Shortness of Breath

Last Updated 05/07/2020

Authors:Alan Roth, RRT, MS, FCCP; Sai Praveen Haranath, MBBS, MPH, FCCP

About Shortness of Breath

Key facts about Shortness of Breath
  • Shortness of breath is a common symptom. It may be related to serious diseases, or it could be a result of being out of shape physically.
  • Your health care provider should assess whether shortness of breath is treatable with lifestyle changes, such as quitting smoking or losing weight.
  • Serious conditions associated with shortness of breath include:
  • Asthma
  • Chronic obstructive pulmonary disease (COPD)
  • Heart disease (heart attack, heart failure)
  • Anemia
  • Blood clots in the lungs, also called pulmonary embolism

Shortness of breath, or breathlessness, is discomfort or difficulty breathing. The medical term for shortness of breath is dyspnea.

How serious is Shortness of Breath?

In a healthy person, shortness of breath can be caused by:

  • Very strenuous exercise
  • Extreme temperatures
  • Bad air quality
  • Obesity
  • High altitude
  • Choking
  • Carbon monoxide poisoning
  • Allergic reaction (for example, following a bee sting)

If you have unexplained shortness of breath, especially if it comes on suddenly and is severe, see a doctor as soon as possible. Breathlessness may be more serious if  it’s accompanied by:

  • Chest pain or pressure
  • Fainting
  • Nausea

Shortness of breath happens when you cannot get enough air to breathe. It can happen suddenly or slowly over weeks or months. You may have shortness of breath when:

  • Walking
  • Climbing stairs
  • Running
  • Sitting still

People describe feeling breathless in different ways, such as:

  • “Short of breath”
  • “Tightness in my chest”
  • “Cannot get enough air”

Breathlessness can be uncomfortable and even scary. Being breathless does not damage your lungs. It can, however, be a sign of another problem.

What causes Shortness of Breath?

Heart and lung conditions are the most frequent causes of shortness of breath. Your heart and lungs transport oxygen to your body and remove carbon dioxide. Problems with either affect your breathing.

Your brain regulates your breathing. Complex communication takes place between chemicals in the blood and in the air you breathe. Oxygen and carbon dioxide levels and the amount of hemoglobin—a protein in red blood cells that transports oxygen—in blood all play a role.

If the carbon dioxide levels in your blood rise, your brain tells your body to increase your breathing rate. This increase can result in deeper or faster breaths as well as a sensation of breathlessness. Too much acid in the blood from an infection, lactic acid buildup, or other causes can also lead to an increased breathing rate and the feeling of breathlessness.

Causes of short-term shortness of breath include:

  • Asthma
  • COPD flare
  • Low blood pressure
  • Pneumonia
  • Anemia (low red blood cell count)
  • Abnormal heartbeat

Causes of long-term shortness of breath include:

  • Asthma
  • COPD
  • Abnormal heart function
  • Obesity
  • Other lung disease

Symptoms of Shortness of Breath

Some people with breathing problems can feel breathless just by doing normal activities like standing up or walking to another room. See your health care provider if you have shortness of breath and:

  • Swelling in your feet and ankles
  • Trouble breathing when you lie flat
  • High fever, chills, and cough
  • Lips or fingertips turning blue
  • Wheezing, a whistling-type sound when you breathe in or out
  • A high-pitched noise when you breathe
  • Worsening shortness of breath after using an inhaler
  • Breathlessness that doesn’t get better after 30 minutes of rest

What are the risk factors for Shortness of Breath?

Common risk factors include:

  • Muscle weakness
  • Low hemoglobin
  • Being out of shape from lack of exercise or illness

Serious risk factors include:

  • Severe obesity
  • Continued exposure to asthma triggers, such as cat dander or ragweed
  • Smoking
  • Prior lung diseases

Diagnosing Shortness of Breath

Prompt diagnosis is important so that you can begin to manage the cause and symptoms of your shortness of breath. A medical history and exam can often give your health care provider a good explanation. Sometimes, special tests are required.

How is Shortness of Breath diagnosed?

Your doctor or other health care provider will ask you about your symptoms. Try to give him or her as much information about your symptoms as you can.

Your provider will listen to your heart and lungs with a stethoscope. He or she may order additional tests, which could include:

When should you see your health care provider?

Visit your health care provider when a normal activity causes unexpected shortness of breath. Get your breathing difficulty checked if it:

  • Comes on suddenly
  • Is persistent
  • Interferes with your daily activities

It’s important that you contact your health care provider if your shortness of breath doesn’t get better with treatment or is combined with other symptoms, such as chest pain. In such a case, you may need to seek emergency care.

Treating Shortness of Breath

Treatment for shortness of breath depends on its cause. If the cause is your lungs or airways, your health care provider may give you medication. If it’s because of anemia, you may need iron supplements. Most people begin to feel better after the diagnosis is clear. Your provider may recommend that you:

  • Avoid asthma triggers
  • Stop smoking
  • Use oxygen
  • Take part in a pulmonary rehabilitation program

Living with Shortness of Breath

Shortness of breath can usually be managed with:

Other things you can do to prevent and control shortness of breath include:

  • Pacing yourself
  • Trying to not hold your breath
  • Sitting in front of a fan so that it blows on your face.
  • Losing weight if you are overweight
  • Avoiding strenuous activity at elevations above 5000 feet unless you’ve trained in a high-altitude environment
  • Avoiding asthma triggers
  • Avoiding exposure to pollutants in the air, both indoors and outdoors
  • Quitting smoking, even if you’ve smoked for a long time
  • Getting a routine health checkup
  • Continuing medications as prescribed
  • Ensuring that your oxygen supply is adequate and your equipment works properly, if you rely on supplemental oxygen

Resources

Questions to ask your health care provider

Set up a meeting with your provider. Together, you can go over how to manage your shortness of breath. See if you qualify for specific treatment, like pulmonary rehab.

When you see your provider, ask:

  • Am I breathless because of my age?
  • What if I stop smoking?
  • How can I reduce indoor air pollutants?
  • How can I exercise if I use oxygen?
  • Why do I get shorter of breath when it’s cold outside?
  • How can I control my asthma?
  • Are my lungs the cause of my shortness of breath, or are there other causes?