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Malignant asthma presenting as right heart failure
Author(s) -
Freiberg David B.,
Colebatch H. John H.
Publication year - 1987
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1987.tb133269.x
Subject(s) - medicine , wheeze , heart failure , crackles , airway obstruction , respiratory failure , asthma , hypercapnia , cardiology , bronchial obstruction , intensive care medicine , respiratory system , surgery , physical examination , airway
Studies are reported of four patients (all lifetime non‐smokers) who presented with right heart failure as a consequence of unrelieved asthmatic airways obstruction. These patients demonstrated severe airways obstruction with crackles on ausculation and hypercapnia. As shown here, such a presentation, without the usual pertem of dyspnoea and wheeze, tends to obscure the diagnosis and delays effective treatment. In three of the patients, treatment to relieve airways obstruction improved gas exchange, and the heart failure resolved. In the remaining patient, improvement was limited, and death ensued from respiratory failure. In patients who present with right heart failure, a relationship with airways obstruction and respiratory failure should be considered and assessed by objective tests. Delays in the effective treatment of these patients may result in the progression of their disease to a stage at which airways obstruction no longer responds to medical therapy.