Differentiating between shortness of breath due to heart failure and asthma.

Shortness of breath is a common symptom in patients with heart failure and asthma. How can you differentiate between the two?

Symptoms of shortness of breath due to heart failure.

Patients with impaired heart function may experience shortness of breath during various activities, both day and night, with the following characteristics:

Difficulty breathing when lying down.

Heart failure is one of the causes of shortness of breath when lying down. Patients often feel breathless when lying down to watch TV, read, or during a medical examination. The shortness of breath usually subsides when they stand or sit up.

Shortness of breath when lying down occurs because when lying on your back, blood from the legs pools in the pulmonary blood vessels, causing fluid to accumulate around the lungs and spill into the alveoli, making gas exchange difficult. Additionally, shortness of breath when lying down can also be a sign of other conditions such as pulmonary hypertension, chronic obstructive pulmonary disease, pulmonary edema, severe pneumonia, etc.

Difficulty breathing at night.

Nocturnal dyspnea occurs during sleep, causing shortness of breath and sudden awakening after 1-2 hours of sleep. Nocturnal dyspnea may be accompanied by coughing, and is related to blood pooling in the pulmonary blood vessels in heart failure. Patients feel more comfortable breathing after 10-15 minutes of sitting up.

Shortness of breath during exertion

Shortness of breath on exertion is the most common symptom of heart failure. In the early stages, patients may experience shortness of breath and chest pain during moderate exertion: walking, climbing stairs, exercising, or strenuous activity. This usually improves with rest. However, in advanced stages, shortness of breath on exertion often does not improve even with rest.

Symptoms of shortness of breath due to asthma

Asthma-related breathing difficulties are often associated with specific triggers such as cold weather, fine dust, excessive exertion, or even strong emotions. An asthma attack occurs when the airways constrict, narrowing the bronchi and causing shortness of breath.

How to differentiate between shortness of breath due to heart failure and shortness of breath due to asthma.

Typical symptoms of shortness of breath due to heart failure include the onset or worsening of shortness of breath when lying down, especially when lying with the head low. Patients may need to elevate their legs with 2–3 pillows to breathe more easily, and in severe cases, may even need to sleep in a semi-sitting position. This condition usually improves when the head and upper body are raised.

An important distinguishing feature is that shortness of breath due to asthma usually responds to bronchodilators. When the medication is used correctly, symptoms can improve significantly. In contrast, shortness of breath due to heart failure does not improve with bronchodilators because the cause lies not in bronchospasm but in circulatory congestion.

How can I improve my shortness of breath?

Shortness of breath due to heart failure

With heart failure, improving shortness of breath should focus on managing the underlying condition. Patients should adhere to their doctor's treatment plan, taking medication regularly and at the correct dosage. When experiencing shortness of breath, they should lie with their head elevated to reduce blood pooling in the lungs.

If shortness of breath progressively worsens, occurs even at rest, is accompanied by leg swelling, extreme fatigue, or requires the patient to sit up to breathe, they should seek medical attention promptly for treatment adjustment.

Shortness of breath is an important warning sign from the body. Correctly identifying the cause not only helps reduce symptoms effectively but also avoids incorrect treatment and missed opportunities for necessary intervention.

Difficulty breathing due to asthma

Immediately move the patient away from the source of the asthma attack to a well-ventilated area, away from crowded surroundings.

Help the patient sit up or have them lie down with their upper body elevated on the bed to make breathing easier.

Use a fast-acting asthma inhaler such as Ventolin or Berodual for the patient. For mild asthma, two puffs per dose should be sufficient to effectively stop the attack. If the attack does not subside after 20 minutes, administer two more puffs. If symptoms still persist, administer two more puffs before taking the patient to the emergency room.

If it's a severe asthma attack (symptoms include difficulty breathing even while sitting, shortness of breath, and inability to finish a sentence), use an inhaler to stop the attack and immediately take the patient to the nearest medical facility for emergency treatment.

If the asthma attack is life-threatening (manifested by cyanosis, confusion, sweating, inability to speak, etc.), call an ambulance immediately. While waiting for the ambulance, administer two puffs of the rescue inhaler. If possible, someone nearby should administer a subcutaneous beta-2 bronchodilator to the patient.

Pham Huong (according to Health & Life newspaper)

Source: https://yte.nghean.gov.vn/tin-chuyen-nganh/phan-biet-kho-tho-do-suy-tim-va-hen-suyen-1007705