Dry Hacking Cough In Adults

  1. Persistent Cough With No Other Symptoms
  2. Persistent Dry Hacking Cough

In This Article

Table of Contents
  • Heart Failure
  • Medication-Related Cough
  1. This type of cough is best treated with lifestyle modifications and natural dry cough remedies. To most of us, a dry cough is nothing but a minor annoyance that we ignore. Unfortunately, when a dry cough does not resolve quickly, it can be a cause for significant discomfort, even disrupting sleep.
  2. Aug 31, 2019  A dry hacking cough is a type of nonproductive cough that is most commonly caused by smoking, asthma, allergies, bronchitis, and colds. People who smoke can sometimes develop a chronic dry cough because of irritants in cigarettes. Some illnesses, such as a cold or bronchitis, can also bring on a this type of cough.

Most people associate coughing with a lung or airway problem, not with the heart. But, it is not unusual for people who have heart failure to experience significant coughing. In fact, a cough may be an important sign that heart failure treatment is inadequate—or even that the treatment may be causing problems.

A dry hacking cough is a type of nonproductive cough that is most commonly caused by smoking, asthma, allergies, bronchitis, and colds. People who smoke can sometimes develop a chronic dry cough because of irritants in cigarettes. Some illnesses, such as a cold or bronchitis, can also bring on a this type of cough. Persistent dry coughs. A dry cough that lingers for more than three weeks may be the result of an underlying medical condition such as: Snoring or sleep apnoea – snoring and/or sleep apnoea can cause irritation to the back of the throat which over time can give rise to a persistent, dry cough upon waking.

Heart Failure

Although it sounds total and catastrophic—like a power failure—'heart failure' doesn't mean that the heart just stops, that's cardiac arrest. Rather, heart failure simply means that the heart's pumping ability has been impaired to the extent that the heart is not always able to keep up all the demands of the body.

Heart failure can result from a variety of cardiac disorders, including coronary artery disease (CAD), hypertension, hypertrophic cardiomyopathy, diastolic dysfunction, and heart valve disease, among several others. Over four million people each year are hospitalized with heart failure.

People with heart failure may experience weakness, fatigue, poor exercise tolerance, unusual dyspnea (shortness of breath) when exercising or when lying down (a symptom called orthopnea), edema (swelling) in the ankles, and sometimes cough.

One common problem with heart failure is that, due to the heart's inefficient pumping ability, blood returning to the heart from the lungs tends to back up, producing pulmonary congestion. This is why people with heart failure are often said to have 'congestive heart failure.'

With pulmonary congestion, fluid (and even a little blood) can leak into the alveoli (air sacs) of the lungs. This lung fluid is what's largely responsible for the dyspnea commonly experienced by people with heart failure. Because coughing is the body's way of clearing the airway and bronchial passages, it makes sense that a cough can also result from pulmonary congestion.

Heart Failure Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Cardiac Cough

Coughing that is caused by heart failure can take several forms. A wet cough producing frothy sputum that may be tinged pink with blood is quite common with heart failure. Heavy wheezing and labored breathing can also accompany spells of coughing, along with a bubbling feeling in the chest or even a whistling sound from the lungs.

Impressive coughing symptoms like this usually are a sign that heart failure has become substantially worse, and indeed such coughing is usually accompanied by a general flare-up of heart failure symptoms.

These symptoms are likely to include dyspnea, orthopnea, edema, and even paroxysmal nocturnal dyspnea (waking up from sleep in the middle of the night, gasping, and coughing). People who have this severe form of cardiac cough are generally sick enough to seek medical help without much prompting.

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Cardiac cough can also take a much less severe form. Some people with heart failure will develop an annoying, more chronic, drier cough that may produce a small amount of white or pink frothy mucus. Some who have this less severe form of cardiac cough may write it off as being due to some other cause and may fail to seek medical assistance.

If they delay seeing a doctor, however, symptoms of heart failure are likely to become substantially worse before too long. So, anyone who has been told they have heart failure should never ignore the onset of cough even if they consider it to be pretty mild.

See your doctor if you have heart failure and a new onset of cough, no matter how mild or severe.

Medication-Related Cough

Ironically, coughing also is a common adverse effect of a class of medication that's frequently prescribed for heart failure: angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are helpful for heart failure because they dilate the arteries, making it easier for the heart to pump blood.

Persistent Cough With No Other Symptoms

However, these drugs produce a cough in about five to 35 percent of people who take them. The cough associated with ACE inhibitors is an annoying, dry hacking cough that does not produce sputum.

Persistent Dry Hacking Cough

While there are reports that suggest taking non-steroidal anti inflammatory drugs (NSAIDs) may improve the cough caused by ACE inhibitors, in the large majority of people who have this problem, the drug has to be discontinued. Often, the ACE inhibitor can be switched to an angiotensin II receptor blocker (ARB), which has many of the same advantages as the ACE inhibitor, but which causes coughing less frequently. A change in medication can help relieve a dry, hacking cough due to ACE inhibitors.

A Word From Verywell

Cardiac cough is an important sign that heart failure is worsening. In most cases, this symptom—and the worsening heart failure—will respond to an adjustment in heart failure therapy. For this reason, people with heart failure should never ignore the onset of cough.

  1. Inamdar AA, Inamdar AC. Heart Failure: Diagnosis, Management and Utilization. J Clin Med. 2016;5(7). doi:10.3390/jcm5070062

  2. Blecker S, Paul M, Taksler G, Ogedegbe G, Katz S. Heart failure–associated hospitalizations in the United States. J Am Coll Cardiol. 2013;61(12):1259–1267. doi:10.1016/j.jacc.2012.12.038

  3. Picano E, Gargani L, Gheorghiade M. Why, when, and how to assess pulmonary congestion in heart failure: pathophysiological, clinical, and methodological implications. Heart Fail Rev. 2010;15(1):63-72. doi:10.1007/s10741-009-9148-8

  4. Tsai MF, Hwang SL, Tsay SL, et al. Predicting Trends in Dyspnea and Fatigue in Heart Failure Patients' Outcomes. Acta Cardiol Sin. 2013;29(6):488–495.

  5. Currens JH, White PD. Cough as a symptom of cardiovascular disease. Ann Intern Med. 1949;30(3):528-43. doi:10.7326/0003-4819-30-3-528

  6. Angerio AD, Kot PA. Pathophysiology of pulmonary edema. Crit Care Nurs Q. 1994;17(3):21-6.

  7. Dicpinigaitis PV. Angiotensin-converting enzyme inhibitor-induced cough: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):169S-173S. doi:10.1378/chest.129.1_suppl.169S

  8. Pylypchuk GB. ACE inhibitor- versus angiotensin II blocker-induced cough and angioedema. Ann Pharmacother. 1998;32(10):1060-6. doi:10.1345/aph.17388

Additional Reading

  • Yancy CW, Jessup M, et al. ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013; 128:e240.

  • Heart Failure Society of America, Lindenfeld J, Albert NM, et al. HFSA 2010 Comprehensive Heart Failure Practice Guideline. J Card Fail 2010; 16:e1.
  • McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012; 33:1787.