Specialist assessment for breathlessness that is new, worsening, unexplained, or out of proportion to your fitness.
Breathlessness is common, but it should not be dismissed when it is new, progressive, or limiting day-to-day life. Some causes are cardiac, some are respiratory, and some relate to anaemia, thyroid disease, medication, weight, fitness or anxiety.
A private breathlessness assessment is useful when symptoms are recurring, unexplained, or have not been tied together into a clear plan. The aim is not simply to order tests, but to understand the pattern and decide which tests, if any, will actually answer the question.
Call 999 or go to A&E if breathlessness is sudden, severe, rapidly worsening, or associated with chest pain, collapse, blue lips, confusion, coughing blood, or severe wheeze. The same applies if you cannot speak in full sentences or symptoms are clearly different from anything you have had before.
This page and private assessment are for stable, recurrent or unexplained breathlessness, not for acute respiratory distress or suspected heart attack, pulmonary embolism or severe infection.
Cardiac causes include valve disease, heart failure, abnormal heart rhythms, coronary artery disease and heart muscle conditions. These are especially relevant when breathlessness occurs on exertion, when lying flat, with ankle swelling, or alongside palpitations or chest discomfort.
Lung disease, asthma, anaemia, thyroid disease, deconditioning, obesity, medication effects and anxiety can all produce genuine breathlessness. The skill is in separating these possibilities rather than assuming one explanation too early.
The assessment starts with when breathlessness occurs, whether it is exertional or at rest, how quickly it has changed, and whether there are associated symptoms such as chest pain, palpitations, swelling, cough or wheeze.
Dr Cassar will examine you, check your blood pressure, pulse and oxygen saturations where appropriate, and usually perform a resting ECG. Further tests are chosen according to the clinical pattern, not as a standard package.
A resting tracing to look for rhythm abnormalities or signs that support a cardiac cause.
An ultrasound scan to assess heart function, valves, pressures and signs of heart failure.
Checks for anaemia, thyroid problems, kidney function and other reversible contributors.
CT coronary angiography, chest imaging or other tests may be arranged when the clinical picture points that way.
Yes. Valve disease, heart failure, heart rhythm problems and coronary disease can cause breathlessness without typical chest pain. The pattern of symptoms and examination findings guide which causes need excluding.
No. Deconditioning is common, but new or progressive breathlessness should not be put down to fitness until more important causes have been considered.
Often, but not always. An echocardiogram is useful when the history, examination, ECG or blood tests suggest a possible structural heart or valve problem.
Yes. Anxiety and hyperventilation can cause very real breathlessness and chest tightness. It should be considered after the clinical pattern has been assessed properly.
A normal chest X-ray is reassuring but does not exclude cardiac causes, asthma, anaemia, rhythm problems or valve disease. It is one piece of the assessment, not the whole answer.
Seek urgent help if breathlessness is severe, sudden, rapidly worsening, associated with chest pain or collapse, or if you are unable to speak in full sentences.
If breathlessness is stable but unexplained, a consultation can help clarify whether the heart is involved and what testing is sensible. Appointments are available in Basingstoke and Winchester.
