Study: Shortness of Breath Could Signal Heart Attack

Nov. 3, 2005 — -- Most Americans know that chest pain is a symptom worth checking out -- it could signal a heart attack, a top killer in the U.S.

But a study published this week reveals that there may be another symptom that's an even better indicator of a heart attack: shortness of breath.

In a study published in the Nov. 3 issue of the New England Journal of Medicine, cardiologists with Cedars-Sinai Medical Center in Los Angeles analyzed the records of nearly 18,000 people referred for cardiac testing.

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 asked participants about symptoms such as chest pain and trouble breathing. The results were clear: People who answered yes to 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.

Dr. Daniel Berman, chief of cardiac imaging and nuclear cardiology at Cedars-Sinai and one of the study's authors, said he was surprised by the study's results.

He recommends 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.

"Now we know that unexplained shortness of breath in patients at risk for heart disease shouldn't be ignored," he said.

Dr. Tracy Wimbush is an emergency physician at Massachusetts General Hospital in Boston.