Breathlessness after climbing stairs is often associated with physical exertion or low fitness levels, but persistent or disproportionate shortness of breath can sometimes point to an underlying heart problem. According to Col Dr Monik Mehta, consultant in cardiology at Manipal Hospital, Gurugram, breathlessness after minimal exertion, particularly when accompanied by dizziness, palpitations or chest discomfort, should not automatically be dismissed as fatigue.

One possible cause is an arrhythmia, or an abnormal heart rhythm, which can affect how effectively the heart pumps blood. When the heartbeat becomes excessively fast, slow or irregular, the heart may not deliver sufficient blood and oxygen to the body during physical activity. Symptoms can vary depending on the type and severity of the rhythm disorder and may include breathlessness, palpitations, fatigue, dizziness, chest discomfort and reduced ability to exercise.

Dr Mehta also pointed to heart block as an important condition that can cause symptoms. Heart block occurs when electrical signals between the upper and lower chambers of the heart are delayed or interrupted. Some forms can result in a significantly slow heart rate and require prompt medical assessment. Persistent or unexplained symptoms therefore warrant attention rather than being automatically attributed to fitness levels.

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Doctors can use several tests to determine whether an abnormal rhythm or another heart condition is responsible for symptoms. These may include an electrocardiogram (ECG), Holter monitoring, echocardiography, stress testing and blood investigations. Treatment depends on the specific condition and its severity, with some patients requiring medication while others may need procedures such as catheter ablation or, in cases of certain heart blocks, a permanent pacemaker.

Some patients may also require treatment for an underlying cardiovascular condition contributing to their symptoms. Depending on the diagnosis, procedures such as angioplasty and stenting can be used to improve blood flow through narrowed coronary arteries. More extensive coronary disease may require bypass surgery, while significant valve problems can sometimes be treated through valve repair or replacement.

The cardiologist stressed that persistent or unexplained breathlessness should not simply be written off as poor fitness. Regular physical activity appropriate to a person's health, a balanced diet, adequate sleep and avoiding tobacco can support cardiovascular health. Anyone experiencing repeated or concerning symptoms should discuss them with a qualified healthcare professional, who can determine whether further evaluation is needed.

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