Shortness of Breath
Shortness of breath, due to a range of heart and lung conditions, may be experienced on exertion and/or can occur at rest.
Not being able to get enough air is one of the most frightening sensations we can experience. Shortness of breath is mainly described as an overwhelming tightening in the chest, difficulty breathing, breathlessness or a feeling of suffocation. Certain life conditions like very strenuous exercise, extreme temperatures and obesity can lead to breathlessness. If not in this context, shortness of breath is more likely a sign of a medical problem.
The heart and lungs are systemically connected in that changes in the lungs can affect the heart and vice versa. These organs are involved in transporting oxygen and removing carbon dioxide; problems with either of these processes will affect breathing.
Commonly, shortness of breath can be caused by a number of lung conditions such as asthma, lung scarring, long Covid, chest infections and smoking related airway disease .
However, there are several heart conditions which can affect the breathing. In such cases, although breathlessness can be the only symptom, chest discomfort, palpitations and leg swelling may also be present.
Patients with breathlessness require detailed clinical assessment and often need further investigations which can include blood tests (including special heart related breathing blood tests like natriuretic peptides -NTproBNP), an electrocardiogram (ECG), echocardiogram, chest radiograph (CXR), lung function tests and a CT scan.
Treatment of breathlessness is aimed at addressing both the underlying cause and improving patients’ symptoms. Medical therapy also plays an important role in reducing hospital admissions and prolonging patient survival. Occasionally, invasive treatments are required to address the underlying pathology which can include the treatment of heart valve and coronary artery disease, pacemaker implantation and ablation procedures.
Here are some different examples of how breathlessness affects the life of different individuals.
Adults who lead an ordinary life but undertake little or no exercise:
Such individuals will notice that their exercise capacity has decreased and that daily tasks tend to be more difficult. Often, they will be unable to complete a task without taking a break and activities which, before, were not causing any symptoms tend to be more troublesome. Older individuals will often delegate such tasks to others or avoid them completely.
Fit adults who routinely undertake aerobic exercise such as running, cycling, swimming and high-intensity interval training (HIIT):
Such individuals tend not to be troubled by daily activities such as walking and shopping. However, their ability to complete a long cycle, run their usual distance or attend their regular gym class is often diminished or becoming exceedingly difficult. In younger individuals, it does not affect their daily activities and so it can go unnoticed. This can, however, signal significant underlying heart and lung issues and therefore specialist advice is advisable.
Senior adults, usually independent of their daily activities, who gradually have to reduce what they can do because of breathlessness:
Such individuals are usually able to independently perform routine daily activities such as shopping, walking their pet, tending the garden and doing housework. Breathlessness, in such cases, results in either the inability to complete these tasks or the need for frequent breaks in order to finish them. Such symptoms are often ignored as they are attributed to increasing age whereas they often signify underlying heart and lung issues. It is therefore important, where a decreased ability to perform routine tasks is seen, for specialist input to be sought.