The association between lung and heart disease is very common. Many of our patients have both heart and lung disease and, when symptoms occur, it can be difficult for physicians, even specialists, to know if the heart or the lungs are causing the problem. This can be frustrating to the patients who often say “the heart doctor says it’s my lungs and the lung doctor says it’s my heart”.

One of the key elements in determining what could be going on is the amount of water in the lungs. Patients who have had heart failure before can begin to retain water in their lungs which, when small but significant, can be hard to detect. A test is being investigated that may be helpful. A device that measures electrical conduction thru the chest, so-called “lung impedance” is being tested with some significant and promising success. The device has basically two electrodes placed on either side of the chest. Once the electrodes are placed it takes about one minute to take a reading.

When increased lung water is found, appropriate adjustments in treatment can be started. The most common adjustment was increasing the patient’s diuretic therapy (water pill). There was a 56% reduction in hospitalizations related to heart failure using this method as a guide to therapy. The important part is that a physician was aware of the finding and took appropriate action. The device is in development. I will keep an eye out for when it is available.