Shortness of Breath (Dyspnoea)

What is Shortness of Breath?

Shortness of breath, also known as dyspnoea, is a feeling of being unable to breathe well enough. It can be a sign of a serious health condition, especially when related to cardiac (heart) issues.

Common Cardiac Causes of Shortness of Breath:

  • Heart Failure: The heart is unable to pump enough blood to meet the body’s needs.
  • Coronary Artery Disease (CAD): Narrowed or blocked coronary arteries reduce blood flow to the heart muscle.
  • Heart Attack: A blockage of blood flow to the heart muscle causing damage.
  • Arrhythmias: Irregular heartbeats that affect the heart’s ability to pump blood efficiently.
  • Cardiomyopathy: Diseases of the heart muscle that make it harder for the heart to pump blood.
  • Pericarditis: Inflammation of the sac surrounding the heart.
  • Valvular Heart Disease: Malfunctioning heart valves that affect blood flow within the heart.

Symptoms Associated with Cardiac Shortness of Breath

  • Difficulty breathing, especially during physical activity or when lying flat.
  • Rapid or irregular heartbeat.
  • Swelling in legs, ankles, or feet.
  • Fatigue and weakness.
  • Chest pain or discomfort.
  • Persistent coughing or wheezing.
  • Need to sleep with multiple pillows or sit up to breathe easily.

When to Seek Medical Help

  • If you experience sudden or severe shortness of breath.
  • If shortness of breath is accompanied by chest pain, fainting, nausea, or a bluish tint to the lips or fingers.
  • If you have a history of heart disease and notice a new or worsening symptom.

Diagnosis

To determine the cause of shortness of breath, especially related to cardiac issues, we may use:

  • Electrocardiogram (ECG): Measures the heart’s electrical activity.
  • Electrocardiogram Monitoring (Ambulatory ECG): Monitor the heart’s electrical activity.
  • Echocardiogram: Ultrasound to check heart structure and function.
  • Chest X-ray: Looks at the lungs and heart.
  • Blood Tests: Check for markers of heart damage or other conditions.
  • Pulmonary Function Tests: Measure how well your lungs are working.
  • Stress Tests: Assess how your heart works during physical stress. (stress echo and MRI)
  • CT Scan: Detailed images of the heart and blood vessels.

Treatment

The treatment for shortness of breath due to cardiac causes depends on the underlying condition:

  • Medications: Such as diuretics, beta-blockers, ACE inhibitors, or anticoagulants to manage heart conditions.
  • Lifestyle Changes: Dietary modifications, regular exercise, quitting smoking, and limiting alcohol.
  • Procedures: Angioplasty, stent placement, or surgery to improve blood flow.

Prevention

  • Maintain a healthy diet low in salt and saturated fats.
  • Exercise regularly as advised by your healthcare provider.
  • Monitor and manage blood pressure, cholesterol, and diabetes.
  • Avoid smoking and limit alcohol consumption.
  • Manage stress through relaxation techniques or counselling.
  • Follow your treatment plan if you have an existing heart condition.

Important Notes

  • Always take shortness of breath seriously, especially if you have heart disease or risk factors for heart disease.
  • Keep a record of your symptoms, their frequency, and what triggers or relieves them to help your healthcare provider make an accurate diagnosis.