Consultant Respiratory Physician in London

Breathlessness specialist in London

Consultant-led respiratory assessment for new, persistent or unexplained breathlessness, helping investigate possible causes and guide appropriate treatment based on your symptoms and clinical findings.

Consultant respiratory physician
Specialist breathlessness assessment
Clinics in London

Understanding your symptom

What is breathlessness?

Breathlessness is the uncomfortable sensation of not being able to breathe as easily as expected. It is also described as shortness of breath, difficulty breathing, air hunger or the medical term dyspnoea.

Feeling out of breath after significant exertion can be normal. An expert assessment is appropriate when breathlessness occurs at rest, follows minimal activity, is getting worse, or now happens during an activity you previously managed comfortably.

Breathlessness is a symptom rather than a diagnosis. The first priority is to understand its pattern, severity and effect on your life, then identify the condition—or combination of conditions—responsible.

Finding the underlying cause

What causes shortness of breath?

Breathlessness can arise from the lungs, heart, breathing muscles or general health. More than one factor may be present, so a structured assessment is often more useful than considering each symptom in isolation.

Respiratory causes

  • Airway disease: asthma, COPD, bronchiectasis and bronchiolitis
  • Interstitial lung disease: including pulmonary fibrosis, sarcoidosis and hypersensitivity pneumonitis
  • Infection: including pneumonia and tuberculosis
  • Pulmonary vascular disease: including pulmonary embolism and pulmonary hypertension
  • Pleural disease: including fluid around the lung
  • Other structural disease: including emphysema or a lung lesion

Cardiac causes

  • Heart failure: reduced pumping function or impaired relaxation
  • Irregular rhythms: including atrial fibrillation
  • Valve disease: affecting blood flow through the heart
  • Coronary disease: reduced blood supply to the heart muscle

Neurological and muscular causes

  • Respiratory muscle weakness: reduced strength of the diaphragm or other breathing muscles
  • Neuromuscular conditions: affecting the control or efficiency of breathing

Other common causes

  • Anaemia: reduced oxygen-carrying capacity of the blood
  • Deconditioning: reduced fitness and exercise tolerance
  • Weight-related factors: increased work of breathing
  • Anxiety or panic: rapid breathing and air hunger
  • Long COVID: sometimes involving several overlapping mechanisms
  • Breathing pattern disorder: inefficient or dysregulated breathing

The timing of symptoms, triggers, examination, oxygen levels, previous results and response to treatment all help determine which causes are most likely and which tests are worthwhile.

A commonly overlooked contributor

Breathing pattern disorder

Breathing pattern disorder describes an inefficient or dysregulated way of breathing. It is also called dysfunctional breathing and may contribute to persistent breathlessness even when routine tests are reassuring.

  • Symptoms may include chest tightness, air hunger, frequent sighing or difficulty taking a satisfying deep breath.
  • Symptoms can worsen with stress, anxiety or exertion, but may also occur at rest.
  • Diagnosis depends on a careful clinical assessment and, where appropriate, specialist respiratory physiotherapy or exercise testing.
Learn more about breathing pattern disorder →

Consultant-led respiratory care

Why should I see Dr Ricardo José?

Breathlessness is often complex. A respiratory specialist can bring your history, examination and previous results together, then select further tests according to the clinical question—not simply order every available investigation.

A broad diagnostic view

Assessment considers airway disease, lung structure, gas exchange, exercise physiology, breathing pattern and potential non-respiratory contributors.

Advanced investigation when needed

Dr José can arrange and interpret full lung function testing, specialist imaging, respiratory muscle tests and cardiopulmonary exercise testing where appropriate.

A plan you can understand

You receive a clear explanation of the likely cause, the significance of your results and practical next steps for treatment or further referral.

A structured, tailored assessment

How does Dr José investigate breathlessness?

Investigation begins with your story and examination. Existing reports are reviewed before targeted tests are selected to distinguish between respiratory, cardiac, physical-conditioning and breathing-pattern causes.

Stage 1

Understand the pattern

Clarify when breathlessness started, what triggers it, associated symptoms, functional limitation and relevant medical or exposure history.

Stage 2

Choose the right tests

Investigations are selected to answer specific diagnostic questions, rather than ordering every available test.

Stage 3

Bring the findings together

Results are interpreted in context so the likely cause, significance and next steps can be explained clearly.

Core respiratory assessment

Understanding how your lungs perform

Lung function and exercise-based testing can be particularly useful when routine assessment does not fully explain why you feel short of breath.

  • Full pulmonary function testing including spirometry, lung volumes and gas-transfer measurement
  • Cardiopulmonary exercise testing to assess the combined response of the heart, lungs and muscles during exertion
  • Respiratory muscle assessment where diaphragm or breathing-muscle weakness is suspected

High-resolution CT

Detailed chest imaging can identify emphysema, bronchiectasis, interstitial lung disease or another structural abnormality.

V/Q SPECT imaging

Ventilation and perfusion imaging may be used to assess chronic thromboembolic disease or regional ventilation-perfusion mismatch.

Additional targeted tests

Blood tests, ECG, echocardiography, ambulatory heart monitoring, oxygen assessment, overnight oximetry or a sleep study may be arranged where appropriate.

You may not need all of these investigations. The assessment is personalised according to your symptoms, examination, previous results and the most important clinical questions.

Personalised management

How is breathlessness treated?

Treatment is directed at the underlying cause or causes. When breathlessness continues despite appropriate disease treatment, additional symptom-focused support may help improve confidence, activity and quality of life.

Treat the diagnosis

Condition-specific care may include inhaled treatment, treatment of infection, management of inflammation or coordination with cardiac and other specialists.

Improve physical capacity

Pulmonary rehabilitation or a tailored activity programme can improve exercise tolerance and help reduce the impact of breathlessness.

Retrain breathing

Specialist breathing-pattern training and respiratory physiotherapy may help when inefficient breathing contributes to symptoms.

Support ongoing symptoms

A multidisciplinary approach may include pacing, recovery positions, anxiety support, nutrition or occupational therapy according to individual need.

About oxygen: oxygen therapy is prescribed for documented low oxygen levels in appropriate clinical circumstances; it is not a general treatment for breathlessness when oxygen levels are normal.

Patient feedback

What patients say about Dr Ricardo José

Choosing a respiratory specialist is an important decision. Independent patient feedback can help you understand how other patients experienced their consultation, communication and ongoing care.

Private breathlessness appointments

Concerned about breathlessness?

Arrange a private consultation with Dr Ricardo José for specialist respiratory assessment, a clear explanation of the findings and a personalised management plan.

This page provides general information and does not replace an individual medical assessment. If your symptoms are severe or rapidly worsening, seek urgent medical help rather than waiting for a private appointment.