Shortness of breath

Shortness of breath may be experienced on exertion or occur at rest and be due to a broad range of cardiac conditions including heart failure, cardiomyopathy, atrial fibrillation and valvular heart disease. Breathlessness due to an underlying heart condition is often associated with other cardiac symptoms such as chest pain, palpitation and leg swelling. Breathlessness can of course be due to reasons other than the heart such as lung disease, obesity, poor cardiorespiratory fitness or anaemia.

Investigation of breathlessness

Patients with breathlessness require detailed clinical assessment and often need further investigations including:

  • Blood tests including natriuretic peptides (NTproBNP)
  • 12-lead Electrocardiogram (ECG)
  • Echocardiogram
  • Chest radiograph (CXR)
  • Lung function/spirometry tests

Treatment of heart failure

Investigations of breathlessness may confirm an issue with the pumping or relaxation function of the heart and indicate a diagnosis of heart failure. There are many medical treatments available for this condition to both reduce symptoms, hospital admissions and to improve survival. These include well established drug therapies such as ACE inhibitors, beta-blockers, mineralocorticoid receptor antagonists (MRA), and newer agents such as Sacubitril/Valsartan (ARNI). Certain patients may benefit from invasive procedures such as biventricular pacemaker and defibrillator insertion.