Pneumonia vs congestive heart failure
Coughing is one of the commonest symptoms of any condition affecting the respiratory system, right from the nose to the lungs. Occasionally, it may be a symptom of a medical condition of the cardio-vascular system too. Few signs and accompanying symptoms will give the diagnosis to a qualified doctor. Pneumonia and a congestive heart failure are two very different medical conditions that might present just with a cough. Here’s how the two differ.
Pneumonia is an infection of the lung tissue. It affects the air sacs called alveoli that form the lung tissue. It is most commonly caused by bacteria and viruses. Rarely is it caused by a fungus or due to an autoimmune disorder. Congestive heart failure is a serious medical condition where there is failure of the pumping action of the heart, leading to accumulation of blood within the heart and deficiency of it everywhere else in the body. Both of these have cough as a leading symptom and often the only one.
The cause of pneumonia commonly is an infectious agent like a virus, bacteria or a fungus. Causes of congestive heart failure are plenty. The leading cause of heart failures is ischaemic heart disease (blockage of the arteries of the heart) followed by smoking, diabetes, obesity, hypertension and congenital heart diseases.
Symptoms of pneumonia are high fever with shaking chills, productive cough, nausea, vomiting, loss of appetite, shortness of breath. There might be coughing up of blood along with phlegm, chest pain and visible gasping/panting. Congestive heart failure is of two types depending on which part of the heart fails in the pumping action, left or right. Both have varying symptoms, cough being the common one. Left sided congestive heart failure will manifest as shortness of breath, accumulation of fluid in the lungs leading to increased breathing rate per minute, cough and cyanosis (blueness of lips due to inadequate oxygen supply). Right sided heart failure will have symptoms like swelling of the abdomen and both legs, breathlessness on lying down on the back which is relieved on sitting, cough and prominent jugular veins in the neck.
Diagnosis of both conditions requires an electrocardiogram, chest x-ray and a haemogram. A suspected pneumonia would also require a throat swab and sputum culture with antibiotic sensitivity test to confirm the organism and initiate treatment. A heart failure would demand a 2D- echocardiogram of the heart along with tests for serum levels of electrolytes, creatinine, cardiac markers like Troponin I, liver function tests, thyroid profile and C-reactive protein.
Treatment for pneumonia is by parenteral antibiotics after an antibiotic sensitivity test of the sputum. Hospitalisation is necessary and intravenous saline might also be administered. Congestive heart failure needs immediate resuscitation and treatment. The patient needs to be started on diuretics to force out the excess accumulated fluid from the lungs and other tissues along with medications to relieve chest pain and improve pumping of the heart i.e. beta blockers, ACE inhibitors, digoxin, clopidogrel etc. As heart failure is only a symptom, the underlying cause needs to be treated immediately, like an impending heart attack.
Prognosis for pneumonia is fairly good due to availability of advanced antimicrobials. Early treatment of heart failure is necessary to save the life of the patient.
Take Home Pointers:
Pneumonia is a life-threatening infection of the lung tissue caused by bacteria, viruses or fungi. Congestive heart failure is a serious disorder where there is failure of the pumping action of the heart leading to a deficit of blood supply to all organs of the body.
Pneumonia is completely curable with the right antibiotics and a heart failure can be managed with medications.
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