Shortness of breath can range from mild and temporary to serious and long lasting. It is sometimes difficult to diagnose and treat dyspnea because there can be many different causes.
Shortness of breath is a common problem. According to the Cleveland Clinic Center for Continuing Education, 1 in every 4 people who visit the doctor have dyspnea.
Contents of this article:
Causes of dyspnea
An episode of dyspnea is not always directly related to an individual's health. A person can feel short of breath after intense exercise, when traveling to a high altitude, or going through major temperature changes.
A person with dyspnea will have trouble taking a deep breath.
However, dyspnea usually relates to health problems. Sometimes, it is just a case of being out of shape, and exercise can improve symptoms. But dyspnea can be a sign of a serious health issue.
According to Dr. Steven Wahls, the most common causes of dyspnea are asthma, heart failure, chronic obstructive pulmonary disease (COPD), interstitial lung disease, pneumonia, and psychogenic problems that are usually linked to anxiety.
If shortness of breath starts suddenly, it is called an acute case of dyspnea.
Acute dyspnea could be due to:
- Choking on or inhaling something that blocks breathing passageways
- Allergic reactions
- Serious loss of blood
- Exposure to dangerous levels of carbon monoxide
- Heart failure
- Hypotension, which is low blood pressure
- Pulmonary embolism, which is a blood clot in an artery in the lung
- Collapsed lung
- Hiatal hernia
If a person experiences shortness of breath for over a month, the condition is called chronic dyspnea.
Chronic dyspnea could be due to:
- Heart problems
- Interstitial lung disease, a disease that causes scarring of the lung tissue
Some lung problems may also cause shortness of breath.
- Earlier lung damage or scarring
- Lung cancer
- Pleurisy, an infection or irritation in the tissues surrounding the lungs
- Pulmonary edema, when there is too much fluid in the lungs
- Pulmonary hypertension, when the blood pressure in the lungs is raised
- Sarcoidosis, when inflammatory cells grow in the lungs
Shortness of breath has also been linked to the following heart problems:
- Cardiomyopathy, a range of diseases affecting the heart muscle
- Heart rhythm problems
- Heart failure
- Pericarditis, when tissue around the heart become inflamed
Dyspnea is associated with asthma.
Environmental pollutants such as chemicals, fumes, dust, and smoke can make it more difficult for people with dyspnea to breathe.
People with asthma may find that exposure to allergens such as pollen or mold may trigger episodes of dyspnea.
Some pollutants such as smoking are self-administered and preventable.
All these conditions make breathing much more difficult.
Not everyone with dyspnea has COPD, but 90 percent of people with COPD were smokers at one point, according to the COPD Foundation.
When to see a doctor
Sometimes, shortness of breath can be a sign of a life-threatening condition.
Emergency medical treatment is needed if an individual has more than one of these symptoms:
- Sudden onset of dyspnea
- Loss of ability to function due to shortness of breath
- Chest pain
Not all cases of dyspnea call for immediate medical treatment, but shortness of breath can indicate serious medical problems.
Medical advice is needed if an individual experiences:
- A change in their ability to breathe
- Increasing limits on their activities due to breathing problems
- Difficulty breathing lying down
- Swelling in feet and ankles
- Fever, chills, and a cough
Diagnosis, treatment, and prevention
A doctor will normally be able to diagnose dyspnea based on a complete physical examination of the person, along with a full description of their experiences, according to Dr. Wahls.
A person will need to explain how their attacks of dyspnea started, how long they last, how frequently they occur, and how severe they are.
Doctors may use chest X-rays and computed tomography (CT) images to make a more specific diagnosis of dyspnea and evaluate the health of the person's heart, lungs, and related systems.
An electrocardiogram (ECG) will show up any signs of a heart attack.
Tests to measure air flow and the patient's lung capacity can help to pinpoint the source and the extent of breathing problems. Additional tests will look at the level of oxygen in a patient's blood, and the blood's capacity to carry oxygen.
To treat dyspnea, doctors will address the cause of the breathing difficulties and work with the individual to help them breathe more easily.
A stream of cool air around the face and neck may help.
Specific treatments vary from person to person, depending on the source of the problem. If dyspnea is linked to asthma, it normally responds well to medications such as bronchodilators and steroids. When it is due to an infection such as pneumonia, antibiotics can bring relief.
Other medications, such as opiates, anti-inflammatory drugs, and anti-anxiety drugs, can also be effective.
Breathing troubles stemming from COPD can improve with special breathing techniques such as pursed lip breathing and strengthening exercises. People can learn how to do this on pulmonary rehabilitation programs.
The Dyspnea Lab, a research center specializing in shortness of breath, report that people find these programs helpful, even if the root causes of the problem remains.
If tests indicate low levels of oxygen in the blood, supplemental oxygen may be supplied. However, not everyone with shortness of breath will have low blood oxygen levels.
According to the Dyspnea Lab, many people with dyspnea find that a gentle stream of cool air around the head and face helps improve their symptoms.
Individuals with dyspnea can take measures to improve their overall health and give themselves more breathing room.
- Quitting smoking
- Avoiding second-hand smoke where possible
- Avoiding other environmental triggers such as chemical fumes and wood smoke
- Losing weight can be beneficial in many ways, such as reducing stress on the heart and lungs and making it easier to exercise, both of which can strengthen the cardiovascular and respiratory systems
- When adjusting to higher altitudes, people should take time, ease into activities gradually, and reduce exercise levels at altitudes above 5,000 feet
Dyspnea in specific patient groups
Dyspnea can affect specific groups of people in different ways:
According to the Cleveland Clinic Center for Continuing Education, mild symptoms of dyspnea are common during pregnancy.
This is because pregnancy reduces a women's breathing capacity by up to 20 percent. However, the number of breaths a woman takes per minute, or the respiratory rate, does not typically change during pregnancy.
Older people and people with serious health conditions
Dyspnea can develop when people are experiencing the advanced stage of certain diseases.
At this point, shortness of breath will be dealt with as part of an end-of-life treatment package, as treating dyspnea with specific drugs may cause the person unnecessary problems.
Diseases of the upper respiratory system are a relatively common pediatric emergency, and one of the most common causes of shortness of breath in infants.
Croup, inhaling a foreign object, and inflammation of the windpipe are all common causes of dyspnea in infants.
The outlook for people with dyspnea depends on the cause.
If the underlying condition can be treated and improved, such as pneumonia or asthma, then breathing problems may be eliminated or greatly reduced.
However, if shortness of breath is due to serious or chronic diseases that worsen over time, such as heart disease or COPD, improvement may be limited.
Patients with dyspnea need to work with their healthcare providers to develop and follow a comprehensive treatment plan.