Shortness of breath can sometimes be linked to mild or temporary causes, such as anxiety, viral infections or reduced fitness. However, it can also be an important warning sign of an underlying heart or lung condition.
In some cases, breathlessness may indicate that the heart is not pumping effectively or that one of the heart valves is not functioning properly. An echocardiogram, also called a heart ultrasound scan, is one of the most useful non-invasive investigations for assessing the structure and function of the heart.
At London Private Ultrasound, patients can access private echocardiography and heart health assessments in London, with rapid appointments and reporting.
What is an echocardiogram?
An echocardiogram, often called an “echo” or heart ultrasound scan, uses high-frequency sound waves to create detailed moving images of the heart. Unlike CT scans or X-rays, echocardiography does not use radiation. It is painless, non-invasive and usually takes between 20 and 45 minutes.
The scan can assess:
- Heart pumping strength
- Heart chamber size
- Heart valve function
- Blood flow through the heart
- Fluid around the heart
- Estimated pressure inside the heart and lungs
- Congenital heart abnormalities
- Signs of heart failure or cardiomyopathy
Why can heart problems cause shortness of breath?
The heart and lungs work closely together to deliver oxygen around the body. If the heart cannot pump blood efficiently, fluid may build up in the lungs or the body may receive insufficient oxygen-rich blood during activity. This can cause breathlessness during exercise, difficulty breathing when lying flat, waking at night gasping for air, fatigue, swollen legs and reduced exercise capacity.
Common heart conditions that can cause breathlessness
1. Heart failure
Heart failure means the heart is not pumping blood as effectively as it should. An echocardiogram helps measure pumping function, including ejection fraction, and can support diagnosis and treatment planning.
2. Valve disease
Leaky or narrowed heart valves can make the heart work harder. Echocardiography is a key test for assessing which valve is affected and how severe the problem may be.
3. Cardiomyopathy
Cardiomyopathy affects the heart muscle. An echocardiogram can show thickened muscle, enlarged chambers, reduced pumping function or obstruction to blood flow.
4. Pulmonary hypertension
Raised pressure in the lung arteries can strain the right side of the heart. Echocardiography can estimate pulmonary pressures and assess right heart function.
5. Coronary artery disease
An echocardiogram does not directly show coronary blockages, but it may identify weak heart muscle, reduced pumping function or signs of previous heart damage.
What can an echocardiogram show?
An echocardiogram provides important information about heart pumping function, valve function, chamber size, fluid around the heart, congenital structural abnormalities, blood flow patterns and estimated pulmonary pressures.
These findings can help your clinician understand whether symptoms such as breathlessness, chest discomfort, palpitations, fatigue or ankle swelling may be related to the heart.
What happens during an echocardiogram?
During the scan, you will usually lie on an examination couch. ECG stickers may be placed on your chest, ultrasound gel is applied, and a small handheld probe is moved across the chest to obtain images of the heart from different angles. Most patients can return to normal activities immediately afterwards.
Echocardiography vs ECG: what is the difference?
Many patients confuse an ECG with an echocardiogram. They are different tests and often complement each other.
- ECG: measures the electrical activity of the heart and is useful for arrhythmias, rhythm abnormalities and signs of previous heart attacks.
- Echocardiogram: produces moving images of heart structure and function and is useful for valve disease, heart failure, cardiomyopathy, pulmonary hypertension and structural abnormalities.
You can also read more about our private ECG test in London.
Can anxiety cause breathlessness?
Yes. Anxiety and panic attacks can cause hyperventilation, chest tightness, shortness of breath and palpitations. However, it is important not to assume that breathlessness is “just anxiety”, particularly if symptoms are new, worsening, associated with chest pain, occurring during exercise, or accompanied by swelling or dizziness.
Other causes of shortness of breath
Not all breathlessness is caused by heart disease. Other causes may include asthma, COPD, pneumonia, lung fibrosis, anaemia, obesity, deconditioning, anxiety, blood clots in the lungs and thyroid disease. A doctor may recommend additional tests depending on your symptoms and clinical findings.
Who may benefit from an echocardiogram?
You may benefit from an echocardiogram if you have breathlessness, a heart murmur, high blood pressure, palpitations, chest pain, swollen ankles, a history of heart disease, family history of cardiomyopathy, previous chemotherapy exposure, diabetes with cardiovascular symptoms, or unexplained reduced exercise tolerance.
Preventive cardiovascular screening may also help identify early heart disease before severe symptoms develop, especially in people with risk factors such as high blood pressure, diabetes, smoking, obesity or a family history of cardiovascular disease.
Can echocardiography detect early heart disease?
In many cases, yes. An echocardiogram may identify mild valve disease, early heart muscle weakness, enlarged heart chambers, raised pulmonary pressures or diastolic dysfunction before symptoms become severe. Earlier diagnosis may support earlier treatment and lifestyle changes.
Lifestyle factors that can affect heart health
Several factors increase cardiovascular risk, including smoking, high blood pressure, high cholesterol, diabetes, obesity, lack of exercise, excess alcohol, poor diet and chronic stress. Improving these risk factors can significantly reduce long-term cardiovascular risk.
When to seek urgent medical attention: seek urgent help immediately if you experience sudden severe breathlessness, chest pain, fainting, blue lips, sudden swelling, severe palpitations, or symptoms suggestive of a heart attack or stroke.
Private echocardiography in London
At London Private Ultrasound, patients can access private echocardiography and wider heart health assessments. Additional cardiovascular investigations may include ECG, blood pressure assessment, carotid Doppler ultrasound, vascular screening and cardiac risk blood tests.
Final thoughts
Shortness of breath should never be ignored, particularly when it is new, worsening, or associated with fatigue, chest discomfort, swelling or palpitations. Although breathlessness has many possible causes, an echocardiogram is one of the most important investigations used to evaluate whether the heart may be contributing to symptoms.
Echocardiography is safe, painless, non-invasive and valuable for assessing conditions such as heart failure, valve disease, cardiomyopathy, pulmonary hypertension and structural heart abnormalities.