Cardiac chest pain occurs when there is a problem affecting the heart or the major blood vessels around it. It often feels like tightness, pressure, heaviness, or squeezing in the centre of the chest — sometimes described as a weight sitting on the chest.
Breathlessness, also known as dyspnoea, can have many causes — from lung conditions to anxiety — but sometimes it is related to the heart. Recognising cardiac breathlessness is important because it may indicate heart failure or other serious heart conditions.
Orthopnoea — difficulty breathing when lying flat
Paroxysmal nocturnal dyspnoea (waking breathless)
Fatigue and reduced exercise tolerance
Ankle swelling (fluid retention)
Breathlessness worsening over weeks or months
Post-COVID breathlessness lasting over 12 weeks
These symptoms result from the heart’s reduced ability to pump blood effectively, causing fluid to build up in the lungs and extremities.
The BNP (B-type Natriuretic Peptide) blood test is currently the most useful screening test for identifying cardiac causes of breathlessness. Elevated BNP levels suggest the heart is under stress.
If BNP is raised, an echocardiogram is usually performed to assess heart structure, function, and ejection fraction. This allows doctors to classify heart failure as HFrEF (reduced ejection fraction) or HFpEF (preserved ejection fraction) — both requiring different treatment approaches.
💡 Even if symptoms seem mild at first, early evaluation and treatment can prevent progression and significantly improve quality of life.
Everything you need to know about Fainting and Dizziness FAQ and how private cardiac assessment works.
Yes. When the heart cannot pump blood effectively, fluid can build up in the lungs, causing breathlessness, fatigue, and reduced exercise tolerance.
You should seek medical assessment if chest pain is new, occurs during exercise, lasts longer than several minutes, or is accompanied by breathlessness, nausea, dizziness, or sweating.
Doctors often start with a BNP blood test followed by an echocardiogram to assess heart function and structure.
