Insights into shortness of breath

In his latest online article, Dr Simon Pearse gives us his insights into shortness of breath. He talks about what heart problems shortness of breath might indicate, the causes of breathlessness, the difference between wheezing and shortness of breath, what can increase the risk, what treatment involves, and how patients can manage at home.  

What heart problems might shortness of breath indicate? 

There are many reasons why someone might feel breathless, but problems with the heart are one of the most common causes. From a heart point of view, breathlessness may be due to weakness or inefficiency of the heart muscle, which may be genetic or due to environmental, medical or lifestyle factors. It may also be due to problems with heart valves, heart rhythm abnormalities or narrowing in the arteries around the heart. In severe cases, this can lead to heart failure, when the heart is not able to pump blood around the body adequately.  

What are the causes of breathlessness? 

It very much depends on the underlying cause, but the result is that the body is not getting enough oxygen or removing waste products such as carbon dioxide from the muscles and organs adequately. This may be due to impaired heart function, lung disease, anaemia, deconditioning, obesity or other less common conditions.  

What is the difference between wheezing and shortness of breath? 

Shortness of breathis a generalised sensation of not enough air/oxygen getting into the body. Wheezing on the other hand, it is much more specific. It is defined as a noise your lungs make as you’re breathing out and is usually associated with a problem with the patient’s airways.  

Wheezing is usually related to underlying lung disease, whereas breathlessness can be due to several different health problems, including heart issues. 

What can increase the risk of shortness of breath? 

Maintaining a healthy heart through exercise, eating well, keeping at a healthy body weight and not smoking reduces the risk of heart disease and breathlessness. In addition, ensuring that blood pressure, diabetes and cholesterol are well controlled or avoided is important. Managing these factors before damage to the heart or other organs occurs is of great benefit.  

What does treatment involve? 

The first step is to diagnose why a person is breathless. Initial tests might involve an ECG to identify heart rhythm problems, an echocardiogram (ultrasound) to look at the function of the heart muscle and valves, a blood test and a chest X-ray to look for lung issues. Depending on the history and results of these tests, an angiogram or alternative to look for narrowing of the arteries around the heart or an MRI scan of the heart might be indicated.  

Once we have identified the problem, we can treat the cause. This might involve medication to strengthen the heart muscle, diuretics to remove excess fluid, a pacemaker, medication or ablation for heart rhythm problems, or surgical or keyhole interventions for valve or coronary artery disease. Doctors, specialist nurses and colleagues would work with you throughout the journey to improve breathlessness and quality of life.  

How can patients manage their shortness of breath at home? Can exercise help? 

Keeping active and healthy is a key part of avoiding and managing breathlessness, although we always advise resting if chest pain develops or a person feels unwell. To get the best results, we work together with our patients to ensure they get the best medical treatment, but also the best lifestyle advice and help, including specialist cardiac rehab programmes. Breathlessness can be very frustrating, frightening and debilitating, but with the right approach great strides can be made to improve quality of life. 

Dr Simon Pearse is an esteemed cardiologist. You can schedule an appointment with Dr Pearse on his Top Doctors profile.