A recent study published in the November issue of the New England Journal of Medicine, reveals that dyspnea, or shortness of breath may be an important indicator of a heart attack. //
Although dyspnea is a common symptom, there has been only limited investigation of its prognostic significance among patients referred for cardiac evaluation.
Cardiologists at the Cedars-Sinai Medical Center in Los Angeles studied 17,991 patients undergoing myocardial-perfusion single-photon-emission computed tomography during stress and at rest. Patients were divided into five categories on the basis of symptoms at presentation (none, nonanginal chest pain, atypical angina, typical angina, and dyspnea).
The patients had all undergone cardiac stress test, during which a patient's heart is 'stressed' with medication or exercise. As this is done, X-ray images are taken of the blood flow through the heart's arteries.
Prior to the testing, researchers interviewed participants about symptoms such as chest pain and trouble breathing.
The results clearly indicated that people who answered suffered from shortness of breath were four times more likely to die from cardiac problems than patients who had no symptoms at all.
More importantly, the researchers found that patients who had difficulty breathing were twice as likely to die from cardiac problems than patients who had the 'classic' heart attack symptoms like chest pain during physical exertion.
The authors recommend that patients with a previous history of heart disease or those at high risk for atherosclerosis, such as people with high blood pressure, high cholesterol or diabetes, should consider difficulty breathing just as serious as chest pain. They also suggest that an assessment of dyspnea should be incorporated into the clinical evaluation of patients referred for cardiac stress testing.
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