Experiencing Shortness of Breath and Wondering Why?
Shortness of breath is a common symptom, described as a feeling of "not getting enough air," that can appear when climbing stairs, walking, or sometimes even while sitting. Behind this symptom, which can involve many different systems, there may be lung, heart, blood-value, or other causes. In this article we look at the possible heart-related causes of shortness of breath and when EECP comes into the picture.
Shortness of Breath Can Have Different Causes
Shortness of breath can result from lung diseases such as asthma and COPD, blood problems such as anemia, conditions such as anxiety or panic attacks, and various heart diseases. For this reason, shortness of breath on its own is not a diagnosis but a symptom whose underlying cause must be investigated. It is not possible to plan treatment without identifying the correct cause.
Coronary Artery Disease and Exertional Shortness of Breath
When the coronary arteries are narrowed, the heart muscle may be unable to meet its increased oxygen demand during exertion. In some patients this shows up as shortness of breath on exertion, either instead of or together with classic chest pain. In particular, shortness of breath that is new, has never occurred before, or is gradually worsening is a finding that requires cardiology evaluation.
Heart Failure and Shortness of Breath
In heart failure, the heart cannot pump the amount of blood the body needs; this can lead to fluid buildup in the lungs and shortness of breath. Shortness of breath due to heart failure usually increases with exertion and in some patients also becomes noticeable when lying flat. This condition must be evaluated by a cardiology specialist and an appropriate treatment plan created.
Persistent Shortness of Breath After Stent or Bypass
After a stent or bypass procedure, some patients may continue to have shortness of breath. The cause may be narrowing in small vessels that were not treated during the procedure, diffuse coronary disease, microvascular circulation problems, or accompanying heart failure. In such a case, the cause should first be clarified, and then appropriate treatment options evaluated.
Why Is the Right Diagnosis Important in Shortness of Breath?
Distinguishing whether shortness of breath is of heart origin or due to the lungs, blood values, or another cause is critical for planning the right treatment. For this reason, a person experiencing shortness of breath is advised to first undergo a comprehensive medical evaluation and, if necessary, to be assessed jointly by cardiology and pulmonology specialists.
When Can EECP Be Considered for Shortness of Breath?
EECP is not an independent treatment for shortness of breath, and shortness of breath alone is not an indication for EECP. However, if the cause of the shortness of breath is a cardiac condition for which EECP is considered, such as coronary artery disease or ischemic heart failure, and symptoms continue despite current cardiac treatments, EECP may be evaluated by the cardiology team as a complementary option. In the PEECH trial, improvements in exercise duration and quality of life were reported after EECP in patients with chronic heart failure.
Source: Feldman AM et al. "Enhanced External Counterpulsation Improves Exercise Tolerance in Patients With Chronic Heart Failure." Journal of the American College of Cardiology, 2006;48(6):1198-1205. PMID: 16979005.
Note: This content is for general information only and is not a substitute for medical advice. For shortness of breath that starts suddenly, is severe, or occurs with chest pain, seek emergency medical care without delay.
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