Breathlessness – that frightening feeling when you can’t get enough air into your lungs – is one of the most common reasons Australians call an ambulance.
While the problem lands thousands in hospital emergency departments every year, too few people are able to get their breathlessness problem resolved quickly, respiratory specialists warn.
Woolcock Institute of Medical Research in Sydney has launched a Breathlessness Clinic to fast track diagnosis and treatment for the many people suffering from this worrying, anxiety-inducing complaint. “The problem is breathlessness can be a very challenging clinical problem,” explains Woolcock respiratory physician Dr Tracy Smith. “The heart, lungs, muscles and the brain can all be involved, making the cause a tricky puzzle to solve.”
Breathless patients are often referred to a respiratory physician or a cardiologist first, only to be sent to the other specialist later, she says. “This process can be time-consuming and frustrating for all involved,” Dr Smith says. On top of this, treatment recommendations for conditions which can lead to breathlessness are constantly changing, and there are few clinical guidelines to help specialists manage problems which affect more than one organ system, for instance patients with both heart AND lung disease.
The Woolcock Breathlessness Clinic seeks to solve this problem with a new and innovative model of care. The multispecialty approach will see patients see a cardiologist and a respiratory physician at the same time to allow rapid, comprehensive assessment.
“We’re creating the state’s first one-stop-shop for breathlessness, promising to investigate, diagnose and treat all patients under one roof and in a timely fashion,” Dr Smith says. “We’ll collaborate closely with GPs to ensure they are kept informed about the patient’s assessment and treatment recommendations.”
Getting breathless when walking up a steep hill or running is normal, however when you get more out-of-breath than expected for the amount of exercise you have done, it can suggest a medical problem.
“Getting out of breath when you don’t expect to be puffed out can be a frightening experience,” Dr Smith says. “It can also be embarrassing and stops many people from doing exercise, which can actually make the problem worse. There’s also a perception among many people that breathlessness is part of getting older and not something a doctor can help with.”
The problem, known in clinical circles as dyspnoea, has many potential causes. “For people with irregular bouts of breathlessness it could be a flare-up of a long-standing lung disease, like asthma,” explains the clinic’s chief cardiologist Professor Len Kritharides.
“There’s also the chance it’s linked to a heart condition such as coronary disease or an abnormal heart rhythm, which is why I get involved,” Professor Kritharides says. For those with daily, long-term breathlessness, it may be caused by a range of lung, heart or muscle conditions, obesity, poor fitness or a combination of things.
“Understanding the problem is the essential first step to treatment,” Professor Kritharides says. “We hope that we can help patients identify their treatment options as quickly as possible and help them live a better, healthier, more active life.”
The Woolcock Breathlessness Clinic is for patients who have been breathless for more than four weeks despite treatment by their GP. Patients must be referred by their doctor.