Shortness of Breath

There are many possible causes, affecting the heart, lungs, or general health.

Heart-Related Causes

• Heart failure – when the heart is unable to pump blood effectively

• Heart valve disease – such as narrowing or leakage of the aortic or mitral valves

• Abnormal heart rhythms (arrhythmias)

• Angina or coronary artery disease – reduced blood flow to the heart muscle

Lung-Related Causes

• Asthma or COPD (chronic obstructive pulmonary disease)

• Chest infections or pneumonia

• Pulmonary embolism – a blood clot in the lungs

• Lung fibrosis or scarring

Other Causes

• Anaemia (low blood count)

• Poor physical fitness or obesity

• Anxiety or panic attacks

You may also experience:

• A feeling of tightness or heaviness in the chest

• Wheezing or noisy breathing

• A persistent cough

• Swelling of the ankles or legs

• Needing extra pillows at night or waking up breathless

• Fatigue or reduced exercise tolerance

Call 999 or go to A&E immediately if you experience:

• Severe breathlessness at rest

• Chest pain or tightness

• Coughing up blood

• Blue lips or fingertips

• Sudden collapse or fainting

If your breathlessness is mild but persistent, or occurs with activity, arrange an appointment with your GP or cardiologist for further assessment.

When to see your cardiologist?

Your cardiologist will begin with a detailed medical history and examination to understand your symptoms and identify potential causes.
You may be recommended one or more of the following investigations:

• ECG (Electrocardiogram): assesses heart rhythm and electrical activity

• Chest X-ray: checks lung fields and heart size

• Echocardiogram: ultrasound scan of the heart to evaluate its pumping function and valve performance

• Blood Tests: to detect anaemia, infection, or signs of heart strain (BNP)

• Lung Function Tests: assess for asthma, COPD, or other breathing disorders

• CT Scan: in selected cases, to provide detailed imaging of the lungs or heart

Treatment options

Treatment depends on the underlying cause identified during assessment.

Options may include:

• Lifestyle changes: maintaining a healthy weight, stopping smoking, and staying active

• Medication:

  • Diuretics for fluid build-up in heart failure

  • Inhalers for asthma or COPD

  • Heart medicines to support rhythm or function

• Procedures:

  • TAVI or valve surgery for severe valve disease

  • Coronary stenting for blocked arteries

  • Catheter ablation for rhythm disturbances

• Pulmonary Rehabilitation: structured exercise and breathing training for chronic lung conditions

• Oxygen Therapy: for advanced heart or lung disease

Key message

Shortness of breath is a common symptom with many possible causes. While it may be harmless in some cases, it can also signal a heart or lung condition requiring treatment. A prompt and accurate assessment helps identify the cause and ensures you receive the most effective care.