Congestive Heart Failure in My Grandmother

Dear Ask The Doctor: My grandmother has a pacemaker, she's had it for years, she's currently hospitalized for congestive heart failure- 2 days ago in the nursing home, they gave her a nebulizer for a cough she had, then they had to rush her to the hospital because she could not breath-could the nebulizer have caused her to have congestive heart failure?

Dear Beate: Congestive heart failure occurs when the blood flow from the heart is insufficient to meet the body’s demands. This can occur due to structural or functional heart disease, such as heart attack, heart valve disease, high blood pressure, and cardiomyopathy. The nebuliser given to your grandmother may have contained Salbutamol, a β2 agonist bronchodilator. This means it opens the airways to ease breathing, although one of the side-effects is that it can make your heart beat fast. This could potentially have precipitated an acute episode of heart failure. However I think it may be more likely in your grandmother’s case, that she has underlying cardiac disease, with a history of a permanent pacemaker, and something else has precipitated an episode of heart failure.