Patients diagnosed with chronic lung disease should undergo cardiac evaluation, say doctors


While concerns about the long-term impact of COVID-19 on lungs are known, doctors now warn that people with lung disease should also get a cardiac evaluation.

“The lungs and the heart are located next to each other and both have to work in tandem. When one organ gets affected, there are disturbances in the other,” said C.N. Manjunath, Director of the State-run Sri Jayadeva Institute of Cardiovascular Sciences and Research.

“Breathing difficulty is not always related to the lungs. When the left heart fails, either due to heart muscle disease, valvular heart disease, delay in treating heart attack or long-standing uncontrolled high blood pressure, the patient will develop shortness of breath, fatigue and tiredness and edema in the feet,” he told The Hindu on Thursday. Every year, September 29 is observed as World Heart Day.

Cardiac asthma

“When there is an acute and sudden rise of pressure in the lungs due to left heart failure, the patient will not be able to breathe, which leads to a condition called ‘cardiac asthma’ or ‘pulmonary oedema.’ This is an acute condition caused by the accumulation of fluid in the lungs. Cardiac asthma is different from bronchial asthma which is allergic asthma unconnected to the heart. But cardiac asthma also shows symptoms similar to bronchial asthma such as cough, breathlessness and wheezing,” he explained.

A recent study published in the UK-based journal Circulation found that people diagnosed with COVID-19 were 21 times more likely to have a heart attack or stroke, increasing the risk of potentially life-threatening blood clots.

The study has brought renewed attention to the link between the two organs, said Atri Gangopadhyay, a Ranchi-based pulmonologist, who is the national spokesperson of Chest Council of India. “Patients diagnosed with any chronic lung diseases such as asthma, interstitial lung disease (ILD) and Chronic Obstructive Pulmonary Disease (COPD) must go for a cardiac evaluation,” he said.

“A huge part of our blood circulation occurs between lungs and heart. Yet the connection between the two is often overlooked when it comes to treatments,” he said.

“When someone discovers a lung problem, the focus is only on treating the lungs. Similarly, when someone develops a heart problem, all attention goes to the heart. The thought that a symptom can occur due to both heart and lungs rarely enters the mind,” said Dr Gangopadhyay.

Rajan Shetty, HoD and consultant Interventional Cardiology at Manipal Hospitals (Old Airport Road), said no system is isolated in the body. “They are all connected to one another and one system always affects the other,” he said. “One of the closest associations in our body is between the heart and the lungs. They are extensions of the same vascular system,” said Dr Shetty.



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