COPD and Heart Failure
Telling the Difference Between COPD and Heart Failure continued...
Doctors cannot consistently or accurately tell the two apart, either. When someone with both heart failure and COPD seeks help for breathing difficulty, a doctor may use various tests to gauge the activity of each condition, including:
- Physical examination: Listening to the lungs and heart, and looking at the veins in the neck, can give a doctor reason to suspect COPD or heart failure.
- Chest X-ray: Heart failure may cause fluid in the lungs to be visible on a chest X-ray; in COPD, the lungs are usually clear.
- Brain natriuretic peptide (BNP): This hormone is usually elevated on blood tests in people with heart failure, whether or not COPD is also present.
- Pulmonary function tests: Breathing tests can be used to diagnose people with COPD.
- Echocardiogram: An ultrasound test of the heart that can evaluate the heart chambers, valves, and pumping strength.
- Cardiac enzymes: This blood test can help diagnose a heart attack or excessive heart strain.
Some people have severe COPD and only mild heart failure; others have severe heart failure and only mild COPD. In these cases, the more severe condition is more likely to be the cause of symptoms.
In people with COPD and heart failure of about equal severity, doctors must make their best guess as to which condition is causing symptoms.
Making things even more complicated, COPD and heart failure can at times act up simultaneously. For example, if someone has worsening heart failure symptoms that cause rapid breathing, this can cause COPD symptoms to worsen, as well.
Treating COPD and Heart Failure
If doctors cannot reliably distinguish between shortness of breath from CHF and COPD, both conditions are often treated together.
Treatments for COPD focus on the lungs and the airways, the branching network of tubes inside the lungs. The main treatments for COPD are bronchodilators, inhaled medicines that help open the airways.
Heart failure treatments reduce the workload on the heart and help prevent unhealthy growth of heart muscle. Categories of treatments for heart failure include:
- Diuretics, which increase urination and reduce the heart strain from fluid overload
- Beta-blockers, which prevent excessive stress on the heart and reduce blood pressure; however, these would not be used if a person is having an acute episode of heart failure.
- Angiotensin-converting enzyme inhibitors, which lower blood pressure and reduce heart stress
- Other blood pressure medicines, which prevent long-term damage to the heart
People with severe shortness of breath from COPD and heart failure may receive other treatments, as well:
- Corticosteroids, such as prednisone or Solu-Medrol, which can improve breathing in COPD
- Antibiotics, for any bacterial infection that may be contributing
- Supplemental oxygen
- Non-invasive positive pressure ventilation, a form of machine-assisted breathing
- Mechanical ventilation, or temporary life support through a breathing tube
- Intravenous medicines to help reduce heart strain
People with both COPD and heart failure are often treated by a team of doctors, including a primary care physician, a cardiologist, and a pulmonologist.