Having a hard time breathing

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Shortness of breath

Sudden shortness of breath, or breathing difficulty (dyspnoea), is the most common reason for visiting a hospital accident and emergency department.

It’s also one of the most common reasons people call 999 for an ambulance.

It’s normal to get out of breath when you’ve overexerted yourself, but when breathlessness comes on suddenly and unexpectedly, it’s usually a warning sign of a medical condition.

The information below outlines the most common reasons for:

  • sudden shortness of breath
  • long-term shortness of breath

This guide shouldn’t be used to self-diagnose your condition, but should give you an idea of what’s causing your breathlessness.

When to call a doctor

You should call your GP immediately if you have sudden unexpected shortness of breath, as there may be a problem with your airways or heart.

Your GP will assess you over the phone, and may either visit you at home or admit you to hospital. If your shortness of breath is mild or the result of anxiety, you may be asked to come to the surgery rather than a home visit.

If you’ve struggled with your breathing for a while, don’t ignore it. See your GP as it’s likely you have a long-term condition, such as obesity, asthma or chronic obstructive pulmonary disease (COPD), which needs to be managed properly.

Your doctor may ask you some questions, such as:

  • Did the breathlessness come on suddenly or gradually?
  • Did anything trigger it, such as exercise?
  • How bad is it? Does it only happen when you’ve been active, or when you’re not doing anything?
  • Is there any pain when you breathe?
  • Do you have a cough?
  • Do certain positions make it worse – for example, are you unable to lie down?

Feeling like you can’t get enough air can be terrifying, but doctors are well trained in managing this. You may be given extra oxygen to breathe if this is needed.

Causes of sudden shortness of breath

Sudden and unexpected breathlessness is most likely to be caused by one of the following health conditions. Click on the references at the end for more information about these conditions.

A problem with your lungs or airways

Sudden breathlessness could be an asthma attack. This means your airways have narrowed and you’ll produce more phlegm (sticky mucus), which causes you to wheeze and cough. You’ll feel breathless because it’s difficult to move air in and out of your airways.

Your GP may advise you to use a spacer device with your asthma inhaler. This delivers more medicine to your lungs, helping to relieve your breathlessness.

Pneumonia (lung inflammation) may also cause shortness of breath and a cough. It’s usually caused by an infection, so you’ll need to take antibiotics.

If you have COPD, it’s likely your breathlessness is a sign this condition has suddenly got worse.

A heart problem

It’s possible to have a “silent” heart attack without experiencing all the obvious symptoms, such as chest pain and overwhelming anxiety.

In this case, shortness of breath may be the only warning sign you’re having a heart attack. If you or your GP think this is the case, they’ll give you aspirin and admit you to hospital straight away.

Heart failure can also cause breathing difficulties. This life-threatening condition means your heart is having trouble pumping enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly. It leads to a build-up of fluid inside the lungs, which makes breathing more difficult.

A combination of lifestyle changes and medicines or surgery will help the heart pump better and relieve your breathlessness.

Breathlessness could also relate to a problem with your heart rate or rhythm, such as atrial fibrillation (an irregular and fast heart rate) or supraventricular tachycardia (regular and fast heart rate).

Panic attack or anxiety

A panic attack or anxiety can cause you to take rapid or deep breaths, known as hyperventilating. Concentrating on slow breathing or breathing through a paper bag can bring your breathing back to normal but should only be done when you are certain anxiety is the cause of your breathlessness.

More unusual causes

These include:

  • a severe allergic reaction (anaphylaxis)
  • pneumothorax – partial collapse of your lung caused by a small tear in the lung surface, which allows air to become trapped in the space around your lungs
  • pulmonary embolism – a blockage in one of the blood vessels in the lung
  • idiopathic pulmonary fibrosis – a rare and poorly understood lung condition that causes scarring of the lungs
  • pleural effusion – a collection of fluid next to the lung
  • diabetic ketoacidosis – a complication of diabetes where acids build up in your blood and urine

Causes of long-term breathlessness

Long-term breathlessness is usually caused by:

  • obesity or being unfit
  • poorly controlled asthma
  • chronic obstructive pulmonary disease (COPD) – permanent damage to the lungs usually caused by years of smoking
  • anaemia – a low level of oxygen in the blood caused by a lack of red blood cells or haemoglobin (the part of red blood cells that carries oxygen)
  • heart failure – when your heart is having trouble pumping enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly
  • a problem with your heart rate or rhythm, such as atrial fibrillation (an irregular and fast heart rate) or supraventricular tachycardia (regular and fast heart rate)

More unusual causes of long-term breathlessness are:

  • bronchiectasis – a lung condition where the airways are abnormally widened and you have a persistent phlegmy cough
  • pulmonary embolism – a recurrent blockage in a blood vessel in the lung
  • partial collapse of your lung caused by lung cancer
  • pleural effusion – a collection of fluid next to the lung
  • narrowing of the main heart valve, restricting blood flow to the rest of the body
  • frequent panic attacks, which can cause you to hyperventilate (take rapid or deep breaths)

When you’re short of breath, it’s hard or uncomfortable for you to take in the oxygen your body needs. You may feel as if you’re not getting enough air. Sometimes mild breathing problems are from a stuffy nose or strenuous exercise.

Many conditions can make you feel short of breath. Lung conditions such as asthma, emphysema, or pneumonia cause breathing difficulties. Heart disease can make you feel breathless if your heart cannot pump enough blood to supply oxygen to your body and stress caused by anxiety can make it hard for you to breathe.

Several breast cancer treatments may cause breathing problems or shortness of breath:

  • chemotherapy
  • radiation therapy
  • some hormonal therapies:
    • Evista (chemical name: raloxifene)
    • Fareston (chemical name: toremifene)
    • Faslodex (chemical name: fulvestrant)
    • Femara (chemical name: letrozole)
    • tamoxifen
  • some targeted therapies:
    • Afinitor (chemical name: everolimus)
    • Herceptin (chemical name: trastuzumab)
    • Tykerb (chemical name: lapatinib)

A number of pain medications, such as acetaminophen, aspirin, ibuprofen, and opiates also may cause breathing problems.

Managing breathing problems

If you have trouble breathing, talk to your doctor. Since breathing problems can be caused by so many things, it’s important to figure out why it’s happening to you. If it’s because of another condition, such as asthma, your doctor can treat it with medication. If your breathing problems are due to breast cancer treatment, you may be able to switch medicines.

Other tips to breathe easier

Several special breathing techniques can help manage shortness of breath.

Pursed-lip breathing may seem awkward at first, but it helps ease labored breathing:

  • Breathe in through your mouth or nose.
  • Purse your lips (as if you were whistling). Breathe out.
  • Try to exhale until all the air is gone. A good way to do this is to take twice as long to breathe out as you take to breathe in. Count to 4 as you breathe in. Purse your lips and count to 8 as you breathe out.

Positioning helps when you get short of breath while doing something physical, such as climbing stairs. When your muscles are relaxed, breathing is easier.

  • Rest by putting your back to a wall and your feet should width apart. Lean forward and put your hands on your thighs. This position relaxes your chest and shoulders, so they can help you breathe.
  • Use pursed-lip breathing.
  • If you can, sit down with your arms resting on your legs.
  • Continue to use pursed-lip breathing.
  • If you can’t lean against a wall, rest your hands or elbows on a piece of furniture or railing just below shoulder height.
  • Relax your neck and rest your head on your forearms.

Paced breathing eases shortness of breath when you walk or lift light objects.

For walking:

  • Stand still and breathe in.
  • Walk a few steps and breathe out.
  • Rest and then begin again.

For lifting:

  • Hold the object, but don’t lift it.
  • Breathe in.
  • Lift the object and breathe out.
  • When carrying something, hold it close to your body to save your energy.

If possible, use the muscles you breathe with for only one activity at a time. Don’t try to walk and breathe in or lift something and breathe in.

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Last modified on April 17, 2019 at 11:44 AM

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If you have severe difficulty breathing or turning blue call triple zero (000) for an ambulance.

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What are breathing problems?

Breathing problems are when you feel you can’t get enough air, your chest feels very tight, you are breathless or you feel like you’re being suffocated.

You might feel short of breath if you are obese or if you have just done some strenuous exercise. It can also happen in extreme temperatures or if you are at high altitude.

If you have breathing problems for any other reason, it is probably the sign of a medical problem.

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When should I call an ambulance or go to the emergency department?

You should call triple zero (000) for an ambulance if:

  • you are so short of breath you can’t speak in sentences
  • you also have pains in your chest, arm or jaw
  • you feel faint or sick

Make an appointment to see your doctor or consider going to an emergency department if, as well as being out of breath, you:

  • have swollen feet or ankles
  • feel more short of breath when you lie down
  • have fever, chills and a cough
  • have blue lips or fingertips
  • make noises when you breathe
  • have to put a lot of effort into breathing
  • are getting worse

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What should I do while waiting for an ambulance?

While you are waiting, try to stay calm. Sit upright and make sure you have someone with you if possible.

If you have asthma, take 4 puffs of your blue or grey reliever puffer. Take 4 more puffs every 4 minutes until help arrives.

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What causes breathing problems?

Common causes of feeling short of breath are:

  • lung problems, such as asthma and chronic obstructive pulmonary disease (COPD)
  • heart problems, such as a cardiovascular disease and heart failure
  • infections in the airways, such as croup, bronchitis, pneumonia, the flu and even a cold
  • a panic attack or anxiety

Other causes of suddenly feeling short of breath are:

  • allergic reactions
  • lung collapse
  • a blockage from a clot in one of the blood vessels in the lung (pulmonary embolism)
  • rare lung conditions

Some people feel short of breath long term. This can be caused by:

  • smoking
  • being unfit
  • being obese
  • anaemia
  • heart failure or other heart problems
  • lung cancer

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What other symptoms might I have?

If your breathing problems are caused by a cold or chest infection, you might also have a cough, fever, sore throat, sneezing, blocked or runny nose and general congestion.

If the problem is to do with your heart, you might also have chest pain, feel light-headed and nauseous. If you have been diagnosed with angina, take your medication as directed. Wait 5 minutes and take another dose.

If the problem is asthma or chronic obstructive pulmonary disease (COPD), you might also have a lot of mucous, a wheezing sound when you breathe, and your symptoms might get worse with exercise or during the night.

If the problem is a panic attack, you might also have a fast heartbeat, sweating and shaking, nausea, dizziness and a sense of impending doom or danger.

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How are breathing problems treated?

The type of treatment you need depends on how unwell you feel, how suddenly it has come on and what other conditions you might have.

If you see a doctor, the tests you might have include:

  • blood tests
  • x-rays and scans
  • breathing tests

Treatments include:

  • help to quit smoking, if you smoke
  • medicines, including tablets and puffers
  • physiotherapy and exercises

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Can breathing problems be prevented?

If you have any breathing problems, and you smoke you should quit. Call 13 78 48 or go to the Quitline website.

If you have any medication for breathing problems, such as puffers, use them as directed by your pharmacist or doctor. You can also:

  • take care of yourself and any underlying cause of feeling short of breath
  • stay calm and stand or sit up straight, which helps the air get in and out more easily
  • avoid pollution
  • avoid anything you are allergic to
  • lose weight if you are overweight
  • have a plan for what to do if things get worse

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Not sure what to do next?

If you are still concerned about your breathing problems, why not use healthdirect’s online Symptom Checker to get advice on when to seek medical attention.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self care, talking to a health professional, going to a hospital or calling triple zero (000).

Shortness of Breath Symptoms, Causes and Risk Factors

Shortness of Breath Symptoms You Shouldn’t Ignore

Some people with respiratory problems can feel breathless just by doing normal activities like getting out of a chair or walking to another room. See your medical professional 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 – abnormal whistling type sound when you breath in or out
  • Stridor – a high pitched noise that occurs with breathing
  • Worsening of pre-existing shortness of breath after using your inhalers
  • Breathlessness that does not go away after 30 minutes of rest

What Causes Shortness of Breath?

Most causes of shortness of breath are due to heart and lung conditions. Your heart and lungs are involved in transporting oxygen to your body and removing carbon dioxide, and problems with either of these processes affect your breathing.

Breathing is regulated by the brain and a complex interaction between various chemicals in the blood and in the air that we breathe. Oxygen levels, carbon dioxide levels, and the amount of hemoglobin in blood play a role. If blood carbon dioxide levels rise, the brain tells the body to increase the breathing rate, which can result in deeper or faster breaths. This may lead to a sensation of difficulty breathing. Likewise, too much acid in the blood from an infection, lactic acid build-up or other causes can lead to an increase in the breathing rate and the sensation of shortness of breath.

Causes of acute shortness of breath can include:

  • Asthma
  • Flare in COPD
  • Allergic reaction (such as bee stings)
  • Carbon monoxide poisoning
  • Heart attack
  • Low blood pressure
  • Pneumonia
  • Anemia (low red blood cell count)
  • Upper airway obstruction (blockage in your throat)
  • Heart failure
  • Enlarged heart
  • Abnormal heart beats
  • Choking
  • Foreign object inhaled into the lungs
  • Guillain-Barré Syndrome
  • Myasthenia gravis
  • Pulmonary embolism (blood clot in the lungs)

In the case of chronic shortness of breath, the condition is most often due to:

  • Asthma
  • COPD (chronic obstructive pulmonary disease)
  • Abnormal heart function
  • Obesity
  • Other lung disease
    • Croup
    • Lung cancer
    • Pleurisy
    • Pulmonary edema
    • Pulmonary fibrosis and other interstitial lung diseases
    • Pulmonary hypertension
    • Sarcoidosis
    • Tuberculosis

What are Risk Factors?

Having prior lung diseases, muscle weakness, low hemoglobin, being out of shape from lack of exercise or illness, severe obesity, and continued exposure to asthma triggers are some examples. Smoking is a major risk factor as it causes diseases that result in shortness of breath.

When to See Your Doctor

You should visit your doctor if you experience any shortness of breath that is not expected from an activity and the current state of your fitness or health. Breathing difficulty that comes on suddenly, is persistent or interferes with your daily activities should be evaluated by a medical professional. Shortness of breath that does not decrease with treatment or that is accompanied by other symptoms like chest pain needs urgent evaluation possibly in an emergency room type setting.

Diagnosing & Treating “

Breathing Difficulties in Dogs

Dog breathing problems can affect all breeds and ages and can quickly become life-threatening. If your dog is having a hard time breathing, he should be seen by a veterinarian as soon as possible.

How the Dog Respiratory System Works

Diseases in any part of the respiratory system, and even in other parts of the body, can lead to breathing problems in dogs.

The respiratory system has many parts, including the nose, mouth, throat (pharynx and larynx), windpipe (trachea) and lungs. Air is pulled in through the nose or mouth and is then carried down into the lungs, through a process referred to as inspiration. In the lungs, oxygen is transferred to the red blood cells. The red blood cells then carry oxygen to the rest of the body.

While oxygen is being transferred to the red blood cells, carbon dioxide is transferred from the red blood cells to the air within the lungs. It is then pushed out through the nose or mouth through a process referred to as expiration.

Respiration and Respiratory Rate for Dogs

Differentiating between a dog who is breathing normally and a dog having trouble breathing is not always as simple as it might seem. At rest, healthy dogs should have a respiratory rate of between 20 and 34 breaths per minute, and they should not appear to be putting much effort into breathing. Of course, dogs may breathe more rapidly and/or more deeply in response to normal factors such as warm temperatures, exercise, stress and excitement.

Owners should get a feel for what is normal for their dogs before any health problems develop. How does your dog breathe when he is at rest, while going for a walk, or after vigorous play? With this knowledge in hand, you will be able to pick up subtle changes in your dog’s respiratory rate and his breathing before a crisis develops.

Symptoms of Breathing Difficulties in Dogs

Dogs who are having trouble breathing can develop different symptoms that are related to the specific health problem they are facing and the severity of it. Your veterinarian will identify the specific type of breathing difficulty your dog is having to help narrow down the potential causes.

Labored breathing in dogs (dyspnea), rapid breathing (tachypnea), and abnormal panting are common types of breathing abnormalities that affect dogs.

Labored Breathing in Dogs (Dyspnea)

When dogs are working harder to breathe than circumstances warrant, they are said to be dyspneic, or suffering from dyspnea. Breathing difficulties can happen when breathing in (inspiratory dyspnea), when breathing out (expiratory dyspnea), or both. Common symptoms include:

  • The chest wall, and sometimes the belly, will move more than is normal when breathing
  • Nostrils may flare open when breathing
  • Breathing with an open mouth (but not necessarily panting)
  • Breathing with the elbows sticking out from the body
  • Neck and head held low and out in front of the body (extended)
  • Noisy breathing

Rapid Breathing in Dogs (Tachypnea)

When dogs are breathing faster than circumstances warrant, they are said to be tachypneic, or suffering from tachypnea. Common symptoms include:

  • Breathing rate is faster than normal
  • Mouth may be closed or partially open, but usually not open as wide as during panting
  • Breathing is often more shallow than normal

Panting in Dogs

Panting can be a normal way for dogs to cool themselves in response to exercise or high temperatures, or it can be an indication of a breathing problem. Panting in dogs is characterized by:

  • Fast breathing
  • Usually shallow breaths
  • Wide open mouth
  • Extended tongue

Some dogs will develop a combination of breathing problems (e.g., expiratory dyspnea and tachypnea) or other symptoms, like coughing, depending on the underlying problem.

Causes of Breathing Difficulties in Dogs

Dyspnea in Dogs

  • Diseases of the nose
    • Small nostrils
    • Infection
    • Tumors
    • Foreign object

  • Diseases of the throat and windpipe (trachea)
    • Roof of the mouth is too long (elongated soft palate)
    • Tumors
    • Foreign object
    • Tracheal collapse

  • Diseases of the lungs
    • Infection (e.g., pneumonia, fungal infection)
    • Heart failure with fluid in the lungs (pulmonary edema)
    • Heart enlargement
    • Heartworm disease
    • Tumors
    • Bleeding or bruising of the lungs
    • Electrocution
    • Trauma

  • Diseases of the small airways in the lungs (bronchi and bronchioles)
    • Infection
    • Tumors
    • Allergies
    • Inflammatory disorders (e.g., chronic bronchitis)

  • Diseases of the space surrounding the lungs (pleural space)
    • Heart failure with fluid around the lungs (pulmonary effusion)
    • Accumulations of air
    • Accumulations of blood or other fluids
    • Tumors
    • Infection
    • Trauma

  • Diseases of the chest wall
    • Injury to the chest wall (trauma)
    • Partial paralysis of the chest wall (e.g., tick paralysis, trauma)

  • Diseases of the diaphragm
    • Injury to the diaphragm (e.g., traumatic rupture)
    • Congenital hernias
    • Diseases of muscle

  • Diseases that make the belly press on the diaphragm
    • Enlarged liver, stomach or spleen
    • Stomach filled with air (bloat)
    • Fluid in the belly (ascites)
    • Tumors

Tachypnea (Fast Breathing) in Dogs

  • Low oxygen level in the blood (hypoxemia)
  • Low red blood cell level (anemia)
  • Blood clots within vessels in the lungs
  • The causes of dyspnea in dogs may also result in tachypnea

Panting

  • Pain
  • Anxiety
  • Medications
  • High body temperature (fever or during exercise)
  • Metabolic acidosis (when the body produces too much acid or can’t remove it normally)
  • Obesity
  • High blood pressure
  • High thyroid hormone levels
  • Some of the causes of dyspnea and tachypnea in dogs may also result in panting

Diagnosis of Dog Breathing Problems

Difficulty breathing can be a life-threatening emergency, and your dog should be seen by a veterinarian as soon as possible. You will need to give a thorough history of your dog’s health, onset of symptoms and possible incidents that might have preceded this condition.

During the examination, your veterinarian will carefully observe how your dog is breathing and listen to his chest for specific sounds that might help pinpoint the problem. Your dog’s gum color will be evaluated as well, since the color of the gums can indicate whether your dog has adequate blood flow and oxygenation.

Your veterinarian may try to get your dog to cough by pressing on his windpipe. If your dog is having extreme difficulty breathing, the veterinarian will give him oxygen before doing any tests.

Initial diagnostic testing for dogs who are having trouble breathing can involve a complete blood count, biochemical profile, fecal examination, urine analysis and chest X-rays. Additional procedures and testing may also be necessary. These can include ultrasound imaging, an electrocardiogram, specialized blood tests, analysis of fluid samples, rhinoscopy or bronchoscopy (using an instrument to look inside the nose or airways, respectively), surgery, and tissue biopsies, depending on the particulars of a dog’s case.

Treating Dogs with Breathing Problems

Treatment will depend on the final diagnosis a veterinarian makes for your dog’s breathing problems. If your dog’s breathing problem is severe, he will need to be admitted into the hospital until his condition is stable. Your dog will probably be given oxygen to help him breathe.

Any prescription pet medications and procedures that your dog needs will depend on the cause and severity of the breathing problem. Your dog’s activity will be restricted until the breathing problem is sufficiently under control.

Managing Breathing Problems in Dogs

Once your dog is able to return home with you, it is very important to follow your veterinarian’s instructions closely. Give all of the medications as directed, and stick to the scheduled progress checks.

Your veterinarian may repeat some of the tests that were done when your dog was diagnosed to determine how your dog is responding to treatment. Depending on the severity of your dog’s problem, his activity level may need to be reduced.

The prognosis for dogs with breathing difficulties depends on the underlying cause. If you notice any worsening in the way your dog is breathing, it is important to consult with your veterinarian immediately.

Shortness of Breath

Go back to Patient Education Resources

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.

Key Facts

  • 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:
    • asthma
    • chronic obstructive pulmonary disease (COPD)
    • heart disease (heart attacks, heart failure)
    • anemia
    • blood clots in the lungs (pulmonary embolism)

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:

  • walking
  • climbing stairs
  • running
  • 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
  • obesity
  • 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
  • fainting
  • nausea

Shortness of Breath Symptoms, Causes, and Risk Factors

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:

  • asthma
  • COPD flare
  • allergic reaction (such as from a bee sting)
  • carbon monoxide poisoning
  • heart attack
  • low blood pressure
  • pneumonia
  • anemia (low red blood cell count)
  • upper airway obstruction (throat blockage)
  • heart failure
  • enlarged heart
  • abnormal heartbeat
  • choking
  • 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:

  • asthma
  • COPD
  • abnormal heart function
  • obesity
  • other lung disease
  • croup
  • lung cancer
  • pleurisy
  • pulmonary edema
  • pulmonary fibrosis and other interstitial lung diseases
  • pulmonary hypertension
  • sarcoidosis
  • tuberculosis

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
  • smoking

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?
    • dizziness?
    • cough?
    • 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
  • echocardiogram

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:

  • medication
  • breathing techniques
  • exercise
  • 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?

Authors

Alan Roth, RRT, MS, FCCP
Sai Praveen Haranath, MBBS, MPH, FCCP

Date Last Reviewed

January 2018

About the author

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