Introduction

Dyspnea, more commonly known as shortness of breath, is the most common symptom of heart failure. This is often described as difficulty breathing, breathlessness, tightness in the chest, or a feeling of suffocation.

Although shortness of breath could indicate a variety of medical conditions — from something as normal as tiredness from strenuous exercise to something more serious such as heart or lung condition - it is important not to ignore the symptom, especially if you experience them long-term and persistently.

When could shortness of breath signal a heart issue?

Oftentimes, shortness of breath could indicate a potentially serious heart condition. It could signal a heart issue when it seems to progressively worsen, from occurring during physical exertion to happening even at rest. It may also occur when you lay flat on your back.

Other accompanying symptoms could be:

• Chest pains or tightness
• Fainting
• Nausea
• A bluish tinge to the lips or nails
• A change in mental alertness
• Swelling in the ankles or feet

In these cases, it is important to seek medical attention immediately as these could be signs of heart failure or pulmonary embolism.

You should also seek medical attention if you are out of breath much sooner than you used to be after exercise or strenuous physical activity, or if you experience breathlessness without any explanation.

What heart problems cause shortness of breath?

Some heart problems that cause shortness of breath are, but are not limited to:

• Coronary Artery Disease — The buildup of plaque narrows the arteries, decreasing blood flow to the heart. This blockage causes shortness of breath.

• Cardiomyopathy — Cardiomyopathy refers to any disorder that affects the heart muscle, causing it to lose its ability to effectively pump blood to other parts of the body. This causes difficulty breathing as not enough oxygen-rich blood reaches the lungs.

• Tachycardia — Tachycardia (abnormally fast heart rate) caused by heart rhythm disorders. Supraventricular tachycardia (SVT), atrial tachycardia, atrial fibrillation or atrial flutter are forms of tachycardia (fast heart rate) that commonly cause shortness of breath.

• Pulmonary oedema — This condition causes extra fluid in the lungs, making it difficult to breathe. This often occurs because of heart problems, where the heart cannot pump enough blood it gets from the lungs. Pressure in the heart builds up, which pushes fluid into the lungs’ air sacs, causing breathing difficulties.

How is shortness of breath evaluated?

Apart from taking a detailed clinical history and physical examination the primary methods of evaluating shortness of breath are through an electrocardiogram (ECG) and a chest X-ray. These are quick and inexpensive tests that provide your cardiologist with a baseline diagnosis to confirm or exclude certain diagnoses.

An electrocardiogram (ECG) can detect abnormalities in your heart’s rate and rhythm. This helps your doctor determine whether there is a problem related to the electrical activity in the heart.

A chest X-ray can help identify any structural abnormalities within your chest that may be causing the dyspnea such as fractures or masses. It can also show an increase in the cardiac silhouette caused by the thickening of the heart muscles.

Other tests may also be carried out by your cardiologist for a comprehensive diagnosis like:

• Blood tests
• Exercise tests
• Holter monitoring (ambulatory cardiac monitoring)
• Echocardiogram
• Chest CT scan

How is shortness of breath treated?

Treatment for dyspnea ultimately depends on the underlying condition causing the symptom in the first place, making accurate diagnosis crucial.

Summary

It’s important to take breathlessness seriously as it could be indicative of a serious cardiac issue. Fortunately, with current diagnostic tools and good communication, there are high chances of diagnosing and treating the problem.

If you experience shortness of breath, take note of when it occurs, how often it occurs and other related symptoms. This would help your cardiologist better understand and diagnose your condition. Early detection is key!