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Breathlessness

Heart related causes of breathlessness

Shortness of breath can be coming from several different organs in our body, one of them is the heart. Breathlessness, is often a distressing symptom that can arise from various underlying cardiac diagnoses. Shortness of breath often triggers several investigations, which can include blood tests, electrocardiogram (ECG)and imaging modalities like echocardiography or cardiac magnetic resonance imaging (MRI).

One of the primary cardiac causes of breathlessness is heart failure. Heart failure. occurs when the heart’s ability to pump blood efficiently is compromised, leading to fluid accumulation in the lungs (known in medical jargon as pulmonary oedema) and peripheral tissues. This fluid overload increases pressure in the lungs, resulting in shortness of breath. Echocardiography plays a crucial role in diagnosing heart failure. by assessing cardiac structure and function. It evaluates parameters such as left ventricular ejection fraction , chamber dimensions, and valvular function. Reduced left ventricular ejection fraction indicative of systolic dysfunction or impaired relaxation pattern suggesting diastolic dysfunction can be identified through echocardiography

Breathlessness
Coronary artery disease , known also as Ischaemic Heart Disease is another important heart related cause of breathlessness. Coronary artery disease results from atherosclerotic plaque buildup within the coronary arteries, leading to reduced blood flow to the heart muscle. Although in classical scenarios coronary artery disease causes chest pain or discomfort on exertion, known as angina shortness of breath can also be a symptom of furring up coronary arteries. This is occurs when demand for oxygen exceeds supply, such as during physical exertion. Investigations such as CTCA (Computed Tomography Coronary Angiography) or traditional coronary angiography help to either confirm or exclude this diagnosis. Significant blockages identified through CTCA or coronary angiography may necessitate interventions like angioplasty, stenting or coronary artery bypass grafting to alleviate symptoms and improve blood flow to the heart.

In addition to this, structural abnormalities of the heart, such as cardiomyopathies or valvular heart disease, can contribute to breathlessness. Cardiomyopathies, including hypertrophic, dilated, and restrictive types, impair the heart’s ability to pump blood effectively. Valvular heart disease, such as aortic stenosis or mitral regurgitation, can lead to volume overload or pressure overload on the heart chambers, ultimately causing breathlessness. Echocardiography aids in the assessment of these structural abnormalities, providing valuable information on chamber sizes, wall thickness, and valvular morphology and function.

To summarise, shortness of breath can occur because of various heart related causes, necessitating a thorough diagnostic approach that often includes ECG, echocardiography, cardiac MRI, and sometimes imaging of coronary arteries. These investigations play complementary roles in assessing cardiac structure and function aiding in the identification of underlying cardiovascular pathology contributing to breathlessness. Early recognition and management of potentially important heart conditions are important in alleviating symptoms, improving quality of life, and reducing the risk of adverse cardiovascular events.

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