Heart or Asthma

[Pulseman]

I have asthma in the small airways and recently suffered from the flu. My doctor sent me for an x-ray which came back with a shadow. He then set me up for a chest CT Scan.  While waiting for the scan I read that distended neck veins were a sign of heart failure. Since that time I have become worried about having heart failure. My doctor said that my veins were a "normal variation" with good pulse. He then checked my feet for edema, there was none. I have never noticed any foot swelling in the past either. And he said that my heartbeat sounded normal.  The ct scan showed no problems, the shadow was likely caused by body movement. A recent EKG was normal although my pulse rate was in the 80's.  My blood pressure was 140/88. My blood work showed a blood sugar level in the lower ranges of normal. I am a 46 year old male 6 feet tall weighing 163 pounds, non smoker. I use pulmicort and maxair inhaler for the asthma and Prilosec OTC for a hiatal hernia and acid reflux.  I walk about 2.25 miles 6 days a week on the treadmill in 30 minutes.  I have not noticed a decrease in my stamina on the treadmill.  I do have mild shortness of breath on exertion but it does not worsen as the exertion continues, my doctor said that this is due to the asthma and suggest using the maxair before working out.  My recent lung function test showed an improvement since last years and the small airways went from 48% of predicted before the bronchodilator to 83% after.   I do not have shortness of breath when laying down although on a couple of occasions in the last few years I have woken up with a rapid heartbeat that subsided within a minute or two.

My questions are 1) Should I be concerned that the neck veins are showing a hidden heart disorder? And 2) How can you differentiate the shortness of breath from Asthma compared to that from a heart disorder?

Thank you.

[Pulseman]

I think the BP was due to the lung infection. My most recent reading was 131/78

[Mantels]

I thought my shortness of breath was asthma also.

It wasn't and i ended up in the ER with a heart attack.

[Gaspipe]

HI I know you didn't ask and the Doc did not mention it but if your BP is consistently in the range you mention you should keep a close eye on it . If diet and excercise do not bring it down I would if I were you inquire with my internist about means of control. Jusy my humble opinion. I remain Gaspipe

[Cleveland Clinic]

My questions are

1) Should I be concerned that the neck veins are showing a hidden heart disorder?

No.  A physical exam and the rest of your workup has nothing to suggest that this is coming from your heart.  The external veins of the neck are not what are referred to when we describe distended neck veins and can be prominent in some individuals.  We generally refer to the internal veins of the neck, if your physician examined them and did not find any abnormalities, I wouldnt worry too much about it.

2) How can you differentiate the shortness of breath from Asthma compared to that from a heart disorder?

Sometimes they are similar and can be confusing in patients with both diseases.  However, it sounds like there are no other features of heart failure that suggest this as a cause. An echocardiogram would be a definitive test to determine the function of your heart.