Congestive heart failure: how to manage ‘air hunger’ (shortness of breath)

Written by: Dr Arjun Ghosh
Published: | Updated: 03/03/2021
Edited by: Emma McLeod

Are you feeling “air hunger” (shortness of breath)? Dr Arjun K Ghosh, a leading London cardiologist, shares his professional expertise with you. Learn from a specialist about what air hunger is, why it happens, how it’s managed and the overall outlook.

An older man looks upwards as he catches his breath. Shortness of breath, or air hunger, can be a symptom of heart problems.

What exactly is ‘air hunger’?

Patients with congestive heart failure (CHF) can often feel shortness of breath (air hunger). This usually occurs with activity and as the disease progresses, it can occur with less intense activity and more frequently. The “air hunger” is a manifestation of the fact that the heart cannot pump oxygenated blood around the body as effectively as it should.


How distressing can shortness of breath be?

Shortness of breath can be very distressing for patients, especially if it occurs with minimal effort - which may be the case in progressive and advanced CHF. It may even wake patients from sleep and make them gasp for breath, which is something called paroxysmal nocturnal dyspnoea (PND) which is a sign that patients should seek medical assistance.


Shortness of breath that makes everyday activities a challenge can understandably negatively impact the mood of patients and feel debilitating. Other symptoms of heart failure which may compound this feeling include tiredness and fatigue on exertion as well as ankle swelling.


Why does congestive heart failure cause this symptom?

The “air hunger” is a manifestation of a lack of oxygenated blood getting to all parts of the body. This occurs in CHF patients when the heart muscle does not pump as well as it should. As a result, there is often a poor flow of blood around the body and an accumulation of fluid in the wrong places. Accumulation of fluid in the lungs can worsen symptoms of breathlessness.


Is there a treatment for patients with this symptom?

A number of treatments are available to help with symptoms of CHF, including air hunger. Many of these treatments have also been shown in clinical trials to reduce hospital admissions with CHF and also to prolong life.


Can you offer any advice for managing air hunger?

Patients with such symptoms should be evaluated by a medical professional to determine if they have CHF. If CHF is diagnosed, it should be reviewed by a cardiologist so that prognostic medication can be started as soon as possible. At that review, they should be given comprehensive guidance on how to make lifestyle changes to improve symptoms. They should also be given a tailored cardiac exercise programme to ensure that they optimise their cardiovascular fitness.


What is the outlook like?

The outlook depends on how quickly a diagnosis is made and how quickly prognostic medications are started. The quicker both of these are instituted, the better the prognosis is and people in that situation can live for years with this chronic condition.


For further information and professional expertise in the diagnosis and management of congestive heart failure and its symptoms, visit Dr Ghosh’s profile.

By Dr Arjun Ghosh

Dr Arjun Kumar Ghosh is an internationally recognised expert consultant cardiologist at The London Clinic and The Wellington Hospital Cardiac Unit in London. His areas of speciality lie in cardio-oncology; treating cancer patients with heart problems. He also performs cardiac imaging, such as cardiac MRIs and echocardiograms and treats patients suffering heart failure, coronary heart disease, palpitations, arrhythmias and shortness of breath. He is also an honorary clinical senior lecturer at University College London and the Queen Mary University of London.

Dr Ghosh has helped establish the cardio-oncology services at University College London and Barts Heart Centre in London, where he is also the Clinical Governance Lead for cardio-oncology. He also holds a number of leadership roles as a Foundation Training Programme Director and is a member of the Education Committee and Programme Committee of the British Cardiovascular Society. He is trained in all aspects of general cardiology receiving his education from several prestigious London teaching hospitals, including the London Chest Hospital and The Heart Hospital.

He is actively involved in cardio-oncology research and completed an international award-winning PhD from Imperial College London. He has presented his work at the Houses of Parliament and most recently, was a keynote speaker at the European Cardio-Oncology conference in Barcelona and the Global Cardio-Oncology Symposium in Brazil. While publishing in several high-impact medical journals, Dr Ghosh has also written book chapters on cardio-oncology. In honour of his contribution to the field of cardiology, Dr Ghosh was awarded a fellowship from the American College of Cardiology in 2019 and from the European Society of Cardiology. Also, he was awarded a fellowships of the Royal College of Physicians and International Cardio-Oncology Society in 2020.  

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