Dyspnea, or shortness of breath, is the sensation of being unable to take a deep breath. A person may say that this feels like not being able to breathe all the way. There are numerous possible conditions that can cause dyspnea.
First off, it is important to understand that dyspnea is a symptom of an underlying condition and not a medical disorder itself.
Acute dyspnea is shortness of breath that occurs very suddenly and usually indicates an urgent situation requiring quick medical care. Chronic dyspnea is shortness of breath or difficulty breathing that lasts for several weeks or longer.
Fast facts on deep breaths:
- There are many different causes of a person feeling as if they cannot take a deep breath.
- Most people are familiar with the sensation of dyspnea after a strenuous workout.
- Treatment for dyspnea centers around identifying and treating its cause. It is also important to relieve the symptoms and discomfort.
In most cases, dyspnea results from one of many conditions affecting either the heart or the lungs.
Shortness of breath and difficulty breathing have been linked with many different conditions, including:
- carbon monoxide poisoning
- hiatal hernia
- pulmonary embolism
- collapsed lung
- airway obstruction or choking
- low blood pressure
- heart failure
- fluid around the heart
- lung cancer
- swelling or inflammation in the heart or lining of the lungs
- heart rhythm problems
- myasthenia gravis
Some of these conditions can be serious and require emergency care. It is important to work with a doctor or healthcare provider for an accurate diagnosis and treatment regimen.
The most common symptom of dyspnea is shortness of breath, or the sensation that it is difficult to breathe or catch a breath. Some of the sensations associated with dyspnea include:
- tightness, pain, or discomfort in the chest
- uncomfortable breathing
- feeling of drowning, being smothered, or suffocation
In some cases, temporary dyspnea is expected and normal and does not require a trip to the doctor. For example, short-lived shortness of breath during pregnancy is a normal occurrence that does not require emergency care.
Shortness of breath after strenuous exercise is both common and normal. However, being unable to take a deep breath with any kind of exertion, or when doing an activity that would not normally cause shortness of breath, should be investigated. This may include something as simple as going up or down a flight of stairs.
There are times when someone experiencing shortness of breath should seek emergency care. Someone with dyspnea and the following symptoms should either call 911 or have someone drive them to the emergency room immediately:
- chest pain
- nausea or vomiting
- shortness of breath that starts suddenly or is severe
A person with these symptoms should not get behind the wheel because of the risk of losing consciousness.
Someone with worsening dyspnea or shortness of breath with the following symptoms should make an appointment with their doctor within a few days:
- swollen ankles or feet
- inability to lie flat
- signs of an infection, such as a fever, chills, or a cough
Diagnosing the cause of dyspnea starts with a very thorough medical history and physical exam. The doctor will ask many questions about the onset, duration, severity, and progression of the symptoms. Factors that worsen and relieve the symptoms are also important.
In addition to asking about shortness of breath, the doctor will ask about family and social history, and any other factors that may contribute to the symptoms.
Next, the doctor will do a physical exam, including listening to the lungs and heart. The doctor may also look for swelling and edema in the arms and legs, and at the veins in the neck for enlargement.
Depending on what is found during the physical exam, the doctor may recommend further diagnostic testing, such as:
- Chest X-ray: This can be used to look for pneumonia, lung disease, collapsed lung, and signs of heart failure.
- Spirometry: This test evaluates lung capacity and function, and can be used to look for an obstructive lung disease, such as COPD, asthma, or chronic bronchitis
- Electrocardiography: Used to detect heart rhythm abnormalities, this test picks up cardiac reasons for dyspnea.
- Blood testing: Routine blood work can look for signs of infection or anemia. Other types of testing can point to obstructive lung disease, blood clots, or heart disease.
- Pulmonary function: Pulmonary function testing evaluates how well the lungs and pulmonary system are functioning. Results can point to obstructive lung disease and other lung disorders.
- Echocardiogram: An echocardiogram uses ultrasound to look directly at the heart chambers and valves. The test can detect structural problems in the heart that can cause shortness of breath.
- Ventilation or perfusion scanning: This is a specialized scan that looks for evidence of a blood clot in the lungs.
- Stress test. Stress testing looks at how well the lungs and heart function during exercise or stress.
There are medications that can help eliminate excess mucus from the airway to improve breathing. Steroids or bronchodilators can be useful in opening tight airways again to help make breathing a little easier.
In some cases, oxygen support may be needed. There are many different ways to deliver oxygen from a simple facemask to a ventilator, depending on a person’s needs.
Pulmonary rehabilitation can be helpful in some cases of chronic lung disease. During this type of treatment, a specialist will teach someone certain strategies for breathing and getting more air.
Finally, some lifestyle modifications may help reduce the severity of dyspnea, including:
- losing weight if necessary
- quitting smoking
- avoiding exposure to pollutants
The outlook for someone with dyspnea varies significantly depending on the cause, their medical history, and other factors.
Due to the potential for numerous medical conditions and some life-threatening complications, shortness of breath is a symptom that should be taken seriously.
In some cases of dyspnea, prompt evaluation and treatment can be lifesaving.