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Breathing Problems & the Heart

Also called: Dyspnea & the Heart

- Summary
- About shortness of breath
- Heart-related causes
- Other causes
- Treatment options
- Prevention methods
- Questions for your doctor

Reviewed By:
Sumit Verma, M.D., FACC
Abdou Elhendy, MD, PhD, FACC, FAHA
David Slotnick, M.D.

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About shortness of breath

Also known as dyspnea, shortness of breath is the feeling that one is not getting enough air. It may leave the person gasping. The person may want/need to breathe in more rapidly (tachypnea), deeply, or to blow out more completely. The individual may also feel the need to stop moving, sit down or lie down to catch the breath. Shortness of breath is sometimes described by patients as “hunger for air” or “chest tightness.”

Shortness of breath occurs when the heart or the lungs (or both) are unable to exchange enough carbon dioxide for oxygen. As a person inhales, oxygen enters the lungs. The air is then transported by red blood cells to the heart and distributed throughout the body. Red blood cells exchange fresh oxygen for carbon dioxide, which is a waste product, and the heart then transports this waste gas to the lungs to be expelled when the person exhales. If any part of this system is compromised, shortness of breath may result.

Any heart disease patient who suddenly feels short of breath for no apparent reason is urged to seek medical attention immediately.

Heart-related causes of shortness of breath

Shortness of breath may be due to an underlying cardiovascular or lung condition, such as the following:

Heart failure. A serious chronic condition in which the heart does not pump enough to meet the body’s need for oxygen. Shortness of breath is one of the earliest symptoms of heart failure.
Valvular heart disease (e.g., valvular stenosis or valvular regurgitation). This condition may occur in any of the four valves of the heart: the aortic valve, the mitral valve, the tricuspid valve or the pulmonary valve. Normally, these valves allow blood to flow in only one direction and only at the right time during a heartbeat. Valvular heart disease can lead to blood flow being restricted due to a narrowed valve (stenosis), or blood flow leaking in the wrong direction (regurgitation). Shortness of breath can occur as a result of the restricted or misdirected blood flow.

Valvular regurgitation is when one or more of the heart's valves allow blood to leak backward.

Valvular stenosis is the narrowing, stiffening, thickening, fusion or blockage of a heart valve.

Coronary artery disease. This is a chronic disease in which there is a “hardening” (atherosclerosis) of the arteries on the surface of the heart. These arteries supply the heart with fresh, oxygen-rich blood. Atherosclerosis causes the arteries to become so narrowed and stiff that they block the free flow of blood. This reduced blood flow can cause shortness of breath.
Disease of the heart muscle (e.g., cardiomyopathy. Any disease of the heart muscle will decrease the heart's ability to effectively pump blood to the lungs and the rest of the body. Shortness of breath is one result.
Increased stiffness of the heart (diastolic dysfunction), resulting in increased pressure within the heart and the lungs. This is related to hypertrophy of the heart, diabetes mellitus, coronary artery disease and certain types of cardiomyopathy.
Cardiac tamponade. An emergency condition involving rapid buildup of fluid in the pericardium (the sac surrounding the heart).
Deep vein thrombosis and embolism, including pulmonary embolism.

Among women, shortness of breath may be an important warning symptom of heart disease or impending heart attack. Women tend to experience the symptoms of heart disease (such as angina) differently from men. Women who experience unusual fatigue or shortness of breath, even without angina, may be suffering from coronary artery disease. Men having a heart attack may also experience shortness of breath or shallow breathing, with or without chest pain.

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Review Date: 03-21-2007