When the patient presents with shortness of breath (SOB) especially on exertion, various causes will have to be excluded. The patient is likely to go for a chest X-ray (CXR) to rule out any lung problems and various blood tests which will rule out other non-cardiac causes of shortness of breath. A blood test that we carry out at our center as a point of care testing is called N Terminal pro-B natriuretic Peptide (NT-proBNP) which can give a result in 15 minutes will guide us to determine if the SOB is coming from the heart.
The next step is to do an echocardiogram to evaluate the structure of the heart. This will help us to determine if the heart function is normal, or whether there are any valve problems that may lead to the SOB. Furthermore, lung pressures can be measured to exclude pulmonary hypertension as a cause of SOB. Finally this test will also help us to exclude structural heart diseases which may cause SOB.
Occasionally, SOB may be caused by blockage of the heart arteries. So your doctor may choose to add on a stress test like a treadmill test or an exercise stress echocardiogram (ESE) in order to rule it out.