Shortness of breath

Overview: Shortness of breath (dyspnea), is a feeling that one cannot breathe adequately.

Background

Shortness of breath (SOB), also called dyspnea, is common in HCM. It is often described as feeling intense tightening in the chest, difficulty breathing, breathlessness, like "an elephant sitting on your chest", or suffocation. SOB does not always mean that a person is ill. It can occur in a healthy person because of strenuous exercise, extreme temperatures, or high altitudes. Some atmospheric pollutants can also cause SOB.

Shortness of breath occurs when too little oxygen is being taken up through the lungs. It can also occur when too little carbon dioxide is being exhaled. If you are short of breath and it is a new symptom, you need to pay attention to it! If you have been exercising too strenuously you need to rest and breathe. If you are at very high elevation, you need to descend. If you are in temperatures that are unusually hot or cold, you need to seek an environment that is more moderate for you.

More Information

Shortness of breath is common in HCM patients

Many patients report the most burdensome symptom of HCM is living with shortness of breath (SOB). This can cause patients to limit many forms of exercise (e.g., team sports, hiking, biking, etc.). But it can also impact simple activities of daily living such as ironing, house cleaning, and getting dressed. Patients report becoming winded walking to the mailbox or making a bed. Some report that it feels like a constriction around their chest.

The most commonly seen misdiagnosis associated with HCM is asthma, specifically 'athletically induced asthma" as a first sign or symptom. This is likely due to transient shortness of breath often seen in HCM.

Having shortness of breath that is new to you?

If you are short of breath and it is new to you, but none of these obvious causes applies, you should seek medical attention. There are medical reasons other than HCM that can cause SOB.

Acute shortness of breath (SOB that comes on suddenly) can be due to these symptoms, among others:

heart or lung problems

severe allergic reaction

asthma

carbon monoxide poisoning

cardiac arrhythmias

COPD

COVID-19

heart attack

heart failure

Acute SOB at rest is also a common symptom of HCM. Chronic shortness of breath (SOB lasting weeks or longer) is often caused by asthma, COPD, other heart problems, pleural effusion (fluid around the lung) or obesity.

What can you do to keep it from getting worse?

To keep chronic shortness of breath from progressing, some steps you can take include the following.

Stop smoking. If you don't smoke, don't start. If you already smoke, quit. Smoking is the leading cause of COPD which can then lead to shortness of breath. Quitting, or avoiding smoking, can slow disease progression and complications.

Avoid pollutant exposure. Try to avoid breathing allergens and environmental toxins as much as possible as they can aggravate shortness of breath.

Avoid extreme temperatures and altitudes. Extreme temperatures and altitudes can increase shortness of breath caused by lung disease. If you are traveling to areas with these situations, make sure you adjust yourself gradually to temperature and altitude and avoid exertion until you do.

Exercise regularly. Exercising can help improve the ability to tolerate activity and condition your body.

Take prescribed medications. Skipping medications used in treating conditions can lead to poorer control of shortness of breath.

Check your equipment regularly. If you use supplemental oxygen, make sure you have an adequate supply and that the machinery works properly.

Mayo Clinic. (2020, July 13). Shortness of Breath. Shortness of Breath - Mayo Clinic. Retrieved November 1, 2020, from https://www.mayoclinic.org/symptoms/shortness-of-breath/basics/definition/sym-20050890

HCMA 6/2021