "T.A.R.L." (Treat Heart, Avoid Fluids, Regular Drugs, Lifestyle Change)
FINAL REVISION WITH MNEMONICS
- Definition = "C.A.R.D.I.A.C. A.S.T.H.M.A." (Cardiac Attack, Rapid Dyspnea, Immediate And Critical – Always Severe Trouble, Heart Malfunctioning Attack)
- Causes = "M.A.H.T." (Mitral, Aortic, Heart Attack, Tachyarrhythmia)
- Pathophysiology = "L.I.F.E." (Leakage of Fluid → Interstitial Stage → Full Edema → Emergency)
- Symptoms = "B.R.E.A.T.H." (Breathless, Restless, Edema in Lungs, Alternans Pulse, Tachycardia, Hypertension)
- Diagnosis = "X.E.E." (X-ray, ECG, Echo)
- Difference from Bronchial Asthma = "C.B.A." (Cardiac = Breathless + Edema, Bronchial = Airway Tightness)
- Treatment = "S.O.S. M.F.A.D." (Sit Up, Oxygen, Support + Morphine, Furosemide, Aminophylline, Digitalis)
- Prevention = "T.A.R.L." (Treat Heart, Avoid Fluids, Regular Drugs, Lifestyle Change)
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