Shortness of Breath

General

The medical term for shortness of breath is dyspnea and it has many causes. The feeling of dyspnea is subjective and involves many psychological, physiological, social, and environmental influences.  Dyspnea must be quantified (how severe) and qualified (are there associated symptoms, how long and when does the dyspnea occur). 

 

What are the common causes?

Shortness of breath is often evaluated by pulmonary physicians.  Common lung conditions including asthma, COPD and interstitial lung disease are causes of dyspnea. Cardiac causes including angina or congestive heart failure must be considered especially if there is associated chest pain. Obesity and deconditioning can also make an individual feel short of breath. Anemia or low blood counts is another cause.

 

What tests are needed to evaluate shortness of breath?

After a thorough history and physical examination, tests to evaluate for common lung and heart conditions are often performed. These tests include pulmonary function studies, x-ray studies including CT scans, echocardiograms (cardiac ultrasound).  If the cause of the dyspnea remains elusive, a cardiopulmonary exercise study (commonly called a pulmonary stress test) is often performed.

 

Can shortness of breath be helped?

Shortness of breath can usually be eliminated or at least helped once the cause is identified. Treatments are aimed treating the cause.

 


 

The following information is an adapted exerpt from the National Library of Medicine - National Institutes of Health


Why breathing can become difficult:

No standard definition exists for difficulty breathing. Some people may feel breathless with only mild exercise (for example, climbing stairs), even though they do not have a medical condition. Others may have advanced lung disease but never feel short of breath.

Wheezing is one form of breathing difficulty in which you make a high-pitched sound when you breathe out.


Shortness of breath has many different causes:

1. A blockage of the air passages in your nose, mouth, or throat may lead to difficulty breathing.

2. Heart disease can cause breathlessness if your heart is unable to pump enough blood to supply oxygen to your body. If your brain, muscles, or other body organs do not receive enough oxygen, a sense of breathlessness may occur.

3. Lung disease can cause breathlessness.

4. Sometimes emotional distress, such as anxiety, can lead to difficulty breathing.

 

The following medical problems may cause breathing difficulty:

Problems with the lungs:

  • Blood clot in the arteries of the lungs (pulmonary embolism)
  • Bronchiolitis
  • Chronic obstructive pulmonary disease (COPD), asthma, and other chronic lung problems
  • Pneumonia
  • Pulmonary hypertension

 

Problems with the airways leading to the lungs:

  • Choking on something stuck in the airways
  • Croup
  • Epiglottitis

 

Problems with the heart:

  • Heart attack or angina
  • Heart defects from birth (congenital heart disease)
  • Heart failure
  • Heart rhythm disturbances (arrhythmias)



Other problems:

  • Allergies (such as to mold, dander, or pollen)
  • Climbing to high altitudes where there is less oxygen in the air
  • Compression of the chest wall
  • Dust in the environment
  • Hiatial hernia
  • Obesity
  • Panic attacks

 

What is a normal acceptable level of Shortness of Breath?

Sometimes, a small amount of breathing difficulty may be normal, and is not cause for concern. Severe nasal congestion is one example. Strenuous exercise, especially when you do not exercise often, is another example.

If breathing difficulty is new or is getting worse, it may be due to a serious problem.

If the breathing difficulty is severe, you may need to go to a hospital. You may receive many different medications to treat the cause of breathing difficulty.

If your blood oxygen level is very low, you may need to receive oxygen. High doses of supplemental oxygen may be hazardous for some patients, however. Oxygen is not always needed for shortness of breath.

 

Tests that may be performed include the following:

  • Blood oxygen saturation (pulse oximetry)
  • Blood tests (may include arterial blood gases)
  • Chest x-ray
  • CT scan of the chest
  • ECG
  • Echocardiogram
  • Exercise testing
  • Pulmonary function tests