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Shortness of breath and fatigue


Shortness of breath or breathlessness may result from numerous causes including problems with the heart or the cardiovascular system. Breathlessness specifically due to heart problems may be as a result of weakness of the heart muscle (most commonly due to coronary disease), narrowed or leaking heart valves or arrhythmias (heart rhythm disorders), most commonly atrial fibrillation.


Shortness of breath caused by arrhythmia

Both slow-pulse and fast-pulse heart rhythm disorders may reduce cardiac efficiency and cause breathlessness. Both types of arrhythmias are more common in patients with pre-existing health problems (such as a previous heart attack, high blood pressure or diabetes) but may also be the first manifestation of a heart problem.

Heart failure

Heart failure is a syndrome which comprises a number of clinical features with breathlessness often as the central, dominant symptom. Heart failure is often caused by an enlarged and weakened heart and there is a wealth of evidence that medication can help to alleviate symptoms and improve prognosis. For many patients further benefit could be gained from implantation of a biventricular pacemaker or an implantable defibrillator or a combined device. These devices and patient suitability are discussed in a separate section here.

Why should I see a specialist at LHRG?

New and insidious breathlessness should be taken seriously. Cardiac causes can often be diagnosed after an initial consultation and some simple non-invasive tests such as an ECG (electrocardiogram) and echocardiogram (ultrasound scan of the heart). The diagnosis and quantification of rhythm disorders may require an ambulatory ECG monitor to tailor treatment appropriately. Treatment options are many and varied and depend on patient's preference and on the nature of the arrhythmia or heart problem. At LHRG we are committed to helping patients make an informed choice about their care. Causes of and treatments for slow-pulse and fast-pulse arrhythmias are discussed in separate sections.

Warning signs

We would particularly recommend early referral to our specialists if you or your patient suffers with new or insidious breathlessness in the context of a known heart disease such as a previous heart attack, coronary artery disease or heart failure, an abnormal ECG, palpitations or previous arrhythmia.

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The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.