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Man clutching chest and coughing, depicting symptoms of illness or respiratory distress in

Breathlessness (Shortness of breath)

Breathlessness, or dyspnea, is the sensation of being unable to breathe comfortably or feeling that your lungs are not getting enough air. It can range from mild discomfort during activity to severe difficulty breathing at rest.
 
While occasional shortness of breath during exercise is normal, breathlessness during minimal activity, at rest, or when lying down may indicate an underlying medical condition that requires specialist evaluation.

Types of breathlessness

Breathlessness can develop over different timeframes, which may provide clues to its cause

Cardiac Causes of Breathlessness

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Heart-related problems are a frequent cause of breathlessness. Inefficient heart function can reduce oxygen delivery to the body, prompting faster breathing, or cause fluid to build up in the lungs. Common cardiac causes include:
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  • Heart failure – reduced pumping efficiency
  • Coronary artery disease (CAD) – restricted blood flow to the heart
  • Heart attack (myocardial infarction)
  • Angina – temporary restricted blood flow
  • Arrhythmias – irregular or rapid heart rhythms, including atrial fibrillation and SVT
  • Cardiomyopathy – disease of the heart muscle
  • Valvular heart disease – e.g., aortic stenosis or mitral valve disorders
  • Post-heart surgery recovery – temporary breathlessness as the heart recovers

Non-Cardiac Causes of Breathlessness

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Not all breathlessness originates from the heart. Other medical conditions can also limit breathing efficiency or trigger a feeling of breathlessness:
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  • Respiratory conditions: asthma, chronic obstructive pulmonary disease (COPD), pneumonia, pulmonary embolism
  • Anaemia – low red blood cell count reduces oxygen transport
  • Thyroid disorders – overactive or underactive thyroid can affect metabolism and heart rate
  • Obesity or deconditioning – reduced fitness can make physical activity feel more strenuous
  • Anxiety or panic disorders – can trigger hyperventilation or the sensation of breathlessness
  • Musculoskeletal issues – rib, diaphragm, or chest wall problems limiting expansion
  • Allergic reactions – severe allergies can cause airway constriction
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Recognising non-cardiac causes is essential to avoid misdiagnosis and ensure the correct treatment plan is implemented.

Assessment and Diagnosis

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During your consultation, we will:
 
  1. Review your symptoms, medical history, and lifestyle factors
  2. Perform a physical examination, including heart and lung assessment
  3. Order tests as appropriate, such as:
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  • Electrocardiogram (ECG) – heart rhythm assessment
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  • Echocardiogram – heart structure and function
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  • Exercise or stress testing – response of heart and lungs to activity
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  • Cardiac MRI – detailed imaging if structural issues are suspected
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  • Blood tests – checking for anaemia, thyroid function, or markers of heart stress
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  • Pulmonary tests – for lung-related causes if needed
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This approach ensures we evaluate both cardiac and non-cardiac contributors to your breathlessness.
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Treatment and Management

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Treatment is tailored to the underlying cause and may include:
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Lifestyle and self-management

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  • Breathing exercises and posture strategies
  • Quitting smoking
  • Maintaining a healthy weight
  • Staying active within safe limits
  • Improving air quality and ventilation
  • Managing stress and anxiety
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Medical and procedural management

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  • Medications to treat heart conditions (beta blockers, diuretics, anti-arrhythmics)
  • Treatments for respiratory conditions (inhalers, oxygen therapy)
  • Interventions for structural heart problems, such as valve repair or coronary procedures
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Recovery plans are personalised to your condition, ensuring your symptoms are relieved and your heart and lung health optimised.

Why Specialist Assessment Matters

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Persistent or unexplained breathlessness may indicate a “silent” heart problem or another underlying condition. Early assessment by a cardiologist ensures:
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  • Accurate diagnosis of heart-related vs. non-cardiac causes
  • Appropriate investigations and monitoring
  • Tailored treatment to relieve symptoms and improve long-term health
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Even mild or intermittent breathlessness deserves evaluation to maintain quality of life and prevent complications.
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