Cough during a heart attack and after a myocardial infarction: symptoms and treatment

09.09.2017
A heart attack is the complete or partial death of a vital organ, which occurs as a result of a sharp lack of blood supply. Most often, in medical practice, myocardial infarction occurs.

Myocardial infarction is the most common type of lack of blood supply, during which parts of the heart muscle are affected and die. This pathological process occurs due to blockage of arterial vessels with plaques and blood clots.

In case of myocardial infarction, the following symptoms occur:

sudden onset of intense pain in the chest area, which can be of a different nature (pressing, stabbing, cutting, etc.);
the appearance of a feeling of panic and fear, which periodically subsides or intensifies;
when using nitroglycerin, the pain does not stop;
the skin turns pale, the person produces cold sweat;
the victim may involuntarily lose consciousness.

If the above symptoms occur, the patient should immediately contact the nearest medical facility or call an ambulance in order to promptly eliminate the emerging pathological process.

In case of untimely or poor-quality treatment, the consequence of a heart attack may be the formation of stagnation in the pulmonary blood supply. During the period of such a deviation, blood plasma begins to leave the lungs and swelling forms inside them, which affects the bronchial nerves and provokes the development of an intense and unpleasant cough.

Self-help for cough at the first signs of myocardial infarction? Don't risk your life!

Sunday, October 16, 2020 13:57 + to quote book
Self-help for cough at the first signs of myocardial infarction? Don't risk your life!

There is a story floating around the Internet that at the first signs of a myocardial infarction, you need to clear your throat well and this will save the person. It would not be so scary if we were talking about a not so serious disease that requires competent emergency care. In case of myocardial infarction, experiments are unacceptable!

This story is spreading “at the speed of light” and it is no longer possible to remember who gave birth to this dangerous myth. One thing is clear, he is far from medicine, and it is difficult to overestimate the harm from such recommendations.

Myocardial infarction is a serious heart disease that leads to death in every third case. According to statistics, 30% of patients die within the first hour, 40% die within 4 hours, and the rest do not survive until the next day.

The high mortality rate from heart attack is not the result of inadequate medical care; half of the “heart attack patients” die without seeing a doctor. Patients underestimate the threat, prefer to treat themselves, and use dubious recommendations from the Internet. Time passes, the disease progresses, changes in the myocardium become irreversible and fatal. What is a heart attack?

Myocardial infarction is a severe manifestation of coronary artery disease, characterized by disruption of the heart as a result of necrosis of an area of the myocardium when the flow of arterial blood supplying it with nutrients and oxygen is stopped.

The coronary arteries are responsible for supplying the heart with nutrition. If the arteries narrow under the influence of stress hormones or as a result of cholesterol deposition and the formation of atherosclerotic plaques, the myocardial muscles begin to starve; at the slightest emotional or physical stress, this is a disaster. Sometimes the cause of a heart attack is a blood clot that enters a coronary artery, clogs it, and sometimes the vessel ruptures due to high blood pressure. The result is the same - the muscle dies, the heart ceases to perform its functions. = What if it’s not a heart attack?

During a classic attack of a heart attack, severe compressive pain is felt behind the sternum, radiating to the neck, left arm and under the shoulder blade. Acute pain stimulates the release of stress hormones, causing tachycardia, spasm of coronary vessels, and worsening myocardial ischemia. The patient begins to panic and cold sweat appears on his forehead. There is a fear of death, a feeling of lack of air, palpitations, interruptions in the functioning of the heart. Nitroglycerin does not help, weakness and loss of consciousness occurs due to heart rhythm disturbances.

A heart attack can develop at lightning speed, but more often it is preceded by attacks of angina and heart pain, lasting from 15 minutes to an hour. This is the time when competent emergency care is vital; in case of myocardial infarction, delay in death is similar.

Coughing does not help with a heart attack

“Woeful doctors” advise at the first signs of myocardial infarction to begin “self-resuscitation.”

“Don’t panic, start coughing quickly and very hard, inhaling deeply each time. The cough should be deep and long, expectorating, from the very depths of the chest. Inhalation and coughing should be repeated every two seconds without a break until help arrives or the heart feels like it’s beating normally.

Taking deep breaths brings oxygen to the lungs, while coughing compresses the heart and helps blood circulate. The squeezing pressure on the heart helps restore normal rhythm.”

Any cardiologist is horrified by such illiteracy.

Firstly, not a single heart attack patient is able to assess their condition and make an accurate diagnosis.

Secondly, during myocardial infarction, the heart is starving and any physical activity, including a tense cough, will rob the already “deprived” heart muscle, and this will lead to an increase in the area of necrosis. What do we have to do?

Emergency care for a myocardial infarction includes calling an ambulance; you won’t be able to cope with the problem on your own, cough or don’t cough.

If heart pain occurs when you are alone, you should:

Dial the emergency medical service number and report the incident.

Provide access to the apartment. Ask strangers for help, call your neighbors. If a suspicion of a heart attack arises while driving, stop the car, turn on the hazard lights, open the windows, and attract the attention of passing drivers by shouting or honking.

Don't panic, don't fuss or rush around. Unfasten the belt, loosen the collar and lie down with your legs above the level of your heart - this will provide additional blood flow to the myocardium.

Take a nitroglycerin tablet under the tongue, and if there is no effect after 5 minutes, take another or even a third. Myocardial infarction rarely occurs “out of the blue”; it occurs more often in patients with angina with experience, which means that nitroglycerin should be at hand.

As for recommendations regarding cough during a heart attack. The authors refer to an article published in the journal “JOURNAL OF GENERAL HOSPITAL ROCHESTER” No. 240. But bad luck, such a journal exists, but there is no article there. The publisher has already published more than one refutation. The benefits of cough therapy for heart attacks are not confirmed by either the American Heart Association or the Resuscitation Council in the UK.

How to treat cough after myocardial infarction

Coughing does not always indicate a cold or a viral infection affecting the throat or bronchi. Often this symptom is a consequence of other diseases. Thus, a cough after a heart attack (cardiac cough) indicates that functional disturbances in the heart rhythm have occurred. Such manifestations should not be ignored to avoid complications.

How it manifests itself

Cough during myocardial infarction and coughing after it have specific symptoms that make it possible to distinguish them from the manifestations of colds and bronchial diseases.

There are the following signs that accompany coughing after a heart attack:

tingling or burning pain in the heart;
increased heart rate, increased pressure in the pulmonary artery;
enlarged neck veins;
blueness of lips, earlobes, fingertips;
rapid intermittent breathing;
gradual intensification of attacks, they are suffocating and long;
dry cough (without phlegm or other mucus), possibly containing blood;
lightheadedness or loss of consciousness;
increased attacks in a supine position as a result of increased load on the left ventricle;
attacks are accompanied by weakness, dizziness, increased sweating;
swelling of the lower extremities in the evenings;
increased attacks in the evening and at night.

Why does the cough start?

Cough during a heart attack is a sign of overstrain in the pulmonary circulation. Against this background, shortness of breath develops and pulmonary edema begins. As a result, coughing occurs, and in more severe cases and in the absence of treatment, hemoptysis. In this case, you must immediately consult a doctor.

The following are the main causes of cough after a heart attack:

incorrect recovery;
colds developing against a background of weakened immunity;
development of pneumonia;
use of ACE inhibitors during treatment;
the appearance of cardiosclerosis;
increased pressure, which increases the load on the heart, thins its walls and impairs blood pumping.

What to do

To eliminate coughing after a heart attack, therapy for the underlying pathology is first prescribed. It includes:

Quitting bad habits. Smoking and drinking alcohol put a lot of strain on the heart.
Proper nutrition. It is necessary to minimize, or better yet, exclude from the diet salt, smoked, fried, fatty foods and dishes, as well as drinks with a high caffeine content.
Organizing a proper daily routine. Do not overwork or subject your body to heavy physical activity. You need to sleep at least 8 hours a day.
Walks. Since when you cough after a heart attack, the tissues suffer from a lack of oxygen, walking and going out into nature will help replenish it.
Prevention of stress. It is necessary to avoid conflict and stressful situations, to receive more positive emotions.
Physical education classes. Physical activity normalizes blood circulation and prevents the appearance of congestion and blood clots. The intensity of the load is selected for each person individually depending on the severity of the pathology.

In addition, the following medications are prescribed to relieve coughing attacks:

antitussive drugs with anesthetics are prescribed for severe debilitating cough;
diuretics (Indapamide, Trifas);
vasodilators (Atacand, Losartan);
Beta blockers reduce the intensity of attacks.

Herbal medicine, physiotherapy, and oxygen therapy can be used as an addition to drug treatment.

It is necessary to treat coughing after a heart attack only under the supervision of a doctor. Self-medication can lead to negative consequences.

Methods of therapy

If at least 1 of the above symptoms is often observed, you should not look for ways to combat cough on your own. Many prescriptions are aimed at suppressing cough syndrome, and in case of post-infarction heart failure and the cough caused by it, this will only lead to a worsening of the condition. In this case, more and more fluid will accumulate in the lungs.

If sputum with blood appears, it is best to immediately consult a doctor (call an ambulance).

Treatment with drugs

A non-operative method of treatment (therapy) is treatment with medications that must be prescribed by a doctor. You cannot take medications on your own after a heart attack. To relieve symptoms of cardiac cough, the following can be used:

diuretics (Veroshpiron, Trifas, etc.) - will help remove excess fluid from the lung tissue and reduce its swelling;
vasodilation drugs (Candecor, Atacand, etc.) - promote vasodilation, increase blood flow and reduce congestion in the lungs;
If the patient's condition is serious, coughing is accompanied by fainting or dizziness, cough medications with an anesthetic effect may be required.

Treatment without the use of drugs

In mild cases, when the use of drugs is not required, breathing exercises help relieve symptoms. When it is carried out, the lungs are better ventilated, and congestion becomes less.

Among the simplest exercises are the following:

Inflate balloons. In this case, you inhale through your nose and exhale the air with effort.
Diaphragmatic breathing. Inhalation is performed using the abdominal muscles. When exhaling, the stomach should be pulled in.

It is advisable to consult a doctor before starting exercises.

General physical activity relieves stagnation no less effectively. But after a heart attack it must be dosed. In some cases, the doctor recommends exercise therapy and walking at a slow pace. When doing exercises or while walking, you need to monitor your own condition: physical education should not cause exacerbations of cough syndrome.

In addition to special methods that help treat cough after myocardial infarction, diet has an impact on the patient’s condition. You will have to exclude foods that increase blood pressure (strong tea, coffee, alcohol, etc.) from your diet. It is undesirable to consume foods containing large amounts of salt (canned meat, fish, smoked meats, pickles, etc.). Excess salt promotes fluid retention in the intercellular space and increases swelling of the lung tissue.

Surgery

A cough accompanied by chest pain (behind the sternum or under the ribs), fainting, and hemoptysis may be a sign of pulmonary embolism. It is also characterized by an increase in heart rate (heart rate) up to 100 beats/min and a drop in blood pressure (blood pressure). Chest pain worsens with deep breaths.

Due to increased pressure in the pulmonary artery, the patient may experience acute failure of the right ventricle of the heart. The development of the syndrome will lead to the formation of cardiogenic shock. If you have a cough with pain, you should call an ambulance.

Cough after myocardial infarction and stroke

Shortness of breath and cough after an acute heart attack are most often a consequence of heart failure. The condition occurs due to disruption of the heart and the formation of a rough scar in its tissues during myocardial infarction. A decrease in cardiac function provokes blood stagnation in the systemic and pulmonary circulation. The pulmonary reaction is felt more strongly than the lack of blood supply to other organs.

In case of a stroke, a cough can be caused by a disruption of the respiratory center. If the hemorrhage is extensive or located in the corresponding area, then irritation of the bronchial mucosa may be neurogenic in nature.

Causes of cough

Post-infarction cough occurs for a single reason - the inability of the heart to pump the same volume of blood. When the function of the left ventricle and atrium is impaired, first of all, the pulmonary circulation suffers.

Respiratory depression develops according to the following scheme:

A decrease in myocardial contractility due to the existing scar prevents the normal outflow of blood from the pulmonary artery to the aorta. In the lungs, blood pressure increases and blood microcirculation decreases.
The pulmonary veins become filled with oxygen-deprived blood. As a result, the pressure in these vessels also increases, and the organ tissues suffer from lack of breathing.
Hypoxia causes microtrauma to the walls of the alveoli and blood capillaries, leading to the formation of collagen fibers and the development of pneumosclerosis. Gradually, the capillaries become completely overgrown.
The obliteration process further reduces blood flow and increases blood pressure. It leads to expansion of the left ventricle, the right half of the heart and aggravates congestion. At the same time, the permeability of the vascular wall increases and blood plasma enters the lung tissue, leading to swelling, irritation of the bronchi and the appearance of cough.

Coughing after a stroke may indicate pulmonary embolism (PE) or may be caused by saliva and food particles entering the lungs. This can lead to aspiration pneumonia and also requires appropriate treatment.