Cardiac Cough: What It Is, Why It Happens, and How to Manage It

When your cough won’t go away and you don’t feel sick, it might not be your lungs—it could be your heart, an organ that pumps blood and can trigger a persistent cough when it’s struggling. This is called a cardiac cough, a dry, nighttime cough caused by fluid backing up from a weak heart into the lungs. It’s not allergies, not bronchitis—it’s your heart telling you something’s off.

Most cardiac coughs happen at night or when lying down, because gravity lets fluid pool in the lungs. People with heart failure, a condition where the heart can’t pump blood effectively often get this cough. It’s also common if you’re taking ACE inhibitors, medications used to lower blood pressure and ease heart strain. These drugs help many people, but about 20% of users develop a stubborn cough as a side effect. That cough doesn’t mean the medicine isn’t working—it means your body is reacting to it.

Cardiac coughs are different from regular ones. You won’t have a fever or runny nose. You might feel short of breath, especially when lying flat. Swollen ankles or needing extra pillows to sleep can go hand-in-hand with this cough. It’s not something you should ignore. Left untreated, the underlying heart issue can get worse.

Doctors check for this by listening to your lungs, ordering an echocardiogram, or checking blood levels like BNP. If it’s your heart, treating the root cause—like adjusting your meds or managing fluid buildup—usually makes the cough fade. Sometimes switching from an ACE inhibitor to an ARB helps. Other times, diuretics are added to drain excess fluid.

You’ll find posts here that dig into how medications like ACE inhibitors can cause this cough, how heart failure leads to fluid in the lungs, and what alternatives exist when your current treatment isn’t working. We cover real cases, practical tips for spotting the difference between a cold and a cardiac cough, and how to talk to your doctor about symptoms you might think are harmless. This isn’t about guessing—it’s about recognizing the signs so you can act before things get serious.