Atrial fibrillation (AFib) is a common type of irregular heartbeat, or arrhythmia, where the heart’s upper chambers beat chaotically and irregularly. This can lead to various heart-related complications, including an increased risk of blood clots, stroke, and heart failure. While coughing is a common symptom, it is important to understand how AFib might be connected to it. Many with this heart condition inquire whether AFib itself can cause coughing.
How AFib Can Lead to Coughing
Atrial fibrillation can indirectly lead to coughing through its impact on heart function, particularly by contributing to or worsening heart failure. When AFib causes the heart to beat rapidly or inefficiently, it struggles to pump enough blood. This reduced pumping effectiveness can cause blood to back up in the veins returning from the lungs, leading to fluid accumulation within the lung tissue.
This fluid buildup, known as pulmonary edema, irritates the airways and triggers a cough reflex. The cough associated with heart failure is often dry, persistent, or produces white or pink, frothy mucus. This mechanism is a significant way AFib can contribute to a cough.
Another way AFib might contribute to a cough involves the physical enlargement of the heart’s upper left chamber, the left atrium. An enlarged left atrium can press on nearby airways, particularly the left main bronchus, leading to irritation and a chronic cough. This direct mechanical compression is a distinct mechanism from fluid overload.
Medication-Related Cough in AFib Patients
Patients with AFib often take various medications to manage their heart condition or co-existing health issues, and some of these drugs can cause coughing as a side effect. Angiotensin-converting enzyme (ACE) inhibitors are frequently prescribed for high blood pressure or heart failure, conditions often present alongside AFib. These medications are a well-known cause of a persistent, dry, and tickly cough.
Beta-blockers are another class of drugs commonly used to control heart rate in AFib patients. While generally beneficial, some beta-blockers can potentially worsen respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD), which might lead to an increased cough in susceptible individuals.
Amiodarone, an antiarrhythmic medication used to maintain a regular heart rhythm in some AFib patients, can also cause lung toxicity in rare cases. This toxicity can manifest as a persistent dry cough, along with shortness of breath and chest pain. Amiodarone-induced pulmonary toxicity is a serious side effect that requires prompt medical attention.
Other Common Causes of Coughing
Beyond AFib and its related medications, many other common conditions can cause a cough, and these can affect anyone, including those with AFib. Respiratory infections are a frequent cause, ranging from mild illnesses like the common cold or flu to more severe conditions such as bronchitis or pneumonia.
Allergies and asthma are also prevalent causes of chronic coughing. Allergic reactions can trigger post-nasal drip, where mucus runs down the back of the throat, irritating the airways and leading to a cough. Similarly, asthma exacerbations can present with coughing, sometimes even without significant wheezing.
Gastroesophageal reflux disease (GERD), a condition where stomach acid flows back into the esophagus, can irritate the throat and cause a chronic cough. This type of cough may worsen when lying down or after eating. Various environmental irritants, such as smoke or dust, can also provoke a cough in anyone exposed to them.
When to Seek Medical Attention
It is important to seek medical attention if a cough is persistent, new, or accompanied by other concerning symptoms, especially for individuals with AFib. If the cough is associated with worsening shortness of breath, particularly if it occurs with activity or when lying down, it could indicate a change in heart function. A cough that produces pink, frothy, or blood-tinged sputum is a significant warning sign that warrants immediate evaluation.
Other symptoms that should prompt a medical consultation include new or worsening chest pain, swelling in the legs, ankles, or abdomen, or unexplained dizziness or fainting spells. Any new or significantly different irregular heartbeats should also be reported. These symptoms could signal a serious underlying issue, such as worsening heart failure or other complications. Only a healthcare professional can accurately determine the cause of a cough and recommend the appropriate course of action based on an individual’s specific health profile.