There seems to be an uptick in the number of patients coming into the office complaining that they feel “winded” when they try to exercise, climb stairs, or walk (especially on inclines). Feeling short of breath during these activities, called “dyspnea on exertion (DOE)” can be due to many reasons including:
· Weight gain: COVID19 seems to be coming along with “COVID10+.” Due to the closure of gyms, changes in schedules, working from home with more easy access to food and snacks with less walking/commuting, and overall increase in stress, it is easy to gain the “COVID 10.” Many people have gained at least ten pounds since the start of the pandemic and it can certainly cause or contribute to DOE.
· Deconditioning: Along the same lines as weight gain, deconditioning is defined as a loss of physical fitness. During the pandemic, due to lockdowns and working from home, sedentary lifestyles became the norm. Instead of taking subway stairs to work, people could roll out of bed and sit at their desk for their 30-second commute. The general lack of movement and formal exercise over even two months can lead to deconditioning (https://www.verywellfit.com/fitness-use-it-or-lose-it-3120089).
· Coronary Artery Disease (CAD): CAD occurs when one of the three major arteries that supply blood flow to the heart muscle, have plaque buildup. This leads to blocked blood supply to the heart muscle and could lead to shortness of breath. CAD occurs over years due to various factors including high cholesterol (dyslipidemia), high blood pressure (hypertension), diabetes, being overweight/obese, poor nutrition, smoking, stress, or family history of heart disease. A consultation with a cardiologist is the best next step to determine if CAD needs to be ruled out with physical exam, stress testing, etc. For further reading on CAD: https://my.clevelandclinic.org/health/diseases/16898-coronary-artery-disease
· Cardiomyopathy: Cardiomyopathy means disease of the heart muscle and can certainly cause shortness of breath. This can be caused by a multitude of factors including, most commonly, CAD. Other causes include viruses and other pathogens, diabetes, and genetic conditions. Often, your cardiologist will perform an ultrasound of the heart or “Echocardiogram” to visualize and evaluate the heart muscle to rule out cardiomyopathy as the cause of DOE. For further reading on cardiomyopathy: https://www.heart.org/en/health-topics/cardiomyopathy/what-is-cardiomyopathy-in-adults
· Valvular Heart Disease: The heart has four valves that function to allow forward blood flow in the heart. Sometimes, valves can get diseased in a way that they partially or completely lose function leading to blood flowing backwards within the heart. This is called “valvular regurgitation” and can be very mild (“trace or mild”), moderate or severe. Treatment options include medications, procedures to clip the valve reducing regurgitation or open-heart surgery to repair or replace the valve. The opposite of valvular regurgitation is when the valves do not open fully. This is called “valvular stenosis” and can occur due to aging or genetics. In this case, blood is not able to move passed the valve easily and the heart must work harder to pump blood, leading to DOE. Your cardiologist may decide to perform an ultrasound of the heart (echocardiogram) to further assess your heart valves. For further reading on valvular heart disease: https://www.hopkinsmedicine.org/health/conditions-and-diseases/heart-valve-diseases
· Pulmonary Disease: DOE can certainly be cause by an issue with your lungs. Common causes include asthma or Chronic Obstructive Pulmonary Disease (COPD). Speak with your Primary Care Physician, cardiologist, or pulmonologist to see how to rule out pulmonary disease for your DOE.
This list is by no means exhaustive but is a good start on how to understand causes of your shortness of breath. The best thing you can do for you, or your loved one is not to assume a diagnosis but get evaluated by an expert.
For a Cardiology Consultation with Dr. Kedar Sankholkar, please call 212-970-0911 or email him at drs@parkviewcardiology.com.
