When Does Shortness of Breath Signal a Potential Heart Problem?

 It’s pretty well-known that chest pain is a possible sign of heart trouble—but it’s far from the only sign. Shortness of breath—which can feel like you’re exerting yourself more than you’re used to—is another big one to pay attention to, because it can signal heart valve disease, heart attack, and heart failure, among other cardiovascular issues.

Shortness of breath, also called dyspnea, can be characterized in a bunch of different ways: You may have difficulty breathing, or feel “air hunger” (a.k.a. severe breathlessness), a sensation of suffocation, or intense tightening in your chest.

According to the Mayo Clinic, most cases of shortness of breath can be linked to either a heart or lung issue. This is because the heart and lungs help carry oxygenated blood to tissues throughout the body, and they also help remove carbon dioxide from your system. Problems with either function can impact your ability to breathe.

Someone who’s generally healthy might feel short of breath while exercising or when spending time in extreme temperatures or high altitudes, especially if you haven’t been exercising much lately. Shortness of breath isn’t a symptom you should ignore, especially if it feels intense and comes on suddenly. Here’s what you should know.

First, what types of heart problems cause shortness of breath?

Heart valve disease

The heart has four valves, which help blood flow in the right direction within the heart and onward to other parts of the body. If one or more of the valves doesn’t work properly, this can cause problems with blood flow, per the US National Library of Medicine.

Heart valve issues typically appear in one of two ways: One or more valves stiffen up and they don’t open correctly, or they don’t close correctly, Hal Skopicki, MD, PhD, chief of cardiology and codirector of the Stony Brook Heart Institute in New York, tells SELF. When the valves don’t operate as they should, blood can back up against the lungs and trigger shortness of breath. Over time this puts strain on the heart and can ultimately lead to heart failure, a condition in which the heart cannot pump a sufficient amount of blood to other vital organs.

Heart muscle problems

“Another way that the heart can cause a person to be short of breath is when the muscle itself is having problems ejecting blood out in the forward direction,” Dr. Skopicki says. People with heart muscle dysfunction, also known as cardiomyopathy, may experience a thickening, weakening, or stiffening of the heart muscle that can affect the organ’s ability to pump blood. A variety of health issues can set the stage for heart muscle problems, including heart disease, endocrine diseases, alcohol addiction, viral infections, and certain types of chemotherapy and radiation, among other factors, per the Centers for Disease Control and Prevention (CDC).

Some pregnant people who are otherwise healthy may develop cardiomyopathy during or after pregnancy. “It’s important to not just assume that breathlessness is normal for pregnancy,” Stacy Rosen, MD, cardiologist and vice president of women’s health at the Katz Institute for Women’s Health at North Shore-LIJ Health System, tells SELF. Preexisting heart issues can also become apparent for the first time during pregnancy, Dr. Rosen says.

Issues with the heart’s electrical system

Normally, electrical signals help regulate your heartbeat. When these signals don’t fire properly, it can cause the heart to beat irregularly (arrhythmia), really quickly (tachycardia), or too slowly (bradycardia) without explanation, per the Mayo Clinic. Sometimes an irregular heartbeat doesn’t cause any noticeable symptoms. Other times it can make you feel short of breath, Dr. Skopicki says.

Blockages in the arteries

Coronary artery disease, also known as coronary heart disease or ischemic disease, develops when the arteries—the major blood vessels that flow oxygen-rich blood to your whole body—can’t send enough blood, oxygen, and essential nutrients to your heart. It’s the most common form of heart disease in the US, per the CDC.

Again, reduced blood flow to the heart (no matter the cause) can potentially cause shortness of breath. Blockages in the arteries can happen slowly over time; when the arteries are completely blocked, a heart attack can occur.

When does shortness of breath signal a potential heart problem?

Cardiovascular issues that lead to shortness of breath can appear suddenly or develop gradually over time. A few factors can help you figure out if your heart is struggling:

1. You’ve noticed other potentially concerning symptoms.

How is your body feeling? If you’re dealing with a heart rhythm problem, for example, you may feel heart palpitations, a sense of anxiety, lightheadedness, chest pain, or extreme fatigue. Meanwhile, “shortness of breath from heart failure will often be seen with leg swelling or breathlessness when you lie down at night,” Dr. Rosen says. Artery diseases may also spur chest pain and heaviness in the chest, along with breathlessness, he adds.

Generally, if you’re feeling any chest pain, tightness, or pressure that’s associated with shortness of breath, you should be evaluated by a doctor as soon as you can, Dr. Skopicki says. Pain, numbness, or weakness in your arms or legs, as well as pain in your jaw, neck, or throat are also red flags if you’re already feeling short of breath. (It’s also crucial to note that you may not notice any symptoms at all—and women tend to experience nontraditional heart-related symptoms.)

2. You’re not exerting yourself when shortness of breath hits.

Pay attention to when, exactly, you experience shortness of breath. Is it during a strenuous workout, or when you’re very clearly exerting yourself more than you’re used to? Or does it happen when you’re definitely not pushing your limits at all? While some heart conditions can make you feel more short of breath than usual when you’re walking or climbing a set of stairs, they can also make you feel breathless when you lay down at night, Dr. Rosen says.

If shortness of breath happens when you’re clearly not exerting yourself, when you’re doing something you normally could do without feeling winded, or comes on suddenly, those are warning signs that a heart issue could potentially be to blame.

3. You already have an elevated risk of heart disease.

If you’re trying to figure out whether shortness of breath is a cause for concern, it’s important to consider whether you have certain risk factors that heighten your susceptibility to cardiovascular issues, Dr. Skopicki says. These include pregnancy, smoking cigarettes, or having high blood pressure (a.k.a. hypertension), diabetes, high cholesterol, kidney disease, or a history of heart attack or other heart issues (including being born with a heart condition).

A lack of exercise or your diet may also play a role, per the CDC, but these factors are complicated and require careful consideration of a person’s circumstances.  Talk to your doctor about your heart disease risk; they’ll carefully consider your medical history and discuss anything you should be aware of during your annual checkups.

When should you see a doctor about shortness of breath?

If your symptoms come on suddenly and are affecting your ability to go about your everyday activities, head to the emergency room ASAP. The acute onset of shortness of breath could be caused by anything from a severe allergic reaction to a blood clot in the lungs, Dr. Rosen says.

You also shouldn’t ignore persistent symptoms that feel less severe—remember, many heart issues can develop slowly over time. “Many of us have a tendency to minimize symptoms,” Dr. Rosen says. “Listen to your body; if something doesn’t feel right, then get it checked out.”

This could mean heading to an ER or urgent care center, or visiting a primary care doctor for a checkup, depending on how urgent the situation feels. The important thing is to seek medical care if you’re experiencing shortness of breath you just can’t explain, or if a voice in your head is letting you know things just don’t feel right. As Dr. Rosen puts it: “You’re never too young or too old to be thinking about heart disease if you’re having shortness of breath.”

 

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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