Harvard Heart Letter

Ask the doctor: Is my breathlessness a heart or lung problem?

Ask the doctor

Is my breathlessness a heart or lung problem?

Q. I had a quadruple bypass seven years ago and felt fine until recently. A few months back I found myself taking frequent short breaths when I climbed the stairs in my home. Once I stopped exerting myself, my breathing soon returned to normal. Is this due to a problem with my heart or my lungs?

A. While your shortness of breath could be due to a lung problem like bronchospasm, you and your doctor should look first at your heart to see if your heart's pumping function has deteriorated. I would recommend getting an echocardiogram to check the size of your left and right ventricles and their ability to pump. If your heart's size and function look normal, or close to it, consider getting an exercise test to see if your heart is developing ischemia (inadequate blood flow) with exertion. While the classic symptom of ischemia is the chest pressure we call angina, many patients experience shortness of breath instead.

— Thomas Lee, M.D.Editor in Chief, Harvard Heart Letter

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