“My mother is suffering from breathlessness but the 2-d echo shows normal. Why?”
My mother is 70 years old and is suffering from breathlessness even when engaging in the slightest amount of activity. We had taken her for a 2-d echogram which showed a normal breathing pattern with slight irregularities due to aging. What should we do now to understand the cause of this breathlessness?
7 Answers
Angina (due to narrowed coronary arteries) can cause mainly breathlessness and this does not show up on a standard echocardiogram but should be apparent on a stress-echocardiogram, an exercise test (treadmill) or a nuclear scan. But lung disease can also cause breathlessness, so this should also be checked – the simplest way is to buy a fingertip pulse oximeter (costing about £30 or $30) and see if her oxygen level drops below 90% with exercise.
If it's not angina and her oxygen level stays good even when she is breathless, the problem is reflex hyperventilation. This is very common and can be prevented by learning conscious breating control.
If it's not angina and her oxygen level stays good even when she is breathless, the problem is reflex hyperventilation. This is very common and can be prevented by learning conscious breating control.
Julia G. Ansari
Cardiologist
It can be due to diastolic heart failure, valvular stenosis or regurgitation or coronary disease that needs to be evaluated with a stress test.
Pulmonary function tests and a stress test
Look into pulmonary cause, lung function test and if diabetic may need stress test rule out blockages as cause for shortness of breath
A 2-D echocardiogram will show you structure, heart strength (Ejection Fraction), its ability to relax (diastolic function) and pulmonary pressure. The echocardiogram will only be abnormal if she has had damage to the heart muscle that is limiting it's ability to pump or with active blockage (ischemia). To further evaluate for other causes of shortness of breath, she could undergo stress testing to evaluate for inducible ischemia as a cardiac cause, will also show if she is having abnormal heart rhythm with exertion. I often will also send my patients for pulmonary function testing if no other signs of cardiac causes are identified.
I would like to know more; does she have a cough, any chest discomfort associated with the shortness of breath. Previous smoker? Does she awaken with shortness of breath during the night? Is she able to lie down on one pillow without shortness of breath? Other tests to consider might include a chest X-ray, pulmonary function tests, or possibly nuclear stress testing.
Hi,
Well, there are patients who have normal heart function, but the heart does not relax well (diastolic dysfunction). The heart not relaxing may be related to age and hypertension. Also, other issues may be asthma, allergies, sleep apnea, or obesity. My advice wound be a history, physical exam, blood tests, looking into what has been stated, and reviewing the echo. Also would consider a 6 min walk test, amd maybe a stress test; make sure she is not diabetic. The answer is in what I texted; also, last resort is anxiety.
Well, there are patients who have normal heart function, but the heart does not relax well (diastolic dysfunction). The heart not relaxing may be related to age and hypertension. Also, other issues may be asthma, allergies, sleep apnea, or obesity. My advice wound be a history, physical exam, blood tests, looking into what has been stated, and reviewing the echo. Also would consider a 6 min walk test, amd maybe a stress test; make sure she is not diabetic. The answer is in what I texted; also, last resort is anxiety.
