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.
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:
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.
Some heart problems that cause shortness of breath are, but are not limited to:
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:
Treatment for dyspnea ultimately depends on the underlying condition causing the symptom in the first place, making accurate diagnosis crucial.
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!
Seek immediate medical help if you experience breathlessness at rest, chest pain, fainting, blue lips or nails or swelling in the legs. These may signal a heart or lung emergency. You should also seek medical help if you feel gradual decline in your effort tolerance.
Yes. Heart conditions such as coronary artery disease, heart failure, valvular heart disease, cardiomyopathy or arrhythmias can cause difficulty breathing, especially during exertion.
Heart-related breathlessness often worsens when lying flat and improves when sitting up. Lung-related causes are more likely to include cough, wheezing, or chest congestion. Sometimes it is difficult to differentiate between them.
Yes, anxiety can make breathing feel difficult, but the symptom should not be dismissed. It’s important to rule out heart or lung issues before attributing it solely to stress.
Common tests include an ECG, chest X-ray, echocardiogram, blood tests, stress test, CT chest/Coronary angiogram. These help identify whether the problem is cardiac, respiratory or due to another cause.
Not necessarily. It can occur after strenuous exercise or in hot, humid weather. However, persistent or worsening breathlessness requires a medical evaluation.
Treatment depends on the cause. Heart-related cases may require medication, fluid management or procedures to improve heart function. Lung or metabolic causes need targeted therapy.
Yes. Over time, uncontrolled high blood pressure strains the heart and can lead to heart failure, which often presents with breathlessness and fatigue.
Your doctor may recommend an ECG, echocardiogram, stress test or Holter monitoring to evaluate heart rhythm, structure and pumping function.
This may indicate fluid buildup in the lungs due to heart failure. If you need extra pillows to sleep comfortably, consult your cardiologist for evaluation.
Yes. Some heart conditions, particularly in older adults or women, may cause breathlessness without classic chest pain. This is known as an “anginal equivalent.”
Keep track of when symptoms occur, how long they last and what makes them better or worse. Bring a list of medications and medical history for accurate diagnosis.
Once serious causes are ruled out, gentle exercise under medical guidance can strengthen the heart and lungs, helping improve endurance and breathing efficiency.
Yes, but it should never be considered normal. Age-related heart or lung conditions can contribute, so persistent breathlessness deserves medical assessment.
Maintaining a healthy lifestyle, such as exercising regularly, managing blood pressure, avoiding smoking and limiting salt intake helps reduce the risk of heart-related breathlessness.
Ignoring it can delay diagnosis of serious conditions like heart failure or pulmonary embolism, which can become life-threatening without prompt treatment.
Yes. Low haemoglobin levels or thyroid imbalance can strain the heart and reduce oxygen delivery, leading to shortness of breath even during mild activity.
If your symptoms are sudden or worsening, seek urgent medical care. For mild but persistent symptoms, book an appointment within a few days for proper evaluation.
This may suggest advanced heart or lung disease, anaemia or fluid retention. It requires immediate medical review to determine the underlying cause.
Avoid smoking, maintain a healthy weight, manage chronic conditions and follow your doctor’s exercise and medication plan to improve breathing and overall heart health.
Dr Devinder Singh is the Medical Director of Cadence Heart Centre. He is an experienced Senior Consultant Cardiologist & Cardiac Electrophysiologist with over 20 years of clinical experience.
His expertise lies in clinical cardiology, cardiac rhythm disorders (arrhythmia), cardiac pacing (including cardiac resynchronisation therapy) and cardiac magnetic resonance imaging. He performs electrophysiology studies and radiofrequency ablation of cardiac arrhythmias, and is well versed in pacemaker and defibrillator insertions.
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