Breathlessness: Heart related or lungs related?

Chest pain is commonly understood as the only sign of heart attack. However, it is far from being the only sign. Shortness of breath- wherein you can feel that you are exerting too much to breath, you face a hunger for air and feel suffocated is a big one you should pay attention to.

Breathlessness is a major indicator of heart disease as well as lung disease. Both heart and lungs are responsible for carrying oxygenated blood across the body and also help remove carbon-di-oxide from the system. Therefore, any impairment in their function impairs our ability to breathe well.

If you have been exercising for a while and your body is used to this intensity, feeling breathlessness can be cause of concern. However, if you are exercising after a long time and suddenly start feeling short of breath, it is completely alright as your body is not used to any kind of exercise and is trying to pace up.

When is shortness of breath heart related?

  1. Shortness of breath due to cardiovascular risk can appear gradually or over time. There are a few signs that will indicate if it is happening due to a heart condition.
  2. If there is a swelling in your legs, you feel more breathless while laying down, it is a potential sign of a heart failure.
  3. If breathlessness is also associated with chest pain, tightness or pressure in chest, jaw and back pain, it should be evaluated immediately by a cardiologist.
  4. Notice the time when you feel short of breath, is it when you are exerting yourself beyond every day or you are feeling short of breath without any change in activity and doing almost nothing. If it’s the second case, you may be at a risk of a heart disease.
  5. Understand your risk factors like obesity, smoking, age, alcohol intake, family history. If you have any of these, shortness of breath should be evaluated by a cardiologist as the risk factors increase the risk of it happening.

When is shortness of breath lung related?

  1. Sudden breathlessness could be an asthma attack. This means your airways have narrowed and you’ll produce more phlegm (sticky mucus), which causes you to wheeze and cough. You’ll feel breathless because it’s difficult to move air in and out of your airways.
  2. Pneumonia also causes shortness of breath. Antibiotics can help heal the infection.
  3. COPD patients are likely to feel breathless. COPD causes obstruction in the lungs and makes it hard for patients to breathe. Cough, wheezing and mucus are associated with breathlessness.

Chest Pain: Different causes and how to differentiate

What is Chest Pain?

Chest pain is like a sharp excruciating pain around the chest. It may level down to your arms or towards your neck or jaw. Most patients feel it like tightness and pressure in the chest that also feels like something is crushing the chest. This may be felt for a few minutes to few hours or months.

What causes Chest Pain?

When you have a chest pain, you link it to a heart attack. However, there is other less serious causes of chest pain than heart attack like muscle related, stomach related and lung related.

1. Heart related causes of chest pain

The following are termed as heart related causes of chest pain:

a. Heart attack: When supply of blood to the arteries is compromised, it leads to a heart attack and the most common sign is a chest pain.

b. Angina: This is caused by blockage in the blood vessels that connect to the heart, causing severe chest pain.

c. Pericarditis: It is the inflammation in the tissues surrounding the heart. This condition can be mild or life threatening if not treated on time.

d. Myocarditis: This is mostly caused by a viral infection that leads to inflammation of the heart muscles. This inflammation reduces the ability of the heart to pump blood and can lead to severe chest pain.

e. Cardiomyopathy: This is a disease of the heart muscles that make it difficult for the heart to pump blood.

f. Aortic dissection: An aortic dissection is a serious condition in which a tear occurs in the inner layer of the body’s main artery (aorta). Blood rushes through the tear, causing the inner and middle layers of the aorta to split (dissect). If the blood goes through the outside aortic wall, aortic dissection is often deadly.

2. Gastrointestinal causes of chest pain

a. Heart burn or acid reflux: It appears like a discomfort or a chest pain that happens when acid runs through the tube that carries food. It may appear as chest pain along with an acidic taste in your mouth which is a common differentiator from a heart attack.

b. Esophagitis: When stomach acids start filling up the esophagus, it may lead to difficult and painful swallowing and intensive chest pain.

c. Gallstones: Gallstones may create pain in upper abdomen, back pain and chest pain. Gallstones that causes pain should immediately be removed.

3. Lung related causes of chest pain

a. Pneumonia: Leads to chest pain that worsens with breathing.

b. Viral bronchitis: Leads to soreness around the chest that results in chest and muscle pain.

c. Pneumothorax: It is caused by a leak of air between the walls of lungs and chest, which causes a sudden chest pain.

d. Blood clot: This causes a shap excruciating pain that worsens as you breathe.

e. Bronchospasm: Gives a feeling of chest tightness and pressure in chest area.

4. Muscle or bone related causes of chest pain

a. Costochondritis: In this condition, the cartilage that connects the ribs with the breast bones become inflamed and causes chest pain.

b. Sore ribs

How to identify if chest pain is heart related:

If you notice one of more symptoms from below mentioned, it is a sure shot sign of a heart attack or heart disease. Reach emergency immediately in case of these symptoms.

• Discomfort, pressure, heaviness, tightness, squeezing, or pain in your chest or arm or below your breastbone.
• Discomfort that goes into your back, jaw, throat, or arm.
• Fullness, indigestion, or a choking feeling (it may feel like heartburn).
• Sweating, upset stomach, vomiting, or dizziness.
• Severe weakness, anxiety, fatigue, or shortness of breath.
• Fast or uneven heartbeat.

Delhi doctors use world’s smallest heart pump to save 70-years-old’s Life

NEW DELHI: A 70-year-old man, who had multiple calcified blockages in all three arteries of his heart and was suffering from multiple comorbidities including diabetes, hypothyroidism, and dyslipidemia, was given a new lease of life after doctors at Max hospital in Delhi’s Shalimar Bagh used world’s smallest heart pump, an Impella device, to help maintain his blood flow during a high-risk protected angioplasty performed on him.

After six hours and stabilisation of the patient, the Impella device which is used to support the heart’s function during the critical procedures, was removed and the functioning of all his vital organs was normal. The patient was discharged after four days.

He has now recovered completely and is leading a normal life, with his heart functioning at 40 per cent, the doctors said.

“We did angioplasty even when all his three blood vessels were blocked and the heart functioning was at just 10 percent. Bypass surgeons had denied him surgery in 2022. The patient landed up with a blood pressure of just 80 systolic along with severe breathlessness and chest pain,” Dr. Naveen Bhamri, Director and HOD- Cardiology, Max Shalimar Bagh, said, adding that two complex angioplasty were performed within a span of 40 minutes only.

The uniqueness of this case was that four stents were implanted in the bifurcation region and it raised the patient’s heart function to 40 per cent.

“It reflects that his heart had a viable myocardium (heart muscles were alive) but his heart function dropped to 10 percent due to inadequate blood supply,” Dr Bhamri, explained, adding that Impella helped them in giving hemodynamic support (to maintain mean arterial pressure to ensure end-organ perfusion and decrease myocardial oxygen demand while maintaining or increasing the cardiac output) to do such a complex angioplasty.

According to doctors, Delhi-based Rajendra Kumar Basoya came to the hospital in a state of shock with complaints of shortness of breath along with chest pain from almost 10 days and was also underweight around 48kg.

“Upon investigation, we found that the patient had triple vessel disease with left main disease and calcified LAD diagonal and a heart function of 10% only,” the doctor said.

In such cases, CABG OR Bypass surgery (very high risk due to poor heart function and frail elderly) or Multi-vessel angioplasty with mechanical circulatory support is effective therapy as an alternative to surgical revascularization in selected patients with triple-vessel coronary artery disease.

Simple ways to Check your Heart Health

Heart diseases is the number one cause of death in men and second most common cause in women. The symptoms of heart diseases take time to show. It is always advisable to take preventive steps, before a disease gets aggressive on our body and understand the changing symptoms that your body tells you.

We know our own bodies best and do notice and understand the changes they show. For example, if a person can climb stairs comfortably but appears to huff more over time, this could be an indication of heart disease.

Awareness and acceptance are the keys. Knowing what indicates a heart disease and accepting that your body is progressing towards it, can save you from the potential damage.

It is recommended that you visit a cardiologist and discuss the changes and symptoms that you may observe. Your cardiologist will prescribe some tests that can easily find out the cause of the changes and the intensity of the same.


Your cardiologist will first check your heartbeat. This involved checking the number of times your heart beats in one minute. This is important, as it helps in understanding the functioning of your heart. 60-100 heart beats per minute are considered a normal heart rate range.


High blood pressure can damage your arteries by making them less elastic, which decreases the flow of blood and oxygen to your heart and leads to heart disease. In addition, decreased blood flow to the heart can cause chest pain called angina. Your cardiologist will check your blood pressure to see if there is any abnormality in your vitals.

High blood pressure mostly goes unnoticed as it doesn’t have any significant signs or symptoms, and most people don’t know if they have it. However, it keeps damaging the arteries at its own pace. Some of the symptoms of high blood pressure that are often ignored are headaches, shortness of breath, and nosebleeds.

Low blood pressure, on the other hand, is often described as causing dizziness, fainting, blurred vision, and a feeling of weakness.


Knowing the range of LDL, the bad cholesterol, and HDL, the good cholesterol, can also help you understand your heart condition. LDL builds plaque in the arteries and makes it difficult for the blood to pass. This may increase the risk of heart attack and stroke. HDL, on the other hand, helps remove the bad cholesterol and reduces the risk of heart attack and stroke.

Your doctor may also suggest blood tests to check your levels of sodium, potassium, albumin, and creatinine. Abnormal levels may indicate problems with organs such as your kidneys and liver, as well as signs of heart failure.


An electrocardiogram, commonly known as an ECG, is done to sense the electrical activity of the heart. It helps your cardiologist to know what is happening in all the areas of the heart and if there is any problem with the heart rate or rhythm. This is a non-invasive procedure, done at a hospital or clinic that usually takes only 5–10 minutes, and the results are generated alongside.


Treadmill testing, also known as TMT, is used to determine how well the heart functions under stress. This means, if you are under a stressful condition or if there is a blockage, how well will your heart function? This is an important test in which you are made to run or walk fast on a treadmill, and your heart rate or rhythm is recorded.

This test gives an insight into heart blockage and the probability of heart disease.


Echo is an ultrasound of the heart. It shows how the blood moves within the heart valves. This test also assesses the pumping chambers of the heart. The normal range of ECHO is 55–65%. If the range is less than or equal to 40%, it means that the heart is not functioning properly.


Calcium scoring is the most accurate test to determine the blockage in the heart. If the calcium score is high, it indicates that the arteries are more blocked and that the risk of heart disease is very high. Many cardiologists consider this to be a reliable indicator of heart disease risk.

Don’t Ignore The Warning Signs of Heart Attacks

Chest pain is considered the most common sign of a heart attack. However, heart attacks may present with other symptoms like breathlessness and lightheadedness. A heart attack also differs in severity. It can be mild or severe, depending on the blockage in arteries. Surprisingly, the symptoms of heart attack differ in both men and women.

What causes a heart attack?

A myocardial infarction, also known as a heart attack, occurs when the blood supply to the heart is interrupted. When blood flow is restricted to the heart, it can become life-threatening.

Blood is supplied to the heart through the arteries. When waxy plaque builds up in the arteries, it creates difficulty for the blood to pass and creates an obstruction. The blood flow is at times slowed or completely cut off.

This waxy plaque is created by low-density lipoprotein (LDL) cholesterol, lipids, and other inflammatory substances. Immediately after a hard plaque ruptures, a blood clot forms. Blood flow to your heart will be obstructed if the clot is large enough. You are more likely to get heart failure and other heart problems if the supply of oxygenated blood to heart tissue is cut off.

How does a heart attack feel?

Heart attack is most commonly experienced as pain in the centre, left side of the chest. This pain can last a few minutes and can even come and go. Every patient experiences a different pattern of pain. Most of the patients explain heart attack coming with a feeling of:

  • tightness
  • pressure
  • squeezing
  • burning

However, in other cases, chest pain is not the only symptom. Additionally, these symptoms may not be accompanied by chest pain in certain circumstances.

Chest pain is frequently accompanied by, or even present without, the following symptoms:

  • shortness of breath
  • lightheadedness
  • weakness or fatigue
  • pain in one or both arms
  • upper back, jaw, shoulders pain or neck pain
  • nausea
  • vomiting
  • sweating
  • feelings of anxiety or impending doom

Pre-heart attack warning signs

Even if a heart attack is unexpected, some symptoms may appear gradually and softly.

By the time we experience the more severe symptoms, as discussed above, a heart attack may be setting its place days prior by showing unusual changes in the body, like fatigue, for a few days. There may be a feeling of increased anxiety as well.
It is also important to note that before a serious heart attack, a patient may experience mild to moderate chest discomfort, nausea, shortness of breath and pain in one or both arms.

Heart attack symptoms differ both in men and women

Heart attack presents with a different set of symptoms in both men and women. Women may experience different symptoms, compared to men. However, chest pain, which is a classical symptom of a heart attack, is present in both men and women.

Other symptoms experienced by women

  • Chest pain, but not always
  • Pain or pressure in the lower chest or upper abdomen
  • Jaw, neck or upper back pain
  • Nausea or vomiting
  • Shortness of breath
  • Fainting
  • Indigestion
  • Extreme fatigue

Other symptoms experienced by men

  • Squeezing chest pressure or pain
  • Jaw, neck or back pain
  • Nausea or vomiting
  • Shortness of breath

When to visit Emergency?

If you experience chest pain or a sensation of pressure in the chest lasting for minutes, do not waste a minute. Reach the hospital emergency immediately. There may be additional symptoms like:

  • breathing difficulties
  • nausea
  • dizziness
  • a sudden cold sweat
  • ache in the jaw, neck, arm, or back
  • extreme exhaustion

If you have aspirin at home, quickly swallow it. It will give you extra time as it thins the blood and makes it easy to cross arteries. Taking aspirin is the heart attacks first medical aid that should be provided to a patient undergoing heart attack symptoms. Try to recall how and when your symptoms first appeared so you can tell the emergency personnel.

Remember, minutes save lives.

In case of a heart attack, reach the hospital emergency on time or call 011-4055 4055 for an ambulance.

Be True to Your Heart

With rising number of cases, timely medical care and invasive life saving procedures such as angioplasty and coronary artery bypass are known to save lives. Patients who have angina that suddenly worsens, angioplasty and stent placement can restore blood flow to the oxygen-starved heart, easing the pain within 30 minutes — the average time for the procedure. Once the patients recover, they are able to exercise longer than before. In addition, the procedure
lowers their risk of death.

However, every heart disease requires a disease management plan. Cardiology has improved itself, with advent of latest techniques, and the best of stents are now available to improve the results. Invasive coronary angiography is the standard technique since the past four decades. Although it has stood the test of time, many shortcomings also have been uncovered. It is an eye ball evaluation of artery by an examiner. A lesion which may be significant, requiring treatment in terms of stent implantation to one cardiologist, may be insignificant, requiring only medical therapy to another. This becomes a source of immense confusion for the patient’s mind. Newer technologies like FFR help in evaluating the right lesions (point of disease), as functional assessment is more necessary than quantitative assessment by angiography only. This technique help remove dilemma from minds of doctors and patients. It is not always necessary that all patients having coronary artery disease have
to be treated by angioplasty or bypass surgery, sometimes management through medicines alone is sufficient.

Even one of the trials also suggested that patients with stable heart disease might do equally well with medicines only. Medicines include blood thinning medications, cholesterol lowering medications, and medicines to normalise the heart rate.

It is extremely important, if you are a heart patient, that you discuss the possible treatment options with your cardiologist, best suited to your clinical condition. Besides, an active and healthy lifestyle with a balanced diet is equally important to reduce your risk of heart diseases and evade the need for angioplasty.

Save Your Heart with Latest Technologies

Everyday we see an ad on TV suggesting “bhaag daud bhari zindagi mein rukna mana hai”. But then we also come across a scenario where there is an emergency in the form of a heart attack. India is fast the becoming the capital of heart disease. The disease itself is becoming complex in nature and is challenging doctors.

Cardiology has improved with the advent of the latest techniques and the best of stents are now available. Invasive coronary angiography is the standard technique since the past four decades. Although it has stood the test of time, many shortcomings also have been uncovered. It is an eyeball evaluation of the artery by the examiner. A lesion which may be significant, requiring treatment in terms of stent implantation to one cardiologist, may be insignificant requiring only medical therapy to another. This becomes a source of immense confusion to the patient. Newer technologies

like FFR help evaluate the right lesions (point of disease) as functional assessment is more necessary than quantitative assessment by angiography only. Many lesions create confusion in the minds of doctors and this technique helps remove that dilemma. It is also not always necessary that all patients with coronary artery disease have to be treated by angioplasty or bypass surgery, sometime management through medicines alone is sufficient.

Once a physician decides to stent the diseased artery, then a successful outcome depends on the correct placement of stents with right size and length. Therapies like Optical Coherence Tomography(OCT) help in correct visual assessment, as one can see inside the artery in a 3D manner, for right assessment of the lesion for diameter and length and also helps in checking post stenting results.

These techniques ensure right short and long term safety of the patient with a better quality of life.

Harnessing the Power of Digital Health to Improve Awareness, Prevention and Management of CVD Globally

During the COVID-19 pandemic, patients and their families preferred online consultations to avoid the exposures associated with going to clinics and interestingly, the outcome was quite beneficiary, indicating the benefits that digital health solutions could provide to patients. Cardiovascular disease (CVD) is the main cause of loss of life in most adults around the world. There has been a rise in CVDs in recent years, and preventive interventions are now seen as one of the key public health priorities. Digital technology is on the way to revolutionize heart health care as these tools have a great potential to improve our ability to prevent, accurately track, diagnose and treat disease effectively. These technologies will not only make users more informative about their health but also help in early diagnosis of diseases. The use of smart phones, internet applications, sleep trackers, blood pressure monitors, glucose and oxygen level sensors are providing valuable information to monitor cardio health and a roadmap to improve patient lifestyles and manage heart care easily. It also helps in ascertaining signs of new ailments or the change in prevailing heart conditions.

Many hospitals have started tele/digital health services for new patients and also for those who have undergone surgeries and are recovering.. Post-surgery patients are being equipped with the tools necessary to monitor their own vital signs and reach out to medical professionals. These services are quite beneficial for patients living far off. By harnessing the power of digital health, we will be able to help transform the healthcare system by reducing costs, improving quality health services and patient satisfaction. Investment on digital health will also benefit patients living in remotes having commuting issues to receive specialty cardio healthcare services.

Implantable devices like pacemaker and CVD or CRT devices that automatically record and transmit data can be used for enhanced home-based monitoring as these have the ability to provide continuous observation and identify relevant problems. Digital health also reduces the volume of device clinic visits and provides early detection of patient or device related problems.

Like every innovative adaptation, digital health also has its own challenges especially in India where providing health care facilities to rural parts of India is a real big task. Lack of buying and maintenance capacity of digital health equipment and digital infrastructure will create a major obstruction for overall implementation of digital health.

Even though the effect of digital health technologies on cardiovascular diseases has to go a long way, Keeping in view most cardiologists’ heavy schedules; there is an urgent need to integrate advanced digital solutions into existing medical solutions to get the maximum from digital healthe. There is also a committed need to invest in compiling healthcare and pharmaceutical data and analysing the same by experts to ascertain strengths and weaknesses to improve CVD digital health.

Air Pollution and your Heart Health

The impact of air pollution on people’s health has become a major topic of global health concern. Nine out of 10 people on the planet breathe polluted air, which is increasing at an alarming rate in major cities. The risk of stroke and cardiovascular disease, as well as other chronic diseases, is increasing as the quality of urban air deteriorates. There has been an unusual increase in hospitalisation cases owing to heart illness in recent years, and it is now clear that patients with health condition are more vulnerable to air pollutants. Pollutants can harm your heart and circulatory system by causing damage to the inside walls of blood vessels, narrowing and hardening them, affecting your heartbeats, and making your blood more likely to clot.

How can we protect ourselves from air pollution?
The most important thing is to use techniques to determine air quality. You may do this with your smartphone or air quality monitors. Consume a well-balanced diet rich in green vegetables, fruits, and whole grains, as well as plenty of water, to keep your body hydrated and resist the health risks associated with air pollution. A well-balanced diet rich in important vitamins and nutrients benefits in the body’s immune system’s strengthening. Exercising is essential because it eliminates pollutants from the bloodstream, increases blood circulation, and promotes heart function. When in polluted areas, however, indoor light exercise is advised.

If you experience shortness of breath, chest pressure, or pain, you should stop exercising. Maintain a healthy BMI. Stop smoking, drink in moderation, and wear a mask when outside. Patients with pre-existing medical conditions should take extra precautions and visit their doctors on a regular basis, in addition to taking the steps outlined above on days when the air quality is severe.

Hypertension- Diagnosis & Management

Hypertension, commonly known as high blood pressure, is a condition in which blood pressure is higher than normal. Blood pressure naturally rises and falls during the day, but if it remains high for an extended period of time, it can harm your heart and cause health concerns.

According to a study, hypertension affects approximately 33% of urban Indians and 25% of rural Indians. Hypertension has a significant public health impact on cardiovascular health and healthcare systems, it is a major risk factor for heart disease, stroke, as well as heart attack and heart failure, in India, it is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease (CHD) deaths.

Controlling blood pressure is critical for maintaining health and minimizing the risk of some of the life-threatening diseases. High blood pressure can exist without creating any symptoms for years. Blood pressure readings on a regular basis might assist you and your doctor in detecting any changes in the same.

If your blood pressure is high, your doctor may want you to check it again in a few weeks to determine if it remains high or falls back to normal. Blood pressure should be less than 120/80 mm/hg in order to be considered healthy. In most cases, a combination of elements such as genetics, obesity, excessive alcohol use, a sedentary lifestyle, diabetes, and a high sodium intake play a crucial role in the improvement of hypertension.

Reducing risk factors for Hypertension
The best first-line treatment for hypertension is to maintain an active and healthy lifestyle. If you have hypertension risk factors, you can follow the activities outlined below to reduce your risk of the condition and its complications.

Consume more fruits and vegetables
Limit refined sugar and stay away from packaged foods
Reduce your sodium intake by cooking fresh foods more frequently
Limiting your intake of fast food
Set weight-loss objectives by eating a more nutritious diet and exercising more
Relaxation activities such as meditation, yoga, and long walks can help relieve stress.

Things to know about Blood Pressure
There are a few things you should know about blood pressure.

The new blood pressure guidelines don’t offer different recommendations for people younger or older than age 65. The guidelines state that normal blood pressure is under 120/80, elevated- 120-129 and less than 80, High Blood pressure stage 1 =130-139 or 80-89, High Blood pressure stage 2 =140 or higher or 90 or Higher Hypertensive crisis= Higher than 180and/0r higher than 120- Time to call your doctor immediately

E R E C T is simple mnemonic to know causes for High blood pressure
E – stands for Essential Hypertension which means it has no cause and is found in 85% of people
R – stands for Renal/Kidney related cause for hypertension like kidney stones, kidney failure, etc
E – stands for Endocrine causes for hypertension like Tumours of Adrenal gland situated just above kidneys or excess consumption of steroids or oral contraceptives
C – stands for Coarctation of aorta a birth defect in aorta which is major blood vessel coming out of heart which needs correction
T – stands Toxemia of pregnancy which happens during second or third trimester of pregnancy

Facts about blood pressure
And Finally, don’t forget to keep in mind the following facts about blood pressure.

Except for essential hypertension all other causes are for hypertension are curable
The difference between Hypertensive Urgency and Emergency.
Hypertensive urgency is when your blood pressure is extremely high, but your doctor doesn’t suspect you have any damage to your organs. In hypertensive emergency, your blood pressure is extremely high and has caused damage to your organs. An emergency hypertensive crisis can be associated with life-threatening complications.
To monitor your blood pressure regularly, Keep a log of your blood pressure readings and take it to your regular doctor appointments. This can help your doctor see any possible problems before the condition advances.