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Having a chronic cough is annoying. But you shouldn’t ignore a chronic, persistent cough — in some cases, it’s your body’s way of telling you something is wrong with your heart.

Keep reading to learn the difference between a heart-related and respiratory cough and when to get tested for a cardiac cough.

What Is The Difference Between a Heart-Related and Respiratory Cough?

Oftentimes, a cough is a sign that something is irritating your throat or lungs. But many things can cause a cough that doesn’t go away, including:

• Allergies or a lingering cold with a postnasal drip.
• Asthma.
• Bronchitis, pneumonia, or an upper respiratory infection.
• Certain medications, like those for high blood pressure.
• Chronic obstructive pulmonary disease (COPD) or other lung diseases.
• Congestive heart failure.
• Heartburn.
• Smoking.

How to identify a respiratory cough

A respiratory cough happens when you have irritation or an infection in your lungs or airways. Respiratory coughs may also have these symptoms:

• Fever.
• Postnasal drip.
• Runny or stuffy nose.
• Sore throat.

Respiratory coughs from allergies or throat irritation are typically dry or nonproductive, meaning you don’t cough up mucus. But respiratory coughs from a lung infection or virus are often productive or “wet.”

Cardiac cough symptoms

A cardiac cough occurs when congestive heart failure causes fluid to build up in the air sacs in your lungs. A cardiac cough can sound wet, and you may cough up pink blood-tinged mucus. This kind of cough is often worse at night or when you’re lying down.

How Do Your Heart and Lungs Work Together?

Your heart and lungs work closely 24/7 to bring blood and oxygen to all parts of your body. Here’s how that happens:

• The chambers on the right side of your heart collect oxygen-poor blood from your body and pump it to your lungs.
• In the lungs, red blood cells pick up more oxygen.
• Oxygen-rich blood then enters the left chambers of your heart, and your heart pumps it throughout your body.

Your heart pumps about 2,000 gallons of blood each day. When your heart and lungs work properly, blood flows smoothly through this cycle. But if you have heart failure, meaning your heart is weak or stiff, it can’t pump blood effectively.

Several things can happen in your lungs when your heart struggles to pump blood:

• Blood starts to back up in the blood vessels in your lungs (pulmonary congestion).
• As blood backs up, the pressure in your lungs’ blood vessels increases. This causes fluid to leak out of the vessels and into the tiny air sacs in your lungs.
• When fluid fills your air sacs instead of air, your lungs become congested, triggering your cough reflex. Coughing is your body’s way of clearing your lungs.

Coughing and Heart Disease Symptoms

A persistent cough may signal a problem with your heart, especially if you notice these other congestive heart failure symptoms, too:

• Chest pain or pressure.
• Coughing or wheezing that won’t go away, even with medications.
• Extreme fatigue or weakness.
• Lack of appetite or nausea.
• Shortness of breath during normal activities or at rest.
• Sudden weight gain (more than 3 pounds) in a few days. This is from fluid building up in other parts of your body.
• Swollen feet, ankles, or legs.

It’s crucial to visit your health care provider if you have a cough that doesn’t go away on its own. They can run tests to check your heart’s health.

Doctors can treat heart failure if they catch it early enough. Many people with heart failure live long, healthy lives. But if left untreated, heart failure worsens and can lead to organ failure and life-threatening complications.

Diagnosing a Cardiac Cough

Your doctor will perform a thorough exam to find out if your cough is respiratory or cardiac. This may include:

• Blood tests — Your doctor may measure levels of brain natriuretic peptide (BNP), a protein that builds up in your blood with heart failure. Blood tests can also measure your kidney and liver function because heart failure can affect these organs.
• Imaging tests — Various imaging tests can help diagnose heart failure. An echocardiogram, a type of ultrasound of your heart, shows how well your heart pumps blood. You may also have a cardiac MRI, which creates images of your heart, or a cardiac catheterization, which examines your blood vessels.
• Physical exam — This includes listening to your heart and lungs. They’ll also check your blood pressure and heart rate, and examine your legs, feet, and abdomen for signs of swelling.
• Your medical history — Your doctor will want to know about any previous heart problems, high blood pressure, or diabetes. They’ll also ask for more details about your cough and if you have other heart-related symptoms.

What Are the Treatments for Congestive Heart Failure?

It’s scary to think that a persistent cough can lead to a diagnosis of heart failure. But it’s important to know that many people can manage heart failure with a combination of medication and lifestyle changes.

The good news is that your cough will improve when your heart failure is under control. You’ll also feel noticeably better and have more energy.

Medicines can:

• Help your heart beat stronger so it pumps more blood.
• Relax your blood vessels so it’s easier for your heart to pump blood.
• Remove extra sodium and fluid from your body.
• Slow your heart rate, so your heart doesn’t work as hard.

These lifestyle changes are a vital part of managing heart failure:

• Aim for a healthy weight — Carrying excess weight puts a strain on your heart.
• Eat a healthy diet that’s low in sodium — Too much sodium causes you to retain more fluid.
• Get regular exercise — Physical activity helps strengthen your heart and lungs and makes it easier to maintain a healthy weight.
• Manage any other health conditions, like diabetes or high blood pressure — Doing this reduces your risk of complications.

If medication and lifestyle changes aren’t enough, your doctor may recommend inserting a medical device to improve your heart function. This might include:

• An implantable cardioverter defibrillator (ICD) to correct an irregular heart rhythm.
• A mechanical heart pump if your heart is unable to pump blood.
• A pacemaker to help your heart beat normally.

The bottom line is that it’s crucial to listen to your body and call your doctor if you have unusual symptoms. Something as simple as an annoying cough can alert you to a much bigger problem.