Getting to the heart of breathlessness
Breathlessness from exertion in exercise is quite normal, until it is not. Many people experience a marked change in their breathing at some stage in their lives. Goodness Me finds out what to look out for and when to seek medical help if you are experiencing breathlessness.
The medical term from breathlessness is dyspnoea. It may involve a feeling of being short of breath or difficulty with breathing. Sometimes people experience acute episodes of breathlessness, while others will notice it creep up over time. It occurs when the body needs more oxygen.
According to Epworth cardiologist Dr Iefan Lim, the best indicator of breathlessness that may require attention is when you have a change in your exercise capacity.
“This might meant that you are exercising as normal, but can’t get your breath back within the usual time or recover as quickly,” Iefan says.
“People who experience breathlessness may still be fit and then find that their normal exercise routine triggers episodes of breathlessness.
“We also see people who are breathless while at rest, or people finding it hard to get through their regular daily routine without getting breathless.”
He says that the older you are the more likely you are to experience exercise-induced breathlessness.
Some of the associated symptoms that may indicate a problem include swollen ankles, or waking up and gasping for air – known as paroxysmal nocturnal dyspnoea.
Your GP is the best place to start, who may refer you for an Electrocardiogram (ECG) to check for any underlying arrhythmia, an Echocardiogram (Echo) to look for heart valve or muscle dysfunction, or directly to a cardiologist.
You may have a stress Echo – either on a treadmill or a bike – to put your heart through its paces when you are in exercise mode to see if there is any change in heart function after exercise. Lung function tests are also commonly ordered for patients experiencing breathlessness.
Iefan says the kinds of underlying problems leading to breathlessness include coronary disease, heart failure, valve problems or lung disease.
“Treatments can include medications such as ace inhibitors, beta blockers or diuretics, lifestyle changes, or angioplasty or bypass surgery in the case of any coronary disease or valve intervention if there are valve problems,” Iefan says.
“Cardiologists often work closely with respiratory physicians where patients are smokers or have exposure to smoke, or have sleep apnoea or signs of lung disease.”
Some of the preventive measures people can take include exercise, weight management and smoking cessation.
“Where there is no sign of any underlying heart issue, we encourage people to push through the initial barrier where they experience breathlessness to increase their exercise tolerance,” he says.
If you have any concerns around your health, and particularly your heart - raise these with your GP.
If you suspect you're having a cardiac event, call 000 and visit your nearest Emergency Department.
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