Dyspnea and Pulmonary Hypertension Program

This specialized clinic brings together providers from Newton-Wellesley Hospital and Brigham and Women’s Hospital to diagnose and treat long-term shortness of breath (chronic dyspnea) and its cause, which is often pulmonary hypertension.

The Dyspnea and Pulmonary Hypertension Program at the Elfers Cardiovascular Center at Newton-Wellesley Hospital is a specialized clinic for people with long-term breathing problems (chronic dyspnea) who haven't found relief from previous treatments or consultations elsewhere. Our team includes highly skilled pulmonary and cardiovascular clinicians who specialize in diagnosing and treating chronic dyspnea.

Meet our Team >

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Our program brings together providers from Newton-Wellesley Hospital and Brigham and Women’s Hospital. This collaboration allows us to use the expertise and resources of Mass General Brigham's integrated health system to ensure comprehensive, coordinated, and specialized care for patients with chronic dyspnea in a convenient community location.  

Our experienced lung health and heart care teams work together to improve your condition through:

• Advanced cardiology and pulmonary testing
• Faster diagnoses
• Coordinated treatment plans
• Collaboration with a full range of specialists within Mass General Brigham

Treatment for chronic dyspnea varies from person to person and aims to address the underlying condition causing it. Our team conducts thorough evaluations and develops customized treatment plans tailored to each patient’s specific needs and goals. We ensure excellence across all aspects of care, utilizing advanced diagnostic and treatment tools, and maintaining a compassionate and skilled care team.

What Is Dyspnea?

Dyspnea is a symptom that refers to difficulty breathing. People experiencing dyspnea, or shortness of breath, have difficulty breathing or are unable to catch their breath. It can feel like there is a weight or tightness in the chest, making it harder to breathe deeply or quickly. They may feel the need to work harder to get enough air into their lungs, perhaps even gasping for air at times. Dyspnea can be acute (temporary) or chronic (long-lasting). Acute dyspnea often develops quickly and lasts for hours to a few days or weeks. On the other hand, chronic dyspnea can happen suddenly or progress gradually over time, lasting from several weeks to years.

Conditions like anxiety can contribute to shortness of breath, and some individuals may feel fatigued or breathless during physical exertion. Dyspnea can also signify a serious underlying issue involving various organ systems, primarily related to the heart and/or lungs.

Frequently asked questions about dyspnea

What Is Pulmonary Hypertension?

Pulmonary hypertension is a form of high blood pressure that occurs in the lungs due to thickening, constriction, or blockage of lung blood vessels, which strains the heart and causes breathing difficulties. This increased pressure forces the right side of the heart to work harder to pump blood to the lungs. Untreated, it can lead to heart enlargement and weakening, resulting in less efficient blood circulation throughout the body.

• About 30% of patients with unexplained shortness of breath are diagnosed with pulmonary hypertension

Our care team includes dedicated pulmonary hypertension specialists who specialize in diagnosing and managing pulmonary hypertension, including chronic thromboembolic pulmonary hypertension (CTEPH). They use advanced diagnostic methods such as cardiopulmonary exercise testing (CPET) and right heart catheterization procedures to assess severity and develop personalized treatment plans.

As Brigham and Women’s is home to an accredited pulmonary hypertension center, our specialists:

• Develop new treatments for pulmonary hypertension
• Lead research on pulmonary hypertension
• Train the next generation of specialists in pulmonary hypertension
• Collaborate closely with heart and lung transplant teams

Learn more about pulmonary hypertension

Signs and Symptoms of Dyspnea

The signs and symptoms of dyspnea can vary between different people and depend on the underlying cause. Some common signs include: 

• Feeling a weight or tightness in your chest
• Having to breathe quicker and/or deeper than usual
• Wheezing or coughing
• Feeling like you have to work harder to breathe
• Chronic fatigue

Dyspnea can occur alongside other symptoms, such as chest pain. If you experience dyspnea in addition to other serious symptoms like chest pain or if your difficulty in breathing is worsening quickly, contact your doctor or call 9-1-1 immediately.

Causes of Dyspnea

Acute dyspnea typically occurs unexpectedly. Chronic dyspnea lasts for an extended period, often indicating an underlying health condition. Dyspnea can arise from various causes, including:

Pulmonary conditions

• Chronic obstructive pulmonary disease (COPD), chronic bronchitis, or emphysema
• Asthma, including exercise-induced asthma
• Bronchiolitis obliterans
• Lung infections like pneumonia or bronchitis 
• Pulmonary embolism (blood clot in the lungs) Interstitial lung disease (ILD)
• Pulmonary hypertension
• Pulmonary edema (fluid in the lungs)

Cardiac conditions

• Heart failure
• Myocardial infarction or coronary artery disease
• Arrhythmias such as atrial fibrillation, atrial flutter, ventricular tachycardia, and supraventricular tachycardia
• Valvular heart disease, including mitral stenosis, mitral regurgitation, aortic stenosis, and aortic regurgitation
• Myocarditis or pericarditis
• Pericardial effusion

Upper airway obstruction

• Vocal cord dysfunction or paralysis
• Tracheal stenosis

Other causes

• Anemia
• COVID-19
• Neurological conditions like neuromuscular weakness (e.g., myasthenia gravis, amyotrophic lateral sclerosis (ALS), or diaphragm paralysis) and dysautonomia
• Psychiatric conditions such as anxiety or panic disorders, hyperventilation, and exercise-induced dyspnea

Diagnosing Chronic Dyspnea

Because dyspnea is most often a symptom of an underlying condition or disease, diagnosis focuses on trying to find the root cause of the shortness of breath. Depending on your other symptoms and the most likely cause(s), your care team will perform tests such as:

• Blood tests
• Imaging tests like chest x-rays or CT scans
• Breathing and lung function tests
• An echocardiogram, which is an ultrasound of the heart 
• Exercise stress tests, including cardiopulmonary exercise testing (CPET), a comprehensive test that evaluates how well the heart, lungs, and muscles work together during physical activity
• Cardiac catheterization

Treatment for Chronic Dyspnea

Treatment of dyspnea varies from person to person. The approach to managing your shortness of breath is tailored to your specific type of dyspnea and primarily centers on addressing the root cause of your breathing difficulties.

Possible treatments for chronic dyspnea include:

• Breathing and relaxation techniques
• Exercise and/or lifestyle changes
• Medications
• Pulmonary or cardiac rehabilitation
• Physical therapy
• Supplemental oxygen
• Surgery (for emergencies or conditions that can be corrected via surgery like certain heart defects)

Meet Our Team

Our team consists of dyspnea and pulmonary hypertension clinicians who are experts at diagnosing and treating dyspnea and its causes.

• Benjamin Stump, MD, MPH, Director of the Dyspnea and Pulmonary Hypertension Program at the Elfers Cardiovascular Center at Newton-Wellesley Hospital
• Aaron Waxman, MD, PhD, Executive Drector of the Center for Pulmonary Heart Diseases at the Brigham and Women's Hospital Heart and Vascular Center
• Eileen M. Harder, MD

Seek a Referral

Patients can access the Dyspnea and Pulmonary Hypertension Program through a referral from their primary care provider, pulmonologist, or cardiologist. To learn more, please contact your doctor, who can submit a referral by calling our center.

• 617- 831-7100