hi my name's Sanjay Gupta and i'm a cardiologist and I working in York, today I
thought I'd do a little video on how to try and work out whether your breathlessness
could be due to a problem with the heart or not, the first thing to say is
that breathlessness is a very common symptom and it's also very non-specific
symptoms when someone complains of breathlessness it could mean a variety of
different things, they could just be very unfit, a person could be overweight and
they may not realize that they put on weight and that's caused some breathlessness
in some who have become breathless, you know as people get older they don't actually
realize and when they take on some kind of physical activity but they haven't
done for a little while they noticed breathlessness and these are obviously
don't signify a major problem at all, then there are other causes of breathlessness
predominantly the lungs, that if you have a problem your lungs and that certainly could
cause breathlessness and that's more of a concern in people who are a heavy smokers or people
who have a history of ashma, people who've been exposed to asbestos
and I suppose if you are getting breathless then it is very important you
at least have a chest x-ray because if there's a problem the lungs that most of
the times that there could be a chest x-ray can give you some clues as to
whether or not it is due to the lungs
the next step would be to simply have some lung function tests and in a small
percentage of people breathlessness could be due to small clots going up to
the lung in which case a CT scan
of the chest would question that question from a heart perspective though there are two main
things, the first is the reason people get breathlessness because of problems with
the heart is, the heart is not able to pump out enough blood and if the heart
isn't able to pump out enough blood then there's less oxygen that goes round and
that causes breathlessness so the first thing to say is that you want to know whether your heart is
actually structurally healthy or not as it is
whilst you're at rest is the heart structurally normal or not and the way that,
way one works that out is firstly to have an ECG and secondly to have an
echocardiogram
what does the echocardiogram tell you, the echocardiogram tells you if you have a nice strong heart if it's pumping
at rest, if it's pumping adequately at rest pumping enough to be able to pump
enough blood out
commensurate with the bodies requirements, it will also tell you, the scan will tell you if you have a
problem with any of your hearts valves a lot of the times a heart valve
problem is suspected when a doctor hears a murmer in a patient's complaining of breathlessness
but sometimes you don't hear a murmer and therefore if you are getting breathless then
undoubtedly it is important to have a heart scan, it's also worth saying that it is very very very
rare for someone to get breathless at rest and not be breathless at exercise so if
you are getting that then almost certainly there that does not signify a
major problem with the heart, heart problems are usually worse on exercise, then
at rest so if you have a normal heart scan and it shows that your heart is
actually functionally normal and it's pumping warmly what is the other way
that you could get breathless,
if the heart isn't getting enough blood when you say - start walking - so at on
exercise when the heart isn't getting blood and that would obviously cause
the heart not to pump as well and that would make someone breathless and that's usually,
that usually happens if the heart arteries, the heart arteries that take blood to the heart are
narrowed, ie angina, so a lot of people associated angina with chest
discomfort but in a few cases they could be the only symptom maybe of breathlessness
so I suppose if you are getting breathless the first thing to try and work
out is - is it at rest or is it on exertion, if it is at rest and not on
exertion then it almost certainly doesn't major major problem with the heart, if it is on
exertion then certainly i think you definitely need an ECG and a heart scan
and if your heart scan is normal then your doctor will need to do a
provocative tests ie get the heart beating faster to see if it's getting
all the blood it needs to keep working and that can be done by putting you on the
treadmill by doing something called the stress echocardiogram or even something
called a myocardial perfusion scan
now when the heart is weak at rest that condition is called heart failure ie
the heart is failing to keep up with the bodies requirements and that is usually something
that we would suspect in people who have had a previous heart attack and therefore have a damaged heart or in
people who have been born with a heart problem -
congenital heart disease, the other thing to be aware of in people with heart failure
is they get other symptoms, they get exercise intolerance they get breathless they get very tired and they often
complain that swelling of the legs swelling of the ankles they find that
they often have to sleep with more pillows than normal because they get
more breathless if they are lieing flat in that setting that's very suggestible
of heart failure and its really important to get checked out, so yes and I suppose that's
about it really
for this tutorial, for this video if you have any concerns if you think it's always worth
getting checked out if you would like to know more about me what I do and if
you'd like more information about heart health and heart matters then feel
free to visit my website alternatively you could give me a ring on the phone
number if you would like to get checked by cardiologists I would be delighted to do so I
think I just want to wish you goodnight and thank you very much for listening I
hope this is useful, bye.