Heart Failure vs. COPD: Identifying the Underlying Cause of Chronic Dyspnea with Imaging Tests and BNP

Chronic dyspnea is a prevalent symptom in clinical practice, particularly in patients with cardiopulmonary diseases. Heart failure and chronic obstructive pulmonary disease (COPD) are two of the most common causes of dyspnea, and differentiating between them is crucial for appropriate management. Both conditions share risk factors and can coexist, further complicating the differential diagnosis.

Diving Deeper into Differential Diagnosis

Heart failure is characterized by the heart's inability to pump sufficient blood, leading to fluid accumulation in the lungs and, consequently, dyspnea. In contrast, COPD is associated with airflow obstruction due to the destruction of lung tissue and chronic inflammation of the airways. Despite these pathophysiological differences, clinical symptoms can be similar, making accurate diagnosis challenging [1].

To differentiate between these two conditions, a thorough clinical evaluation is essential, including imaging tests and biomarkers. Echocardiography and the measurement of natriuretic peptides (BNP and NT-proBNP) are valuable tools for confirming or ruling out heart failure [2]. For COPD, spirometry is fundamental for assessing airflow obstruction [3].

Additionally, lung ultrasound has proven to be an effective technique for distinguishing between pulmonary edema and COPD exacerbations, thanks to its ability to identify specific sonographic artifacts [4]. Oxygen therapy may be necessary in both cases, but its use must be carefully monitored to avoid complications.

Conclusions

Accurate identification of the underlying cause of chronic dyspnea is essential for the effective treatment of patients with heart failure or COPD. A diagnostic approach that combines clinical evaluation, imaging tests, and biomarkers can significantly enhance diagnostic accuracy and, consequently, clinical outcomes. Interdisciplinary collaboration and the use of advanced technologies are fundamental to addressing this clinical challenge.

Referencias

• [1] COPD and heart failure: differential diagnosis and comorbidity.
• [2] Heart failure and chronic obstructive pulmonary disease: a review.
• [3] The diagnosis of chronic obstructive pulmonary disease.
• [4] Clinical application of lung ultrasound in patients with acute dyspnea: differential diagnosis between cardiogenic and pulmonary causes.

Created 6/1/2025