Dr. Christopher Quirk

BA Oxon, MA, MBBS Hons, MRCP, FRACP, DDU

Breathlessness PDF Print E-mail
Friday, 27 November 2009 01:06

Breathlessness is one of the most difficult symptoms we have to deal with. The reason for this is breathlessness is subjective, and we all experience breathlessness on certain activities – even Robert Di Costello will get breathless running up a flight of stairs! Therefore, it is more a question of the extent of breathlessness and trying to decide whether the breathlessness is abnormal or whether it is a normal response related to a patient’s fitness, age and exercise capacity. We also forget that exerting ourselves can be strenuous, and one of the commonest symptoms we are presented with is breathlessness on walking up stairs or a hill, but being completely well walking on the flat. Again, this could be a completely normal phenomenon.

 

HOWEVER, it is important in the presence of breathlessness that before putting it down to lack of fitness, that we do rule out an underlying cause for this.

 

Breathlessness can be a manifestation of cardiac or lung disease, for example asthma or bronchitis. Cardiac conditions that lead to breathlessness include blockages of the coronary arteries, weakness of the heart muscle, so called Cardiomyopathies, abnormalities of the heart valves, abnormalities of heart rhythm, high blood pressure and various other non specific heart abnormalities. These all need to be ruled out during investigation for breathlessness. Fortunately, most of these are easily assessed using a conventional exercise test and imaging the heart function using a standard non-invasive Cardiac Ultrasound. On occasions, it may be required to proceed to more invasive testing such as coronary angiography, but your doctor will assess the need for this depending on the results of non invasive cardiac testing.

 

Having ruled out heart and lung disease as the cause of the breathlessness, I am a strong believer that the mainstay of treating breathlessness is a controlled and graded exercise program, which needs to be individualized to the patient, and we would discuss some basic exercise regimes once cardiac abnormalities are ruled out.

 
 
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