Manh, a 35-year smoker with a family history of lung cancer, was initially diagnosed with pneumonia. However, his condition did not improve with medication, leading him to seek further examination at Tam Anh District 7 Polyclinic. A cardiac ultrasound revealed an ejection fraction (EF) of 27%, significantly lower than the normal range of 50-70%, and a 95% narrowing of the circumflex artery.

Doctor Luong Sy Bac, a cardiology specialist, explained that Manh's severely reduced EF was due to critical narrowing in a major coronary artery. This caused myocardial ischemia and low EF heart failure, a condition where the heart's pumping ability is weakened, failing to adequately supply oxygen and nutrients to the body's tissues and organs. Common symptoms include: fatigue, shortness of breath, leg swelling, and reduced exercise tolerance; some patients also experience a persistent cough.

Doctor Bac noted that a cough and shortness of breath are also linked to respiratory diseases, which can easily lead to misdiagnosis and delay appropriate treatment for heart failure. "Manh may have previously suffered a myocardial infarction, and now faces risks of recurrence and arrhythmia", Doctor Bac diagnosed.

Doctors performed an intervention, placing a stent in the circumflex artery, combined with optimal medical therapy to improve his heart failure. In addition to adhering to treatment and scheduled follow-ups, Manh was advised to quit smoking, control his diet (increasing green vegetables, limiting fats and organ meats, reducing salt and sugar), and engage in regular exercise appropriate for his physical condition.

Doctor Bac performs a heart ultrasound for Manh during a follow-up visit. *Photo: Tam Anh District 7 Polyclinic*

Persistent cough and shortness of breath are common indicators of various heart and lung conditions, including heart failure, chronic obstructive pulmonary disease (copd), asthma, and pneumonia. However, each condition presents with distinct patterns of shortness of breath and accompanying symptoms.

Characteristic symptoms of heart failure include: increased shortness of breath when lying flat, paroxysmal nocturnal dyspnea (waking up gasping for air), or breathlessness during physical exertion. Patients may experience fatigue, weakness, and leg swelling that worsens by the end of the day due to fluid retention. A cough caused by heart failure is often dry, intensifying at night or when lying down. In some instances, it may produce thin, blood-tinged sputum due to pulmonary edema. Other symptoms include: poor appetite, weight loss, dizziness, fainting, a rapid heart rate, palpitations, and chest pain.

Causes of heart failure encompass: coronary artery disease, valvular heart disease, congenital heart defects, cardiomyopathy, arrhythmias, thyroid disease, diabetes, and hypertension. Several risk factors can exacerbate heart failure, such as: late diagnosis, non-compliance with treatment, a high-salt diet, infections, and heavy alcohol consumption.

Doctor Bac recommends regular cardiovascular check-ups for older adults with heart disease risk factors, including: smoking, underlying conditions like hypertension, dyslipidemia, diabetes, and obesity. Patients experiencing persistent cough and shortness of breath should consult both respiratory and cardiovascular specialists for a comprehensive health evaluation.

Ngoc Chau

*Patient's name has been changed*