It’s a chilling scenario. An older adult out for a walk experiences shortness of breath, serious enough that he/she decides to save the walk for a later day. However, all too often, once home the individual feels better and so lets the episode pass from memory. The problem is, for some people, this story ends with a sudden Heart Attack — and death — not long after the ill-fated walk. The fact of the matter is, shortness of breath, as a recent study makes clear, is as important a symptom of Heart Disease (and a possible Heart Attack) as chest pain and should prompt an immediate call to the doctor.
The study, conducted in part by Cedars-Sinai Medical Center in Los Angeles, investigated medical records of nearly 18,000 patients who came for cardiac Stress testing and who were then followed for one to four years. It found that patients without known coronary artery disease (CAD) who had shortness of breath were twice as likely to suddenly die from a cardiac cause as patients who had typical Angina (symptoms of pressure, fullness, squeezing or pain in center of the chest, sometimes also in neck, jaw, shoulder, back or arm after exertion). This sad statistic is apparently because people don’t realize that shortness of breath can signal danger and they don’t seek help, says Daniel S. Berman, MD, director of cardiac imaging at Cedars-Sinai, who is a co-author of the study.
When I called him, Dr. Berman explained several important aspects of shortness of breath as a cardiac symptom. First, it is often associated with exertion, coming on during physical activity such as brisk walking. As a cardiac symptom it applies most commonly in older adults who could be considered for possible cardiac risk — usually having one or more of the cardiac risk factors, such as High Blood Pressure and Cholesterol, excess abdominal weight, are over 45, smoke — usually not to a young person without risk factors who may become short of breath while at the peak of exercise. This type of shortness of breath that we are discussing here can be the first manifestation of a CAD symptom, which can occur in both men and women, though usually about 10 years later in women.
If a person has unexplained exertional shortness of breath, he/she should see a physician. There are tests that can be done to determine if the symptom is from the heart and to assess the risk. “We have excellent treatments to prevent heart attacks and cardiac death as long as we identify who is at risk.
The key is to be aware of the risk factors and the symptoms of CAD so that appropriate tests can be done and treatment begun before an event occurs, ” says Dr. Berman.
Bottom line: If you have known CAD or are at risk due to your risk factors, and should you experience unexplained exertional shortness of breath, stop the exercise. Think of this symptom in the same way you would think of exertional chest pain — and ask your doctor what to do.
Hidden Heart Attack Symptom
- Daniel S. Berman, MD, director of cardiac imaging, Cedars-Sinai Medical Center, Los Angeles.
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