Don’t get caught short when it comes to breathing

Written by: Dr Julian Collinson
Published:
Edited by: Karolyn Judge

Shortness of breath can be caused by several issues within the body, but what about when it’s related to the heart?

 

Top consultant cardiologist Dr Julian Collinson speaks to us about shortness of breath when it’s connected to heart conditions, in this informative article.

 

Girl with shortness of breath sat on floor next to a bed

 

What does shortness of breath most commonly indicate?

Shortness of breath is a pretty broad symptom. It can represent a number of things. From my perspective, obviously the most important part is the heart, but it can also reflect problems with the lungs, and occasionally anaemia and so on. It's a very broad symptom that can have a large number of causes.   

 

 

When should I see a doctor for shortness of breath?

The key time to see your doctor is, if things are changing. So, if you become shorter of breath, for example going up the stairs, or coming out of the tube station then that's time to start thinking about it. Obviously if things change very quickly overnight, that's an important sign. Sometimes it can be more subtle and come on over a period of days or weeks.

 

Essentially, if you're shorter of breath than you expect for your level of fitness, you should probably see a doctor and just make sure everything is fine.

 

 

What tests will I undergo to determine the cause of my shortness of breath?

The first thing to do when your doctor sees you about shortness of breath, is to have a talk where they take a history, and try and understand if there's any particular reason why this might be the case. That might define which investigations are the most important.

 

In general terms, there will be some blood investigations, for example to look if there's any evidence of anaemia. From the heart perspective, the tests that are done are:

 

  • An ECG, which is a simple heart tracing;
  • An echocardiogram, which is an ultrasound of the heart.

 

There are various other investigations that are maybe necessary to see if there's anything more subtle going on. If the main causes are felt to be a lung or respiratory cause, then you may well have a chest X-ray, or some lung function tests to have a look at how the lungs are working.    

 

 

How is shortness of breath managed?

The main management of shortness of breath is to treat the cause. If the cause is something to do with the heart pump failing, so heart failure, then the usual treatment for that is medication. There is probably a half a dozen of different types of tablets that can be used in this situation, and they're extremely successful in managing the symptoms in this particular situation.

 

Clearly, identifying the cause and treating the cause is also important so, for example if the main cause is shortness of breath is to do with a valve problem with the heart, then various procedures might be necessary to try and replace the valve.     

 

 

When the underlying cause is determined, what happens next?

Once the underlying cause is found, then maybe, for example, if it's anaemia you may need to do more investigation as to determine why that's happened. If it's to do with heart failure, then usually there'll be some investigations to find out whether it's to do with problems with narrowing of the arteries or a heart valve problem, and those causes are treated.

 

Sometimes, the cause of heart failure and shortness of breath in a cardiology context is to do with weakness to the muscle of the heart. Often, that isn't completely reversable and something that would require medication, which usually will be for the long term.

 

 

Do you have shortness of breath, and are concerned it’s related to a heart condition? Arrange an appointment with Dr Collinson via his Top Doctors profile.

By Dr Julian Collinson
Cardiology

Dr Julian Collinson is an industry-leading cardiologist based in central London, specialising in cardiac intervention devices, heart failure and valvular diseases alongside cardiac risk factors, atrial fibrillation and shortness of breath. He privately practices at Chelsea Outpatient Centre at Chelsea and Westminster Hospital, Cromwell Hospital, RB & HH Specialist Care at Royal Brompton Hospital and The Lister Hospital, Chelsea. 

Dr Collinson has significant leadership experience as a practitioner, having been the clinical lead for cardiology and the clinical director for medical specialities at Chelsea and Westminster Hospital. He is also the clinical lead for syncope there, set up a comprehensive device service where he introduced day-case pacemaker and ICD implantation and established the hospital's pacemaker follow-up service.  

Dr Collinson graduated with an MBBS from the University of London in 1992, completing his undergraduate training at King's College Hospital and general training at Manchester University. His speciality training in cardiology was undertaken at world-renowned cardiac centre; the Royal Brompton and Harefield Hospitals. After completing research into the epidemiology and management of acute coronary syndromes at the Royal Brompton Hospital and the University of London, Dr Collinson received an MD in 2000. 

Dr Collinson's main interests are in the management of acute coronary syndromes, heart failure and valvular heart disease. His research into these topics have been published in various peer-reviewed journals while he has also contributed to publications about angina and heart failure. 

He is an active member of the British Cardiovascular Society, the British Heart Rhythm Society (formerly Heart Rhythm UK) and the British Cardiovascular Intervention Society and is a fellow of the Royal College of Physicians after receiving his qualification in 2010. 

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