One of the clues emergency room doctors look for when they suspect heart failure is a patient's sleeping position. It is the complaint that breathing becomes easier only after adding an extra pillow or raising the upper body.
According to the medical community Monday, Dr. Alex Wibberley, a British emergency medicine specialist, said, "Many patients dismiss such changes as simple sleeping habits, but they may be a sign of declining heart function."
This is medically classified as "orthopnea," a symptom in which lying flat causes shortness of breath while sitting up or standing improves breathing. The pattern also includes a dry cough or wheezing that appears while lying down and eases when the upper body is raised.
The cause lies in fluid movement. Fluid that has pooled in the legs during the day rises toward the chest when a person lies down, increasing pressure around the lungs. If the heart is already struggling to process blood, this pressure change can lead to breathing difficulties. "In the emergency room, we view this symptom as an important clue to heart failure," Dr. Wibberley said.
The early signs of cardiovascular disease are generally ordinary. They may amount to feeling unusually tired after climbing a single flight of stairs or becoming short of breath more easily than before, which is easy to attribute to a lack of exercise or aging. When strain accumulates on the heart, the muscle can thicken and its relaxation function can decline. This change is not easily detected in a standard electrocardiogram.
The habit of using more pillows does not by itself mean heart disease. Acid reflux, sleep apnea, rhinitis and lung disease can also cause breathing discomfort when lying down. However, medical attention is needed if breathing has suddenly become easier only after raising the upper body recently, or if shortness of breath while climbing stairs, chest tightness, leg swelling and severe fatigue occur together.
In terms of prevention, blood pressure management and aerobic exercise are the basics. Continuous, rhythmic exercise such as brisk walking, cycling and swimming is effective for vascular health and blood pressure control. For diet, the recommendation is to reduce refined carbohydrates and sodium while eating a balanced intake of vegetables, whole grains, protein and healthy fats.
