Does heart failure cause cough?

When the heart does not move blood efficiently, pressure can rise in the blood vessels of the lungs. Fluid may then move into lung tissue, making breathing harder and causing a dry or persistent cough. The cough may be worse when lying flat or at night and may occur with breathlessness, wheezing, tiredness, or swelling in the ankles. Cough can also come from infection, asthma, reflux, smoking, or medicines, so its presence alone does not establish heart failure. A clinician considers the pattern and other findings together.

Note when the cough occurs, whether it is dry or produces mucus, and whether lying down or exertion makes it worse. Take prescribed heart medicines as directed and do not stop them without medical advice; some medicines can also cause cough and may need review. Arrange a clinical assessment if the cough is new, persistent, or paired with swelling, reduced exercise tolerance, or breathlessness. Bring a list of medicines and describe any recent weight or symptom changes without trying to change treatment yourself.

Seek emergency help for severe or rapidly worsening breathlessness, blue or grey lips, confusion, fainting, chest pain, or coughing up pink or bloody foam. Sit upright while waiting for help and avoid lying flat if that makes breathing harder. A clinician may check oxygen levels, the heart and lungs, and tests that look for fluid or another cause.

Ask whether your cough pattern fits fluid congestion, infection, reflux, asthma, or a medicine effect. Ask which symptoms suggest worsening heart failure, how to monitor breathing and swelling, and when your medicines or follow-up should be reviewed.