What is Cardiac Dyspnea?
Diastolic heart failure is a condition in which the heart’s relaxation function is not normal.
It is one of the two main impediments that cause congestive heart failure, along with systolic heart failure (when the heart can not contract and expel blood normally).
Diastolic heart failure is the root problem in 50% of patients with congestive heart failure and often the reason for shortness of breath in cardiac patients or with dyspnea.
Feeling short of breath can be an uncomfortable or frightening experience, especially if it has never happened before.
It can be caused by problems with the lungs or with the heart, or by a low blood count, but its specific cause can sometimes take a while to be localized.
Luckily, most causes of shortness of breath can be treated quickly once the cause is identified.
Many cases of shortness of breath are caused by simple, short-term problems such as respiratory tract infections or allergies.
The medical term for shortness of breath is cardiac dyspnea.
One of the characteristics of diastolic heart failure is the increase in the pressures on the heart during the period of relaxation or diastole.
Such high pressures again in the lungs and lead to lack of air and fluid accumulation in the lungs, which together characterize congestive heart failure.
Patients with diastolic heart failure do not have symptoms such as swollen legs, inflamed neck veins, and shortness of breath when at rest.
However, they may experience difficulty breathing with exertion due to increased pressure in the heart (dyspnea on exertion).
Risk factors for diastolic heart failure:
- Advanced age.
- Chronic kidney disease.
- Hypertrophy of the left ventricle.
- Obstructive sleep apnea.
A different type of heart failure
Because diastolic heart failure is not as well recognized as other common medical problems, many patients who must be treated for diastolic heart failure are treated inadequately by:
- Complications of chronic lung disease.
- Uncontrolled hypertension or non-specific fluid overload.
Primary care physicians often do not realize that their patients’ lack of air is due to heart failure, because the typical cardiac image reveals the normal ejection fraction (compression function) of the heart.
One of the most important things we can do is increase awareness of diastolic heart failure in the population.
If you have a family member who has persistent difficulty breathing without obvious abnormalities in your lung function or systolic heart function, that patient may have diastolic heart failure.
The lack of acute air, which occurs suddenly, over the course of minutes or hours, usually has different causes than chronic lack of breathing, which develops over weeks or months.
Acute breathlessness – The lack of acute air usually occurs along with other symptoms. The most common causes of acute shortness of breath include:
- Respiratory tract infections, such as pneumonia. These infections usually cause other symptoms, such as fever, cough with sputum or mucus.
- A severe allergic reaction (anaphylaxis), which usually also causes itching, swelling, rash or other symptoms.
- An obstruction in the respiratory tract, which could occur after accidentally inhaling a foreign object, such as a peanut or partially chewed meat.
- A blood clot or other blockage in an artery in the lungs.
- A collapsed lung (pneumothorax).
- Interruptions in blood flow to the heart muscle, which can occur during a heart attack. When this is the cause of shortness of breath, there are often other symptoms, such as pain or pressure in the chest.
- Heart failure, a condition that affects the heart’s ability to pump blood throughout the body.
- Pregnancy changes the circulatory and respiratory systems of a woman, even before the woman is visibly pregnant. This type of shortness of breath is a normal change that occurs during pregnancy.
People describe shortness of breath in different ways.
Some people say they feel “short of breath,” others say they feel as if they “can not breathe deeply enough” and some feel a tight feeling in the chest that prevents breathing.
When you experience shortness of breath, you should pay attention to the sensations you feel and try to be as specific as possible when describing these sensations to your healthcare provider.
If your shortness of breath varies with position, for example, it begins when you are lying down, this can be a clue to certain types of problems such as the accumulation of fluid in the lungs.
Your health care provider can learn a lot about your condition by hearing your description of the problem and asking about any other symptoms you may have.
He or she can also learn a lot by listening to your heart and lungs with a stethoscope, and checking your legs for swelling.
Tests – Your health care provider may also request one or more of the following tests to help diagnose the problem:
- A blood test called a hematocrit can detect anemia, a condition that affects the blood’s ability to carry oxygen.
- A blood test can tell if you have fluid buildup in your lungs.
- A chest x-ray to detect pneumonia, or inflammation or lung scarring.
- An electrocardiogram is a test of your heart muscle that looks for signs of a heart attack.
- A test called spirometry to measure how much air your lungs can hold and how effectively your lungs can empty and fill with air. This test can also tell if you have asthma or emphysema.
- A test called oximetry to measure the amount of oxygen in the blood.
The treatment for your shortness of breath will depend a lot on what it is causing. Shortness of breath caused by asthma, for example, will need a type of treatment, while shortness of breath caused by heart failure will need another solution.