Congestive heart failure may present with wheezing or other respiratory symptoms that can mimic asthma. Edema of the bronchial mucosa can result in airway obstruction. This presentation is referred to as "cardiac asthma."
The patient is usually an older adult without a history of heart failure.
If the patient has a history of asthma, then the patient may present with worsening of symptoms and poor response to standard therapy.
If the patient does not have a history of asthma, then the patient may develop wheezing, cough and shortness of breath.
Findings supporting the diagnosis of heart failure:
(1) pulmonary edema on chest X-ray
(2) elevated brain natriuretic peptide (BNP or pro-BNP)
If the heart failure is the cause of symptoms then they should improve on specific therapy for the heart failure.
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