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Patients & Consumers Online Tools Find an Allergist / Immunologist Pollen Counts Diseases 101 Drug Guide Featured Resources » AAAAI Tips Brochures Topic of the Month New Research Information Request Form Donate Now En Español Just for Kids Seniors Contact Us Search by Condition (A-Z) Request a Speaker Smoke Free Homes Referral Guidelines Other Resources En Español Just for Kids Seniors		Seniors and Asthma Distinguishing Between Asthma and Heart Disease By Clifford W. Bassett, MD, FAAAAI June 2007 Asthma treatment and intervention for the mature adult Asthma and other related respiratory diseases are common in older adults because there is a decrease in lung capacity in people over the age of 40. The senior age group represents the fastest growing segment in our country and therefore asthma is a disease of significant importance. Patients with longstanding or chronic persistent asthma (which is not being treated) can have problems with their lung function. These problems may not be reversible with medications, illustrating the importance of timely and proper use of the best available medications for this condition and continued care by a physician. Varying patterns of asthma and heart disease In general, the history of lung symptoms in asthma patients may include one or more of the following: Chest tightness or aching Cough Wheezing Shortness of breath The pattern of these symptoms will change with depending on the severity and the duration of the symptoms. Trouble breathing [especially while lying flat in bed] due to asthma which may be associated with awakening at night from sleep, and swelling of the ankles/feet may easily be confused with symptoms of congestive heart failure and coronary heart disease. Lung capacity and functioning can be decreased as a result of heart failure. Cardiovascular disease is commonly seen with a history of chest tightness or aching and associated shortness of breath. The term "cardiac asthma" has been used to describe these similar symptoms that are caused by true heart disease, which can often be diagnosed by the appropriate diagnostic cardiology tests (cardiac stress testing, echocardiograms, and angiography). If these symptoms are present, you should contact your physician to be fully evaluated for pulmonary and cardiac diseases for the best possible evaluation of the problem and to receive for proper treatment for your diagnosis. Impact of medications and other conditions Older persons may be using multiple medications for other conditions (i.e. diabetes, high blood pressure, etc) that may have an adverse impact on lung function and affect patients with asthma and respiratory disease. Angiotensin converting enzyme inhibitors may be associated with cough as well as beta blocker medications, which may worsen asthma in some older patients. Patients with aches and pains, especially of the chest wall, ribs and joints, who suffer from arthritis, can also have trouble distinguishing these symptoms from heart or lung problems. Probably one of the most important non-cardiac causes of chest symptoms other than asthma and lung disease is gastrointestinal reflux disease (GERD). Symptoms of GERD include heartburn and hoarseness and may be may also be present and worsen asthma in previously well-controlled asthma. Checklist to help distinguish the cause(s) of chest symptoms Sudden worsening of previously well-controlled breathing after the addition of "new medications" Discuss with your health care provider possible major risk factors for cardiovascular disease See your doctor for regularly-scheduled visits to re-evaluate your current needs and assess other illnesses which may have an adverse impact on your health Notice difficult breathing or worsening of nighttime cough Identify trouble breathing after previously tolerated exercise and other activities Difficulty with chest discomfort and heartburn after eating large meals Clifford W. Bassett, MD, is a Fellow of the AAAAI and Vice Chair of the AAAAI Public Education Committee, and is an Assistant Clinical Professor of Medicine at The Long Island College Hospital, Brooklyn, NY and a Clinical Instructor at NYU School of Medicine. <back>
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