What is shortness of breath in heart failure and how to relieve it?

Contents:

• What Is Cardiac Shortness of Breath
• What Shortness of Breath Occurs in Heart Failure
• Cardiac Shortness of Breath: Symptoms of the Condition
• What to Do with Cardiac Shortness of Breath
• What to Take for Cardiac Shortness of Breath
• How to Treat Cardiac Shortness of Breath

The feeling of lack of air is often associated with lung diseases, but the cause is not always related specifically to the respiratory system. In many cases, shortness of breath can be one of the first manifestations of impaired heart function, in particular heart failure.

At first, unpleasant sensations appear only during physical activity, but over time they may occur even during regular walking, rest, or sleep. A person gets tired faster, has to stop while moving, and familiar everyday tasks require more effort.

In this article, we will look at what kind of shortness of breath is typical for heart failure, how to distinguish it from other types of breathing disorders, what symptoms to pay attention to, and what to do if your well-being worsens. We will also explain when you should urgently contact a cardiologist and what modern approaches to diagnosis and treatment are used.

What Is Cardiac Shortness of Breath

Cardiac shortness of breath is a breathing disorder that occurs because the heart cannot cope with pumping the necessary volume of blood. As a result, blood may stagnate in the vessels of the lungs, and the body begins to experience a lack of oxygen. It becomes harder for a person to breathe, a feeling of lack of air appears, or there is a need to take deeper and more frequent breaths.

Most often, cardiac shortness of breath develops in heart failure, but it may also accompany other diseases of the cardiovascular system. In the early stages, it usually occurs only during physical activity, and as the disease progresses, it may bother a person even at rest.

Doctors at Oxford Medical recommend not ignoring shortness of breath if it occurs regularly or gradually worsens. Such a symptom may be one of the first signals that the heart is working under increased strain and needs examination.

What Shortness of Breath Occurs in Heart Failure

Heart failure is characterized by shortness of breath that gradually worsens as the disease progresses. At first, it becomes harder for a person to breathe only during physical activity, but over time unpleasant sensations may occur even at rest. An important feature is that the severity of shortness of breath often depends on body position and level of activity.

Cardiac Shortness of Breath During Physical Activity

In the early stages of heart failure, shortness of breath usually occurs during brisk walking, climbing stairs, physical work, or sports. A person notices that a load that was previously tolerated easily begins to require more frequent stops for rest.

Gradually, endurance decreases. If at first shortness of breath appears only with significant exertion, over time it may be triggered by ordinary walking, household chores, or even a slow climb to one floor.

Shortness of Breath at Rest and at Night

As heart failure progresses, it may become difficult to breathe not only during movement but also at rest. For many patients, worsening of symptoms while lying down is typical. Because of this, a person tries to sleep on several pillows or assumes a semi-sitting position.

Sometimes a person wakes up at night because of a sudden feeling of lack of air and has to sit up or stand up to make breathing easier. This condition is considered one of the characteristic signs of progression of heart failure.

How Cardiac Shortness of Breath Differs from Pulmonary Shortness of Breath

Cardiac and pulmonary shortness of breath may feel similar, so it is not always possible to determine the cause independently. However, there are certain differences between them.

Doctors at Oxford Medical recommend not trying to determine the cause of shortness of breath independently based only on sensations. Examinations of the heart and respiratory organs may be needed to establish an accurate diagnosis.

Cardiac Shortness of Breath: Symptoms of the Condition

Manifestations of cardiac shortness of breath may differ depending on the stage of the disease and the degree of impaired heart function. In some people, symptoms appear only during exertion, while in others they occur daily and significantly limit usual activity. It is important to pay attention not only to difficult breathing but also to other changes in well-being that may accompany this condition.

Feeling of Lack of Air

The most characteristic symptom is the feeling that there is not enough air for a normal breath. A person has to breathe more often or more deeply to ease the condition. Sometimes there is a need to stop while walking, take several deep breaths, or open a window for access to fresh air.

Some patients describe this condition as an “inability to breathe in fully” or a feeling of tightness in the chest. The severity of symptoms may change depending on physical activity and body position.

Rapid Heartbeat and Weakness

When the heart works less effectively, the body receives less oxygen and nutrients. Because of this, even usual loads may be tolerated worse than before.

Common accompanying symptoms include:

• a feeling of rapid or irregular heartbeat;

• rapid fatigue;

• general weakness;

• decreased endurance;

• dizziness during exertion.

In some cases, a person notices that it has become harder to perform ordinary household tasks or walk usual distances without rest.

Swelling, Cough, and Other Accompanying Symptoms

As heart failure progresses, other signs related to fluid retention and impaired blood circulation may also appear.

These symptoms include:

• swelling of the feet, lower legs, or ankles;

• increase in body weight due to fluid accumulation;

• dry or low-productive cough that often worsens while lying down;

• a feeling of heaviness in the legs at the end of the day;

• frequent night awakenings due to worsening well-being.

If symptoms occur more and more often or begin to bother you even at rest, medical examination should not be postponed. Timely diagnosis helps establish the cause of shortness of breath and choose treatment that can improve quality of life and prevent complications.

What to Do with Cardiac Shortness of Breath

With cardiac shortness of breath, it is important to reduce the load on the heart, ease breathing, and assess the overall condition. If shortness of breath appeared after physical activity, you need to stop, sit down, and give the body a few minutes to recover. If breathing is difficult at rest or the condition worsens quickly, medical help is needed.

First Aid During an Episode of Shortness of Breath

During an episode of shortness of breath, you should not lie down, because in heart failure this may worsen the feeling of lack of air. According to British Heart Foundation, breathing may be eased by a comfortable sitting position or a position with the upper body raised, as well as slow relaxed breathing.

What can be done during an episode:

• sit with support for the back or arms;

• raise the head and upper body;

• unbutton the collar, belt, tight clothing;

• open a window or move to a well-ventilated place;

• breathe slowly, without sharp and frequent breaths;

• if possible, measure pulse, blood pressure, and oxygen saturation;

• take only those medications that a cardiologist previously prescribed specifically for such situations.

If the episode occurred for the first time, you should not independently take heart medications or blood pressure medicines. Such drugs may have contraindications and affect blood pressure, electrolytes, and heart function, so they must be prescribed by a doctor.

When You Need to See a Doctor Urgently

Not every episode of shortness of breath indicates an emergency condition. However, there are situations when delaying medical help is dangerous, because symptoms may indicate an acute disorder of heart or lung function.

Seek medical help immediately if shortness of breath is accompanied by:

• pain, pressure, or burning in the chest;

• severe weakness;

• fainting or a pre-fainting state;

• bluish lips or fingertips;

• marked difficulty breathing at rest;

• cold sweat;

• sudden worsening of well-being.

Even if the symptoms do not require calling emergency medical services, you should not postpone examination if shortness of breath occurs regularly, gradually worsens, or begins to appear with less exertion than before.

Doctors at Oxford Medical recommend contacting a specialist also in cases when shortness of breath is combined with leg swelling, interruptions in heart function, or if heart murmurs were previously detected during an examination. Such symptoms may be a sign of cardiovascular diseases and require additional examination.

What to Take for Cardiac Shortness of Breath

Many people want to find a medication that will quickly remove shortness of breath. However, with heart diseases, such a universal remedy does not exist. Medications are selected depending on the cause of the symptoms, because difficult breathing may be associated with heart failure, high blood pressure, heart rhythm disorders, or other cardiovascular diseases.

For treatment, the following may be used:

• medications for removing excess fluid from the body in case of swelling and blood congestion;

• medications for controlling blood pressure in hypertension;

• medications for improving heart function;

• medications for treating heart rhythm disorders;

• other medications depending on the established diagnosis.

If shortness of breath is associated with heart failure, the main task is not only to ease breathing but also to control the disease. That is why treatment of heart failure is aimed at reducing the load on the heart, improving blood circulation, and preventing disease progression.

Doctors at Oxford Medical warn: you should not independently take diuretics, heart medications, or increase the dosage of previously prescribed medicines. Incorrectly selected treatment may worsen well-being and affect blood pressure, kidney function, and the body’s water-salt balance.

How to Treat Cardiac Shortness of Breath

The treatment strategy depends on the underlying cause of shortness of breath. To clarify the diagnosis, the doctor may prescribe ECG, echocardiography, blood tests, chest X-ray, and other examinations. If it is necessary to assess the condition of the respiratory system in more detail or exclude other causes of breathing disorders, CT of the chest organs may be recommended.

The treatment strategy for cardiac shortness of breath depends on the underlying disease and the degree of impaired heart function. It may include:

• treatment of the underlying cardiovascular disease;

• medication therapy to improve the pumping function of the heart;

• control of blood pressure and heart rhythm;

• elimination of excessive fluid accumulation in the body;

• correction of lifestyle, nutrition, and level of physical activity;

• treatment of concomitant diseases that may worsen shortness of breath.

According to American Heart Association, effective control of heart failure helps reduce shortness of breath, increase tolerance to physical activity, and improve quality of life. That is why timely treatment of heart failure aimed not only at eliminating symptoms but also at slowing disease progression is important.

The information in the article is provided for informational purposes and is not an instruction for self-diagnosis and treatment. If symptoms of a disease appear, you should consult a doctor.

Sources:

American Heart Association

US National Library of Medicine

NHS