Could My Shortness of Breath Be Caused by Heart Failure?
Shortness of breath is one of the most common health complaints in daily life. Getting out of breath when climbing stairs, tiring quickly when walking, or waking up at night because of shortness of breath can be signs of many different health problems. One of these problems is heart failure.
However, it should be remembered that not every case of shortness of breath means heart failure. Many conditions, such as asthma, COPD, pneumonia, anemia, excess weight, poor physical fitness, thyroid disease, and even anxiety, can also cause shortness of breath. For this reason, it is important to see a doctor to correctly determine the cause of shortness of breath.
What Is Heart Failure?
The term "heart failure" can be misleading for many people. This disease does not mean that the heart has stopped completely or is not working. The heart keeps working, but it cannot pump blood strongly enough to meet the body's needs, or it cannot relax enough to fill with blood. As a result, while the amount of blood reaching the organs decreases, fluid may start to build up in the lungs and in certain parts of the body. This leads to symptoms such as shortness of breath, tiring easily, and swelling in the legs.
Why Does Heart Failure Cause Shortness of Breath?
When the heart's pumping strength decreases or the heart cannot relax sufficiently, blood begins to back up as it passes through the lungs. As a result, fluid can collect in the lung tissue. Fluid buildup in the lungs makes breathing harder, reduces the passage of oxygen into the blood, and causes a feeling of "I can't get enough air." Shortness of breath that at first appears only when walking or climbing stairs may, as the disease progresses, occur even at rest.
What Is Shortness of Breath Due to Heart Failure Like?
Shortness of breath due to heart failure usually shows up in the following ways:
- No longer being able to climb stairs you used to climb easily
- Getting out of breath even on a short walk
- Having to stop frequently when walking uphill
- Having trouble breathing when lying flat
- Sleeping on several pillows to breathe more easily
- Waking up suddenly at night because of shortness of breath
- Breathing becoming easier when sitting up or standing
- These symptoms often develop gradually; however, they can sometimes also worsen rapidly
within a few days.
What Are the Other Symptoms of Heart Failure?
If shortness of breath is accompanied by the following symptoms, the likelihood of heart failure increases:
- Tiring easily
- Feeling weak while doing daily tasks
- Swelling in the feet, ankles, or legs
- Rapid weight gain, such as 2–3 kilograms (about 4–7 pounds) within a few days
- Frequent urination at night
- Palpitations
- Constant fatigue
- Loss of appetite
- Abdominal swelling
- A cough that gets worse, especially at night
- Coughing up white or pink frothy phlegm (in advanced cases)
Who Is at Higher Risk of Heart Failure?
Heart failure is more common in the following people:
- People who have previously had a heart attack
- People with coronary artery disease
- People with high blood pressure
- People with diabetes
- People with heart valve disease
- People with heart muscle disease
- Older adults
- People who are overweight or obese
- People with kidney disease
- People who have had uncontrolled blood pressure for many years
- Does All Shortness of Breath Mean Heart Failure?
No. Shortness of breath can have many different causes. For example:
- Asthma
- COPD
- Lung infections
- A blood clot in the lung artery (pulmonary embolism)
- Anemia
- Thyroid disease
- Excess weight
- A sedentary lifestyle
- Anxiety disorder or panic attacks
For this reason, heart failure cannot be diagnosed based on shortness of breath alone.
How Is Heart Failure Diagnosed?
The doctor will first listen to your complaints in detail and examine you. Then, if necessary, they may order the following tests:
- Electrocardiography (ECG)
- Echocardiography (ultrasound examination of the heart)
- Chest X-ray
- Blood tests
- Blood tests called BNP or NT-proBNP, which show strain on the heart
- When needed, an exercise stress test, cardiac MRI, or coronary angiography
- One of the most important tests in diagnosing heart failure is echocardiography. With this method,
- the heart's pumping strength, the condition of the heart valves, and the way the heart works can be evaluated
in detail.
Can Heart Failure Be Treated?
Yes. Thanks to new medications and treatment methods developed in recent years, many people with heart failure are able to lead active, good-quality lives for many years. Although the treatment plan varies from patient to patient, it may include:
- Heart failure medications
- Reducing salt intake
- Regular physical activity (as recommended by your doctor)
- Quitting smoking
- Controlling blood pressure and diabetes
- Healthy eating
- Losing excess weight
- A pacemaker or other interventional treatments for patients who need them
- Taking medications regularly and not missing doctor's appointments
are very important for successful treatment.
When Should You Go to the Hospital Immediately?
If any of the following symptoms are present, you should seek emergency medical care without delay:
- Severe shortness of breath even at rest
- Being unable to breathe along with chest pain
- Bluish discoloration of the lips or fingertips
- Fainting or feeling faint
- Coughing up pink, frothy phlegm
- Rapidly increasing leg swelling and shortness of breath within a few days
These symptoms may be warning signs of serious heart or lung diseases that require emergency treatment.
What Can You Do to Protect Yourself From Heart Failure?
Although heart failure cannot always be prevented, you can significantly reduce your risk. To do this:
Have your blood pressure checked regularly. If you have diabetes, keep your blood sugar well controlled. Keep your cholesterol at target levels. Do not smoke. Walk or do similar exercise for at least 150 minutes a week. Avoid eating too much salt. Choose a healthy Mediterranean-style diet. Maintain a healthy weight. Take the medications your doctor recommends regularly. Can heart failure be completely cured? Heart failure that develops due to certain causes can resolve completely. In most patients, however, the disease can be brought under control with appropriate treatment, and quality of life can be markedly improved.
Does Everyone With Heart Failure Have a Weak Heart?
No. In some people, the heart's pumping strength is normal; however, heart failure can still develop because the heart cannot relax enough to fill with blood.
Can Heart Failure Be Prevented?
Heart failure is a serious health problem that affects millions of people. However, many people think this disease is inevitable. Yet scientific research shows that a significant proportion of heart failure cases can be prevented.
Heart failure is usually not a disease that appears suddenly. It develops as a result of damage done to the heart over many years by high blood pressure, diabetes, high cholesterol, smoking, heart attacks, and unhealthy lifestyle habits. For this reason, controlling risk factors early can significantly reduce the risk of developing heart failure. Conclusion:
- Shortness of breath can be one of the most important symptoms of heart failure, but it is not the only
- cause. Especially if shortness of breath that starts when walking or climbing stairs, waking up at night
- short of breath, being unable to lie flat, leg swelling, and tiring easily occur together,
- you should definitely see a cardiologist. Today, thanks to early diagnosis and
- modern treatment methods, many people with heart failure are able to lead a long, good-quality
- life. For this reason, it is very important not to ignore shortness of breath by telling yourself "I'm getting older" or "I'm out of shape,"
and to get evaluated early.
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McDonagh TA, et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. ESC Scientific Document Group.Eur Heart J. 2023 Oct 1;44(37):3627-3639. Coccia CB, et al. Dyspnoea: Pathophysiology and a clinical approach. S Afr Med J. 2016 Jan;106(1):32-6. Laviolette L, Laveneziana P; ERS Research Seminar Faculty. Dyspnoea: a multidimensional and multidisciplinary approach. Eur Respir J. 2014 Jun;43(6):1750-62. Pande JN. Evaluation of dyspnoea. Indian J Chest Dis Allied Sci. 1989 Oct-Dec;31(4):239-40 Heidenreich PA, et al 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. ACC/AHA Joint Committee Members. Circulation. 2022 May 3;145(18):e895-e1032.