Are You Experiencing Shortness of Breath and Wondering Why?
Shortness of breath is a common symptom that can occur when climbing stairs, walking, or sometimes even while sitting, described as the feeling of "not getting enough air." This symptom can involve many different systems, and its underlying cause may be the lungs, the heart, blood values, or other factors. In this article, we look at the heart-related causes of shortness of breath and when EECP comes into consideration in this context.
Shortness of Breath Can Have Different Causes
Shortness of breath can result from lung diseases such as asthma and COPD, blood value issues such as anemia, conditions such as anxiety or panic attacks, and various heart diseases. For this reason, shortness of breath is not a diagnosis in itself, but a symptom whose underlying cause needs to be investigated. It is not possible to plan treatment without first determining the correct cause.
Coronary Artery Disease and Exertional Shortness of Breath
When there is narrowing in the coronary arteries, the heart muscle may be unable to meet the increased oxygen demand during exertion. In some patients, this can present as shortness of breath brought on by exertion, either instead of or alongside classic chest pain. In particular, shortness of breath that is new, has never occurred before, or is gradually increasing is a finding that requires a cardiology evaluation.
Heart Failure and Shortness of Breath
In heart failure, the heart cannot pump enough blood to meet the body's needs, which can lead to fluid buildup in the lungs and shortness of breath. Shortness of breath related to heart failure typically increases with exertion, and in some patients becomes more pronounced while lying flat. This condition must always be evaluated by a cardiologist, who can develop an appropriate treatment plan.
Persistent Shortness of Breath After Stent or Bypass
In some patients, shortness of breath can persist after a stent or bypass procedure. This may be due to narrowing in smaller vessels not addressed during the procedure, diffuse coronary disease, microvascular circulation issues, or accompanying heart failure. In such a case, first clarifying the cause and then evaluating the appropriate treatment options is necessary.
Why Correct Diagnosis Matters in Shortness of Breath
Determining whether shortness of breath is heart-related 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, a joint evaluation by cardiology and pulmonology specialists.
When Can EECP Be Considered for Shortness of Breath?
EECP is not a standalone 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 persist despite existing cardiac treatments, EECP may be considered by the cardiology team as a complementary option. The PEECH study reported improvements in exercise duration and quality of life following 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 informational purposes only and is not a substitute for medical advice. If you experience sudden-onset, severe shortness of breath, or shortness of breath accompanied by chest pain, seek emergency medical care without delay.
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