Shortness of breath symptoms, causes and treatment

Shortness of breath is a very frightening sensation. The condition is medically known as dyspnea, which is often described as a very intense tightening in the chest, difficulty breathing, air hunger, feeling of suffocation or breathlessness. 

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Shortness of breath is typically the result of very strenuous exercise, obesity, extreme temperatures, and higher altitudes. Outside of these situations, shortness of breath is most likely a medical problem.

If you experience shortness of breath, especially when it is sudden or severe, you must see your doctor right away. 

Some individuals with problems in the respiratory system can feel shortness of breath just by performing normal activities such as walking to another room or simply getting out of a chair. You should see your doctor if you experience shortness of breath that is accompanied by:

  • Difficulty breathing when lying flat
  • Swelling in the ankles and feet
  • Cough, chills, and high fever
  • Turning blue of lips or fingertips
  • Wheezing, which is the abnormal whistling type of sound when breathing in or out
  • Stridor, which is a high pitched noise when breathing
  • Worsening of pre-existing shortness of breath after using inhalers
  • Breathlessness that will not go away even after 30 minutes of rest.

A healthy adult breathes in and out about 20 times a minute, which is about 30,000 breaths each day. After a vigorous workout or when experiencing a common cold, you might experience shortness of breath from time to time, but generally, you should never feel short of breath. 

If you experience sudden and severe trouble catching your breath, you should immediately call the emergency medical service, especially when it is accompanied by nausea or chest pain.

Shortness of breath is quite a common symptom. While it could be related to a serious illness, it also may be the result of being physically out of shape. Medical evaluation is necessary to assess if the shortness of breath may be treated by changes in the lifestyle, which include losing weight or quitting smoking. Shortness of breath may be associated with the following serious conditions:

  • Chronic obstructive pulmonary disease or COPD
  • Asthma
  • Anemia
  • Heart diseases such as heart attack or heart failure
  • Pulmonary embolism or blood clots in the lungs.

Shortness of breath is the inability of getting enough air to breathe. It can come slowly or suddenly over weeks or months. The condition may occur when:

  • Climbing stairs
  • Walking
  • Running 
  • Sitting still

The feeling of breathlessness may be described as:

  • Short of breath
  • Cannot get enough air
  • Tightness in the chest

Shortness of breath can uncomfortable and scary. Shortness of breath does not cause damage to your lungs but it can be a symptom of another problem.

Causes of Shortness of Breath

The most common causes of shortness of breath are lung or heart problems. These two organs of the body are involved in the transport of oxygen to your tissues and the removal of carbon dioxide. Any problem with either of the two processes will affect how you breathe. 

Acute shortness of breath, which comes suddenly, has a limited number of causes, such as:

  • Asthma
  • Anaphylaxis or a severe allergic reaction
  • Carbon monoxide poisoning
  • Chronic obstructive pulmonary disease or COPD worsening symptoms
  • Heart rhythm problems or heart arrhythmias
  • Heart failure
  • Pneumothorax or collapsed lung
  • Pneumonia and other pulmonary infections
  • A blood clot in an artery in the lung or pulmonary embolism
  • Obstruction in the upper airway
  • Sudden loss of blood

In the case of chronic shortness of breath, one that has lasted for weeks or longer, the condition is usually caused by:

  • Asthma
  • Chronic obstructive pulmonary disease or COPD worsening of symptoms
  • Heart dysfunction
  • Deconditioning
  • Obesity
  • Interstitial lung disease
  • Accumulation of fluid around the lungs or pleural effusion

Several health conditions can also make it difficult to get enough air, including:

Lung problems

  • Croup, which is common in young children
  • Inflammation of the membrane surrounding the lungs or pleurisy
  • Lung cancer
  • Excess fluid in the lungs or pulmonary edema
  • Scarred and damaged lungs or pulmonary fibrosis
  • High blood pressure within the blood vessels in the lungs or pulmonary hypertension
  • Collections of inflammatory cells in the body or sarcoidosis
  • Tuberculosis

Heart problems

  • Problem with the heart muscle or cardiomyopathy
  • Heart failure
  • Inflammation of the tissue around the heart or pericarditis

Other problems

  • Anemia
  • Broken ribs
  • Anxiety disorders
  • Choking
  • Swelling of the lid of the windpipe or epiglottitis
  • Inhalation of a foreign object
  • Guillain-Barré syndrome
  • A chest wall deformity of kyphoscoliosis
  • Myasthenia gravis or a condition causing muscle weakness

Diagnosis and Treatment of Shortness of Breath

When you complain of shortness of breath, the doctor will examine you. Part of the examination is listening to your lungs. The doctor might ask you to have a lung function test, or spirometry, to determine how air you can blow in and out of your lungs, as well as how fast you can do it. This test will help diagnose if you have asthma or COPD. 

The doctor might conduct other tests, including:

  • Pulse oximetry – The doctor clips a device to your finger or ear lobe to measure the amount of oxygen in your blood.
  • Blood tests – These tests will show if you an infection or anemia. It can also check for a blood clot or fluid in your lungs.
  • Electrocardiogram – This test measures the electric signals from your heart. This checks if you have a heart attack and also to find out how fast your heart beats and if there is a healthy rhythm.
  • Chest X-ray or a CT scan – These tests can see if you have pneumonia, a blood clot in your lungs, or other lung diseases. A CT scan puts together several X-rays from various angles to make a complete picture.

Treatment for Dyspnea

Relaxation and breathing methods can help address the problem of dyspnea. Your treatment depends on what causes your shortness of breath. If you have asthma, the doctor may prescribe that you use an inhaler during a flare. Fluid in the lungs needs to be drained by the doctor. Medication will be prescribed if it is determined that you have an infection in the lungs. Giving you oxygen provides temporary relief. If your doctor prescribes medication for your shortness of breath, they should be taken exactly as prescribed.

Exercise can help you build up the strength of your lungs. You can ask your doctor about the types of exercise that will be good for you. You should quit smoking if you are a smoker. 

It will help your shortness of breath problem if you can stay away from polluted air, such as secondhand smoke, or chemical fumes, and extremes in temperature. When going to a high elevation place, you should spend some time getting used to the thin air.

Living with shortness of breath

Your chronic shortness of breath can be controlled by:

  • Breathing techniques
  • Medication
  • Supplemental oxygen
  • Exercise

There are other things that you can do to prevent or control shortness of breath, including:

  • Pacing yourself when performing tiring activities
  • Sitting in front of a fan that blows on your face
  • Try not to hold your breath
  • Use pursed lips technique of breathing
  • Asking your doctor about pulmonary rehab
  • Losing weight if you are obese or overweight
  • Avoiding exertions at elevations above 5,000 feet, unless you have been trained to do it
  • Avoiding triggers that will worsen your asthma
  • Avoiding exposure to pollutants in the air, both indoors and outdoors
  • Quitting smoking even if you have smoked for a long time. It will reduce your risk of heart and lung diseases.
  • Going to a routine checkup with your doctor
  • Inquiring your doctor about your shortness of breath
  • Continue taking your medications as prescribed by the doctor
  • Following the action plan that your doctor developed for you
  • Ensuring having an adequate oxygen supply. If you are relying on supplemental oxygen, ensure that your equipment works properly. 

Risks of Having Shortness of Breath

There are several risk factors for you to have shortness of breath, including:

  • Prior lung diseases
  • Low hemoglobin
  • Muscle weakness
  • Severe obesity
  • Being out of shape from illness or lack of exercise
  • Continued exposure to asthma triggers
  • Smoking

When to Seek Medical Attention

Do not ignore the symptoms of shortness of breath. Call your doctor immediately if your problem gets worse after using an inhaler, your symptoms change, or if your shortness of breath is accompanied with:

  • Swelling in your ankles and feet
  • The difficulty of breathing when lying flat
  • Cough, chill, and high fever
  • An unusual whistling sound when you breathe
  • A gasping sound when you breathe

Set up a meeting with your doctor if you are experiencing shortness of breath. Together you and your doctor can make plans on how to manage your shortness of breath. Your doctor will determine the best treatment plan for you.

Going to the ER

Ask someone to take you to the nearest emergency room of a hospital if:

  • You have sudden shortness of breath
  • Your shortness of breath is accompanied by nausea, chest pain, or fainting
  • Your lips or fingertips turn blue.

If you feel you are too weak to go to the emergency room, immediately call emergency medical services.