Understanding Breathlessness
Breathlessness is a common symptom that may arise from a broad spectrum of cardiac, pulmonary, or systemic conditions. It is characterised by an uncomfortable awareness of one’s own breathing and can range from mild exertional limitation to distressing breathlessness at rest.
From a cardiological perspective, breathlessness is a key indicator of conditions such as heart failure, valvular heart disease, heart rhythm abnormalities and coronary artery disease. Dr Navin Chandra specialises in identifying cardiac causes of breathlessness and developing targeted management strategies to improve patients’ symptoms and quality of life. Accurate diagnosis is essential, as the treatment of breathlessness differs substantially depending on its underlying cause.
Symptoms
- Shortness of breath during everyday activities
- Breathlessness when lying flat (orthopnoea)
- Waking at night due to breathlessness (PND)
- Reduced exercise tolerance or fatigue
- Wheeze or a feeling of chest tightness
- Swollen ankles alongside breathlessness
Common Cardiac Causes
- Heart failure (systolic or diastolic)
- Atrial fibrillation and other arrhythmias
- Aortic or mitral valve disease
- Coronary artery disease
- Pulmonary hypertension
- Pericardial effusion
Diagnostic & Treatment Options
Dr Chandra employs a methodical diagnostic pathway to identify or exclude cardiac causes of breathlessness. This typically begins with clinical assessment and is supplemented by targeted investigations to provide a definitive diagnosis as efficiently as possible.
- Blood testing (e.g. full blood count, renal function, thyroid function, cardiac biomarkers including Troponin & NT-proBNP)
- Prolonged heart rhythm monitoring (from 24hr up to 7 day Holter monitoring)
- Comprehensive trans-thoracic echocardiography
- Cardiopulmonary exercise testing
- Heart failure medication optimisation
- Device therapy (CRT, ICD) where appropriate
- Valve disease surveillance and intervention planning
- Pulmonary hypertension investigation pathway
Frequently Asked Questions
Is breathlessness always a sign of heart disease?
Not necessarily. Breathlessness can be caused by conditions affecting the lungs, blood, thyroid, and other systems, as well as being related to deconditioning or anxiety. However, cardiac causes must be considered and excluded where appropriate, as early identification of heart failure or valve disease significantly improves outcomes. Dr Chandra’s evaluation provides clarity on whether the heart is a contributing factor.
What is heart failure and can it be treated?
Heart failure is a condition in which the heart cannot pump blood as efficiently as required. It does not mean the heart has stopped; rather, it is not meeting the body’s demands. Modern heart failure treatments are highly effective — many patients experience significant improvement in symptoms and exercise capacity with the right combination of medication, lifestyle changes, and cardiac device therapy. Dr Chandra has considerable expertise in managing this condition.
How long will I wait for investigation results?
Dr Chandra aims to provide patients with investigation and results as promptly as possible. An ECG and point-of-care blood tests can often be interpreted at the time of consultation. Echocardiography reports are typically available within 24–48 hours. Dr Chandra or a member of the clinical team will discuss all results with you directly.
Do you see patients from outside Ascot?
Yes. Dr Chandra’s practice at The Parkside Suite, Heatherwood Hospital welcomes patients from across Berkshire and Surrey (including Windsor, Bracknell, Slough, Maidenhead, Gerrards Cross, Beaconsfield). Travel and parking are straightforward at The Parkside Suite, Brook Avenue, Ascot SL5 7GB.