Learn About Shortness of Breath
Breathlessness, or shortness of breath, is discomfort or difficulty with breathing. The medical term for shortness of breath is “dyspnea.”
Looking for more information on shortness of breath? View this webinar discussion from Victor Test, MD, FCCP, and Clayton Cowl, MD, FCCP.
- Shortness of breath is a common symptom. It may be related to serious diseases. It could be a result of being physically out of shape.
- Medical evaluation should assess if shortness of breath is treatable with lifestyle changes. These include quitting smoking and/or losing weight.
- Serious conditions associated with shortness of breath are:
What Is Shortness of Breath?
It is the inability to get enough air to breathe. It can come on suddenly or slowly over weeks to months. It may occur when:
- climbing stairs
- sitting still
Feeling breathless is described in different ways, such as:
- “short of breath”
- “tightness in my chest”
- “cannot get enough air”
It can be uncomfortable and sometimes scary. Being breathless does not damage your lungs. It can, however, be a sign of another problem.
How Serious Is Shortness of Breath?
In a healthy person, it can be caused by:
- very strenuous exercise
- extreme temperatures
- bad air quality
- high altitude
In non-extreme situations, it may be a sign of a medical problem.
If you have unexplained shortness of breath, especially if it comes on suddenly and is severe, see a doctor as soon as possible. It may be more serious if accompanied by:
- chest pain or pressure
Shortness of Breath Symptoms, Causes, and Risk Factors
You Shouldn’t Ignore These Symptoms
Some people with respiratory problems can feel breathless just by doing normal activities like standing up or walking to another room. See your doctor 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, an abnormal whistling-type sound when you breathe in or out
- stridor, a high-pitched noise that occurs with breathing
- worsening of pre-existing shortness of breath after using inhalers
- breathlessness that doesn’t stop after 30 minutes of rest
What Causes Shortness of Breath?
Heart and lung conditions are most often the causes of shortness of breath. Your heart and lungs transport oxygen to your body and remove carbon dioxide. Problems with either affect your breathing.
Breathing is regulated by the brain. It is a complex interaction between chemicals in the blood and in the air that we breathe. Oxygen and carbon dioxide levels and the amount of hemoglobin in blood all play a role.
If blood carbon dioxide levels rise, the brain tells the body to increase the breathing rate. This can result in deeper or faster breaths. It may lead to a sensation of difficulty breathing. 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 shortness of breath.
Causes of acute shortness of breath include:
- COPD flare
- allergic reaction (such as from a bee sting)
- carbon monoxide poisoning
- heart attack
- low blood pressure
- anemia (low red blood cell count)
- upper airway obstruction (throat blockage)
- heart failure
- enlarged heart
- abnormal heartbeat
- foreign object inhaled into the lungs
- Guillain-Barré Syndrome
- myasthenia gravis
- pulmonary embolism (blood clot in the lungs)
In chronic shortness of breath, it is most often due to:
- abnormal heart function
- other lung disease
- lung cancer
- pulmonary edema
- pulmonary fibrosis and other interstitial lung diseases
- pulmonary hypertension
What Are Risk Factors?
- prior lung diseases
- muscle weakness
- low hemoglobin
- being out of shape from lack of exercise or illness
- severe obesity
- continued exposure to asthma triggers
When to See Your Doctor
Visit your doctor when a normal activity causes unexpected shortness of breath, especially with your current state of fitness or health. Breathing difficulty should be checked by a doctor if it:
- comes on suddenly
- is persistent
- interferes with your daily activities
Shortness of breath that does not decrease with treatment or that is combined with other symptoms like chest pain needs urgent evaluation. This includes a possible emergency room visit.
Diagnosing and Treating Shortness of Breath
Prompt diagnosis is necessary. This is important for proper management of the cause and symptoms. A medical history and exam can often give a good explanation. Sometimes special tests are required.
What to Expect
Your doctor or other health-care provider will ask you a series of questions, such as:
- What is the nature of the shortness of breath?
- When does it get worse?
- When does it get better?
- Are you having any other symptoms, such as:
- chest pain?
- sputum (mucus or phlegm)?
They will listen to your heart and lungs with a stethoscope. Additional tests may be ordered, which could include:
- chest scan
- lung function tests
- blood tests
How is Shortness of Breath Is Diagnosed?
Information from the symptoms reported by the patient or other observers is usually enough. An exam and further tests as noted above may be required. Some people may need more complex testing, including high-resolution CT scans or cardiopulmonary exercise testing.
How is Shortness of Breath Is Treated?
It depends on the cause and duration of symptoms. If it is from the lungs or airways, bronchodilators may be prescribed to relax the airways. If it is due to anemia, iron supplements may be needed. Most people will respond once the diagnosis is clear. Doctors may recommend in certain situations to:
- avoid asthma triggers
- stop smoking
- use oxygen
- enroll in a pulmonary rehabilitation program
Living with Shortness of Breath
It can usually be controlled by:
- breathing techniques
- supplemental oxygen
Other things you can do to prevent and control shortness of breath include:
- pacing yourself
- try to not hold your breath
- using the pursed lips breathing technique
- sitting in front of a fan, so it blows on your face
- asking your doctor about pulmonary rehab
- losing weight if you are overweight
- avoiding exertions at elevations above 5,000 feet, unless trained
- avoiding triggers that worsen asthma
- avoiding exposure to pollutants in the air, indoors and outdoors
- quitting smoking, even if you’ve smoked for a long time (It reduces your risk for lung and heart disease.)
- getting a routine health checkup
- asking your doctor about your shortness of breath
- continuing medications as prescribed
- following an action plan developed with your doctor
- ensuring your oxygen supply is adequate and your equipment works properly, if you rely on supplemental oxygen
Questions to Ask your Healthcare Provider
Set up a meeting with your doctor. Together you can go over how to manage shortness of breath. See if you qualify for specific treatment, like pulmonary rehab.
- 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 more short of breath when it’s cold outside?
- How can I control my asthma?
- Are my lungs the cause of shortness of breath, or are there other causes?
Alan Roth, RRT, MS, FCCP
Sai Praveen Haranath, MBBS, MPH, FCCP
Date Last Reviewed