What Causes Increased Heart Rate And Shortness Of Breath While Climbing Stairs?

Posted on Thu, 2 Jun 2016

Question: What conditions would cause a rapid increase in heart rate and shortness of breath when going up stairs or an incline? Then a rapid decrease in heart rate when lying down. Also, what does it mean when a murmur is only heard after exertion (like going up a couple flights of stairs)? I am a young, thin female that used to exercise regularly but over the past year I have become more short of breath when active. I feel fine when lying down, but my heart rate increases from 70-80 to 130+ when going up 2 flights of stairs. I often find myself taking in deep breaths when active. I do not have asthma

Answered by Dr. Anantharamakrishnan (33 minutes later)

Brief Answer:
Right heart failure...

Detailed Answer:
Hi friend
Welcome to Health Care Magic

This is typical description of early heart failure – inability of the heart to meet the body’s demand on effort.
the murmur is most likely a valve defect or flow murmur...
Since you are comfortable lying down, it may point to right heart, as a primary cause.
The common diagnosis for women at this age is Primary Pulmonary Hypertension
You need examination, further investigations - Blood test, ECHOcardiography) etc at times stress tests or catheterisation
The treating doctor alone could conclude better based on total clinical picture
You seem to be in good hands, go ahead and get investigated

Good luck
God bless you

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Anantharamakrishnan (56 minutes later)

I have been dealing with this for over a year. I have had pulmonary function tests-which only showed Reduced DLCO. An echo that was normal except a minimal left to right shunt, but bubble test did NOT show a right to left shunt. I also had a stress test that showed no signs of ischemia, or irregular heart rate, just a flat blood pressure response. I have had several different doctors mention pulmonary hypertension but my echo did not show signs of it. My doctor is suggesting a right heart XXXXXXX with exercise to determine if pressures change with exertion. Wouldn't a normal echo rule out pulmonary hypertension? What would a right heart XXXXXXX determine?

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer: XXXXXXX is better placed

Detailed Answer:
Hi

Catheterisation and angiography is the gold standard for this. It is the only way to directly measure the pressures and oxygen saturations - of the veins, arteries and chambers at rest and after stress.
It can also see the chamber – wall motion, size, ejection fraction; valves deformity, obstruction, regurgitation etc.
Most of the tests are reassuring. ECHO has got limitations. It can rule in but not rule out certain conditions, for absence of proof is no proof of absence
Reduced DLCO may need further evaluation by a specialist (Pulmonologist) for Pulmonary Fibrosis

Regards

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Sonia Raina