Differences between bronchial asthma and cardiac asthma

In order to distinguish between cardiac asthma and bronchial asthma, a few tests are necessary. Basically, however, it can be said that bronchial asthma is a disease that usually occurs in early childhood and remains in varying degrees until old age. Cardiac asthma, on the other hand, is a disease that only occurs in the course of a serious underlying heart disease and is therefore more likely to be a disease of old age.

For a reliable differentiation, however, it requires an examination of the lungs and heart. The lung is examined by means of a pulmonary function test and is also subjected to a provocation test, which is intended to trigger a mild asthma attack. If this test is negative, bronchial asthma is almost always ruled out.

The heart, on the other hand, can be examined in detail with a series of tests for cardiac insufficiency leading to cardiac asthma. The method of choice here includes an ECG and ultrasound examination of the heart and heart valves. If changes are found, a cardiac insufficiency can be reliably detected.

Therapy for cardiac asthma

Since cardiac asthma is caused by heart failure, the therapy is the same as for heart failure. Raising the upper body at night can help to alleviate the night-time symptoms. A severe cardiac asthma attack is often based on decompensation of the heart disease, which is why an ambulance should be called as soon as possible.

This can be caused, for example, by the occurrence of new heart rhythm disturbances, acute pulmonary oedema or a heart attack. Until the arrival of the rescue services, the patient should be positioned with the upper part of the body in an elevated position and oxygen should be administered if available. A quick preparation of old doctor’s letters, findings and a current list of medication is very helpful for the emergency doctor to get a quick picture of the situation and save important time. Unlike bronchial asthma, the cause of cardiac asthma is not primarily in the lungs, which is why most common asthma medications only bring about a slight improvement in the symptoms. All drugs that support the heart and blood circulation, including

ACE inhibitors
Beta blocker
Aldosterone antagonists
Diuretics

Diagnosis of cardiac asthma

Lung congestion as a result of heart failure can be confirmed by detecting the so-called heart defect cells (scavenger cells in the lung that absorb red blood cells that have leaked as a result of congestion) in the Berlin blue stain. These cells are found in the patient’s sputum (coughing up secretion). Otherwise, the clinical picture of heart failure is decisive, see also Heart failure.