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Shortness of breath

Shortness of breath is a common symptom that people mention to their doctor and has a number of causes than can be caused by heart problems but also caused by lung disease and problems in other body systems.

 

Symptoms
People with shortness of breath usually are aware of a reduced ability of people tasks they would otherwise have had no difficulties in completing.  For example, they may struggle to walk to the shops,
struggle walking up stairs or even struggle laying down to sleep at night.

 

They may also be a number of the following associated symptoms:

  • Cough (either dry of productive)

  • Wheeze

  • Chest discomfort

  • Palpitations

 

Causes
There are a number of cardiac causes of shortness of breath which are
listed below. Common non-cardiac causes are also listed and are a very
common cause of breathlessness too.


Cardiac causes:

  • Heart failure

  • Significant heart valve abnormality

  • Abnormality of the heart muscle

  • Heart attack

  • Angina (rarely)

  • Abnormalities of the lining of the lung (pericardial disease)

 

Non-cardiac causes:

  • Asthma

  • Chronic obstructive pulmonary disease

  • Interstitial lung disease

  • Cancers affecting the lung

  • Lung infections

  • Pulmonary hypertension

  • Pleural disease

  • Pulmonary embolism

  • Obesity

  • Disorders of acid base balance

 

Investigations
The following investigations can be performed to investigate for
causes of shortness of breath.

  • Blood tests to look for anaemia, infection, liver and kidney failure all of which can produce similar symptoms of shortness of breath are important to perform.

  • Measurement of NT-proBNP, a protein released by the heart when it is stretched.

  • A chest X-ray to assess the lungs and assess the size of the heart

  • An ECG or electrocardiogram is an electrical reading of the heart that is performed by placing electrode stickers on the skin of the chest wall.

  • Ultrasound of the heart or echocardiogram is a test used to assess the structure and function of the heart. This will determine whether the heart’s squeezing or stretching ability is inhibited.

  • A cardiac MRI can be performed to have a detailed assessment of the heart’s structure and function.

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