Shortness of Breath
What is It?
Shortness of breath – also called dyspnoea or breathlessness – is difficulty or discomfort experienced when breathing. It can occur at rest or during activity, and may develop gradually (chronic) or come on suddenly (acute). Shortness of breath is a very common symptom that can be caused by a wide range of conditions, from a lack of fitness to serious heart or lung disease. Sudden, severe shortness of breath – particularly with chest pain, dizziness or collapse – is a medical emergency and requires immediate assessment by calling 000.
What are the symptoms?
Shortness of breath may present as an uncomfortable sensation of not getting enough air, tightness in the chest, a feeling of suffocation, or having to work hard to breathe. It may occur during exertion, at rest, or specifically when lying flat (orthopnoea). Associated symptoms may include wheezing, cough, palpitations, dizziness, fatigue, swelling of the legs, and, in severe cases, pale or bluish lips.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of shortness of breath. Cardiac and respiratory causes include:
- Heart conditions: Heart failure, heart attack, coronary artery disease, arrhythmias, valve disease, and cardiomyopathy.
- Lung conditions: Asthma, chronic obstructive pulmonary disease (COPD), pneumonia, pulmonary embolism, and interstitial lung disease.
- Other cardiac contributors: Pericardial disease and pulmonary hypertension.
- Non-cardiac causes: Anaemia, obesity, anxiety, panic attacks, and poor physical conditioning.
How is it investigated?
Your One Heart Centre cardiologist will take a detailed history and perform a physical examination including listening to your heart and lungs. Investigations typically include an ECG, chest X-ray, blood tests (including full blood count, BNP, and D-dimer where appropriate), and an echocardiogram to assess heart function. Additional tests may include lung function tests (spirometry), cardiopulmonary exercise testing (CPET), CT scan, and cardiac MRI to identify the underlying cause.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing shortness of breath and will provide a personalised treatment plan based on the underlying cause of your breathlessness. Treatment options include:
- Treating the underlying cause: Medications for heart failure, coronary artery disease, arrhythmias or valve disease.
- Lifestyle measures: Smoking cessation, weight loss, regular exercise, and pulmonary or cardiac rehabilitation programs.
- Medications: Diuretics for fluid overload, bronchodilators for airway disease, and oxygen therapy where appropriate.
- Procedural and surgical interventions: Such as coronary revascularisation, valve repair or replacement, or device therapy, depending on the cause.