Feeling short of puff can obviously be due to a number of things. It also depends if the shortness of breath comes on suddenly or has been gradually getting worse over weeks/months/years. It occurs because the body is not getting the amount of oxygen it needs to do what is being asked of it.

This can be because there isn’t enough oxygen available to the person (being suffocated or something stopping the oxygen getting down to the lungs). The lungs may not be working properly (asthma, emphysema, chest infections, fluid in the lungs or some form of trauma). It’s also possible the oxygen can’t get from the lungs into the blood system (problem with the blood itself, blood clot in the lung or heart not pumping properly).

We could write a whole book just about shortness of breath, so obviously, the explanation & advice given here will be very limited. We’re going to concentrate on the heart causes of shortness of breath (since this website has been written by a cardiologist!).

So, heart problems that result in you feeling short of breath:


This is chest pain or shortness of breath which occurs because the fuel pipes to the heart itself (coronary arteries), are narrower than they should be, due to cholesterol building up inside the artery. Therefore, when the heart is beating harder/faster than normal (for example, walking quickly or walking uphill), it needs more fuel but if the fuel pipes supplying it narrower than they should be this will cause problems in the form of chest tightness or shortness of breath..

Heart Attack

This occurs if one of the fuel pipes to the heart becomes blocked, as a result a certain area of the heart doesn’t receive any blood (hence oxygen or fuel) and the heart muscle starts to die. It depends on the amount of muscle that dies whether the heart can continue working & hence whether the person survives.


Fluid in the lungs

The medical term is ‘pulmonary oedema’. Fluid can build up in the lungs because the heart is damaged (for example following or during a heart attack), resulting in the lungs not working properly.

Fluid around the heart (Pericardial Effusion)

Can occur due to a number of reasons, such as an infection that affects the lining of the heart or due to certain cancers. Fluid fills the sack which normally protects the heart. As the fluid increases it compresses the heart itself, stopping it working properly.

Valve problems

The heart has 4 valves which open to allow blood to pass from one chamber to the next (the heart has 4 chambers) then snap shut to stop the blood gushing back the way it has come. These valves can become stiff & thickened or floppy & incompetent. Both problems result in the heart not working efficiently & be associated with feeling short of breath.

Holes in the heart

These are abnormal channels from one chamber of the heart to another, again result in the heart not working efficiently. Some babies are born with these holes & the majority close by themselves without causing any problems. Some of these holes do cause problems as the person gets older – such as shortness of breath.

Fast or slow heart rate

Again stops the heart working efficiently. Both fast & slow heart beats can result in similar symptoms such as shortness of breath, dizzy episodes or blackouts. A fast heartbeat can be associated with palpitations.

Consultant cardiologist – Derby, Solihull & Burton

The investigations we do obviously depend on what we think is causing the problem. If you book an appointment, most people will have a private ECG. Then we go on to a private echocardiogram, heart monitor, a stress test for the heart or even an angiogram.

Please get in touch to arrange a clinic appointment & any further tests if required.