Shortness of breath is a common symptom that may appear quickly or gradually. If you’re feeling short of breath, it doesn’t mean you have to worry about a serious condition like lung cancer or heart disease, but you should see your doctor as soon as possible.
There are many causes of shortness of breath, and they are treatable. You will need to speak with your doctor, perform a physical exam, and possibly have diagnostic tests to understand the cause of your shortness of breath.
Most people describe this symptom as a subjective feeling of difficulty breathing. You may feel unable to get enough air, or breathe harder than usual. Some also described a feeling of tightness in the chest.
Shortness of breath can strike quickly within minutes or hours, or it can come and go over days, weeks, months, or even years.
When to see a healthcare provider
It can sometimes be difficult to know how bad your shortness of breath is. In fact, sometimes the most severe shortness of breath may not be life-threatening—like hyperventilation or a panic attack—while the mildest symptoms may be related to a serious cause.
Serious causes may be accompanied by other symptoms.
When to call 911
Symptoms that indicate shortness of breath may be serious include:
- chest pain
- blue fingers or lips (cyanosis)
- Swelling or feeling of fullness in the throat or lips
- unable to speak due to difficulty breathing
- your symptoms get worse quickly
- redness or swelling of the legs
- cough up blood
If you’re trying to decide whether to call 911, it’s best to seek emergency help.
Some causes of shortness of breath can be life-threatening and require immediate medical attention.
You will see different terms related to shortness of breath. A brief explanation of some of these terms includes:
- Dyspnea is a feeling of shortness of breath
- Shortness of breath is shortness of breath, with or without a feeling of shortness of breath
- Difficulty breathing means slow breathing
The normal respiratory rate for adults is considered to be 12 to 20 breaths per minute at rest and varies according to the age of the child.
It is important to note that at normal breathing rates, you may experience shortness of breath. Vice versa, you may experience abnormal breathing rate without any difficulty breathing.
In 85% of people, shortness of breath is caused by a medical condition that affects the heart or lungs.
Some of the more common causes include:
- Chronic Obstructive Pulmonary Disease (COPD)
- Infections such as bronchitis and pneumonia
- congestive heart failure
- heart attack
- pulmonary embolism
- pneumothorax, collapsed lung
Other common causes include:
- Anemia: When you have anemia, you may also experience fatigue, pale skin, and dizziness
- Thyroid disorders: Both hyperthyroidism and hypothyroidism can cause difficulty breathing
Less common but important causes of shortness of breath may include:
- Benign and malignant tumors, including lung cancer
- anxiety and panic attacks
- Accidental inhalation of an object into the lungs
- heart valve problems
- acid reflux
- anaphylaxis (a severe allergic reaction)
- Neurological diseases such as multiple sclerosis
- other lung diseases, such as sarcoidosis and bronchiectasis
- lack of regular exercise
Before blaming inactivity for shortness of breath, consult your healthcare professional.
If you experience shortness of breath, be sure to make an appointment to see your healthcare professional, even if you think you may know the cause of your symptoms. They will take a careful medical history and perform a physical examination.
Some of the questions they might ask include:
- When did you first experience shortness of breath and how did it start?
- Do you have any other symptoms such as chest pain, cough, wheezing, fever, leg pain, unexplained weight loss or fatigue?
- Have you recently traveled by car or plane?
- Are your symptoms at rest or only with activity?
- What activities seem to be causing your symptoms?
- Do you feel more breathless when you sit or lie down?
- Do you have a personal or family history of any heart or lung problems?
- Have you ever smoked? If so, how long will it take?
Testing and Imaging
The diagnostic tests you may need will depend on your specific symptoms and physical examination results.
Tests you might take include:
- A pulse oximeter, a test that estimates the amount of oxygen in the blood by placing a clip on your finger or earlobe
- Electrocardiogram (EKG) to look for signs of a heart attack or irregular heartbeat
- Chest X-rays to look for lung infections or growths
- blood tests to look for anemia and other causes
- Pulmonary function tests to look for signs of asthma or emphysema and other lung diseases
Other tests may include:
- Chest Computed Tomography (CT)
- pressure test
- An echocardiogram, which is an ultrasound of your heart to check for problems with your heart valves and any damaged areas of your heart
- Bronchoscopy uses a flexible tube passed through your mouth and down into the bronchi to look for tumors or foreign objects. Bronchoscopy is performed for tachypnea only if relevant findings are present on chest imaging.
Dyspnea and COPD
Dyspnea is common in COPD. Your doctor may use the Modified Medical Research Council Dyspnea Scale to determine the severity of your breathing difficulties.
Assess for shortness of breath
Treatment for shortness of breath depends on the cause, but the most important first step is to make sure you get enough air to give your tissues the oxygen they need. This is called ABC:
- respiratory tract
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