Heart Disease Expert Forum
Shortness of breath, 9 years after bypass
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Shortness of breath, 9 years after bypass

Posted By  CCF Cardio MD-SGM on March 20, 1998 at 00:20:29:

In Reply to: Shortness of breath, 9 years after bypass posted by Deniz Kalfaoglu on March 12, 1998 at 12:24:42:

: I have been a patient of Dr. Conrad Simpfendorfer of Cleveland Clinic Foundation,
  with clinic # 1983-220-1. I underwent coronary bypass surgery on June 14 1989
  by Dr.Paul Taylor. About 4 years ago, I received a phone call from the CCF,
  asking me a range of questions, including "Do you suffer from shortness of
  breath?" , since I felt fine at the time, I answered negative (but I
  neglected to ask why this question was asked).
  However, recently I have been experiencing shortness of breath from
  time to time, and it seems unrelated to my level of physical activity
  at the time. I have no chest pains or any other pain, I feel fine apart
  from the shortness of breath.
  I was wondering if the shortness of breath I am feeling is something
  that I should be concerned about or is it normal?  
  Thank you in advance.
  My phone is: 90-232-421-4819, fax:  90-232-479-2850,
  or email: pamela.***@****  or  ***@****
  Deniz Kalfaoglu
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Dear Deniz,
Shortness of breath is most commonly a result of disorders affecting the heart or lungs.  Since you have been diagnosed with coronary artery disease and have undergone a bypass surgery nine years ago, it would be reasonable to suspect the heart as the cause of your symptoms.  However, a thorough evaluation should consider lung problems including emphysema, high blood pressure in the pulmonary arteries, blood clots to the lungs(pulmonary embolism)  as well as multiple other causes such as physical deconditioning.
Returning our attention to the heart, your symptoms could result from recurrence of coronary artery blockages that are causing silent angina.   In this scenario, the heart muscle may be suffering from reduced blood flow, causing shortness of breath, despite the absence of angina.  It is not unusual for heart bypass patients to suffer problems with their grafts around this time (eight to ten years post-operatively).   Also, dysfunction of the heart's main pumping chamber, the left ventricle, could be causing your symptoms.  Such dysfunction may have been longstanding, or may have developed in recent years.    Many other cardiac problems can lead to shortness of breath, including disorders of the cardiac valves.
I believe that the symptoms you describe definitely merit investigation.  If you wish, make an appointment with Dr. Simpfendorfer or perhaps a cardiologist closer to your home.  A reasonable starting point, following a thorough history and physical examination, would be an exercise stress test to look for recurrence of coronary disease.  An X-ray of the chest is indicated as well.  
I hope these comments will be helpful.  Information provided in the Heart Forum is for general medical purposes only.  Specific diagnoses and therapies can only be provided by your physician.





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