Shortness of breath

What is Shortness of Breath?

Feeling short of breath can be an uncomfortable or frightening experience, especially if it has never happened to you before. It can be caused by problems with the lungs or with the heart, or by a low blood count, but its specific cause can sometimes take a while to pinpoint. Luckily, most causes of shortness of breath can be treated quickly once the cause is identified.

Many cases of shortness of breath are caused by simple, short lived problems, such as respiratory tract infections or allergies. The medical term for shortness of breath is dyspnea.

Very strenuous exercise, extreme temperatures, massive obesity and high altitude all can cause shortness of breath in a healthy person. Outside of these examples, shortness of breath is likely a sign of a medical problem. If you have unexplained shortness of breath, especially if it comes on suddenly and is severe, see your doctor as soon as possible.

Shortness of Breath Symptoms

People describe shortness of breath in different ways. Some people say they feel “hungry for air,” others say they feel as though they “cannot breathe deeply enough”. When you experience shortness of breath, you should pay attention to the sensations you feel and try to be as specific as possible when describing these sensations to your healthcare provider.

When to Seek Help

If you develop shortness of breath, particularly if it occurs or persists while at rest or is significantly worse than what you ordinarily experience (eg, it is provoked by less activity than usual), you should see a you pulmonologist. If you have severe shortness of breathe or also have chest pain or nausea, go to the closest emergency room. Shortness of breath is not a symptom to ignore.

Shortness of Breath Diagnosis

Your pulmonologist can learn a lot about your condition by listening to your description of the problem, and by asking about any other symptoms you may have. He or she can also learn a lot by listening to your heart and lungs with a stethoscope, and by checking your legs for swelling.

Tests — your healthcare provider may also order one or more of the following tests to help diagnose the problem:

• A blood test called a CBC can check for anemia, a condition that affects the blood’s ability to carry oxygen.
• A blood test called a BNP can indicate if you have fluid buildup in your lungs.
• A chest x-ray to look for pneumonia, or lung inflammation or scarring.
• An EKG is a test of your heart muscle that looks for signs of heart disease.
• A test called spirometry, or a pulmonary function test (or “PFT”) to test how your lungs work. This test can also indicate if you have asthma, emphysema or other lung diseases.
• A test called oximetry to measure the amount of oxygen in your blood.

Causes of Shortness of Breath

Acute shortness of breath, which comes on suddenly, over the course of minutes or hours, usually has different causes than chronic shortness of breath, which develops over weeks or months.

Acute shortness of breath — acute shortness of breath usually happens along with other symptoms. The most common causes of acute shortness of breath include:

• Respiratory tract infections, such as pneumonia, or acute bronchitis. These infections usually cause other symptoms, such as fever, cough, or coughing up sputum or mucus.
• A severe allergic reaction (anaphylaxis), which usually also causes itching, swelling, a rash, or other symptoms.
• Asthma, which often causes wheezing.
• A blockage in the respiratory tract, which could happen after accidentally inhaling a foreign object, such as a peanut or partially chewed meat.
• A blood clot or other blockage in an artery in the lungs.
• A punctured lung (pneumothorax).
• Interruptions in blood flow to the heart muscle, which might happen during a heart attack. When this is the cause of shortness of breath, there are often other symptoms, such as pain or pressure in the chest.
• Heart failure, a condition that affects the heart’s ability to pump blood throughout the body.

Chronic shortness of breath — Some of the same things that cause acute shortness of breath can also cause chronic shortness of breath. For example, asthma symptoms can come and go over months or years. Heart failure can also continue to cause shortness of breath over months or years.

The most common causes of chronic shortness of breath include:

• Asthma.
• Chronic obstructive pulmonary disease, a lung condition that often affects current or former smokers, includes conditions such as emphysema and chronic bronchitis.
• Interstitial lung disease, a collection of lung disorders that involve damage or scarring of lung tissue.
• Cardiomyopathy, a heart condition that leads to changes in the heart’s shape and size, and ability to pump blood to the rest of the body.
• Deconditioning, the technical term for being out of shape. For example, if you do not exercise regularly, you may develop shortness of breath when climbing stairs simply because of being deconditioned.
• Obesity can cause shortness of breath as extra weight in the chest and abdomen increases the work the muscles that control breathing must do.
• Pulmonary hypertension, which is high blood pressure in the arteries to your lungs. 

When to see a doctor

Make a doctor’s appointment

Make an appointment with your doctor if your shortness of breath is accompanied by:

• Swelling in your feet and ankles
• Trouble breathing when you lie flat
• High fever chills and cough
• Lips or fingertips turning blue
• Wheezing
• Stridor — a high pitched noise from the neck or throat that occurs with breathing
• Worsening of pre-existing shortness of breath 

Self-care

To help keep chronic shortness of breath from getting worse:

• Stop smoking. The benefits of quitting smoking are extraordinary. Once you’re tobacco-free, your risks of heart disease, lung disease and cancer begin to drop — even if you’ve been smoking for years.
• Avoid exposure to pollutants. As much as possible, avoid breathing allergens and environmental toxins.
• Lose weight if you are overweight.
• Take care of yourself. If you have an underlying medical condition, take care of it.
• Have an action plan. Discuss with your doctor what to do if your symptoms become worse.
• Avoid exertion at elevations higher than 5,000 feet (1,524 meters).
• If you rely on supplemental oxygen be sure your supply is adequate and the equipment works properly.