Bendopnea - A "New" Symptom of Heart Failure

Shortness of Breath While Bending Over Can Be A Sign of Advanced Heart Failure

bending over
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“Bendopnea” - shortness of breath while bending over - is a recently described symptom of heart failure.

Shortness of breath, or dyspnea, is a well-known symptom in people who have heart failure. The dyspnea can take several forms. Dyspnea with exertion is the most common form. Dyspnea that occurs when lying down - orthopnea - is another frequent symptom. Because of their orthopnea, patients with heart failure may need to use several pillows to sleep, or may have to sleep sitting up.

Paroxysmal nocturnal dyspnea - PND - is a particularly dramatic form of dyspnea that wakes the victim out of a sound sleep. Dyspnea on exertion, orthopnea, and PND are each considered to be classic symptoms of heart failure.


Recently, researchers from the University of Texas described yet another kind of dyspnea seen in patients with heart failure - shortness of breath that occurs while bending over. To describe this new symptom they coined the word “bendopnea.” (“Pnea” from the Greek pnoia, breath. “Bendo” from the Texan, bend over.)

The researchers noticed that some of their patients with heart failure complained of dyspnea when bending over, so they conducted a study to assess the frequency of this symptom, and its medical significance.

They studied 102 patients with heart failure due to dilated cardiomyopathy. Each patient was asked to sit in a chair and bend over for 30 seconds, as if they were tying a shoe.

Twenty-nine patients (28%) experienced bendopnea.

Further, the researchers performed a full cardiac evaluation on all 102 patients in the study. They found that the 29 patients with bendopnea, on average, had significantly more advanced forms of heart failure than patients without bendopnea. In addition, their more “classic” symptoms of heart failure (such as dyspnea on exertion and orthopnea) also tended to be more severe.

In particular, the presence of bendopnea was more commonly experienced by patients who had significant fluid retention, as well as elevated cardiac pressures.

What This Means

While this was a small study, it strongly indicates that the appearance of bendopnea in a person with heart failure may be taken as a likely sign that their condition is worsening. The test for bendopnea is quick and simple to perform (that is, sit down and bend over for 30 seconds), and many doctors may end up adding it to their routine evaluation of patients with heart failure.

Whether the symptom of bendopnea may also be helpful in diagnosing previously unknown heart failure is unknown, because this newly-recognized symptom has not been studied as a screening tool. However, since bendopnea seems to correlate with more advanced heart failure, it seems likely that in most instances the diagnosis of heart failure would be evident from other symptoms and signs before bendopnea ever appears.

Finally, it is worth noting that feeling short of breath while bending over may be caused by many conditions other than heart failure, including various lung disorders, or simply being overweight. So if you notice the symptom of bendopnea it does not necessarily mean that you have heart failure - but it does mean you should check with your doctor about this symptom.


Thibodeau JT, Turer AT, Gualano SK, et al. Characterization of a novel symptom of advanced heart failure: Bendopnea. JACC Heart Fail 2014; 2:24–31. 

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