Shortness of Breath

Shortness of breath, medically known as dyspnea, is the feeling that you can't get enough air or that breathing requires more effort than usual. It can range from mild discomfort to a feeling of suffocation. While it's normal to feel short of breath during intense exercise, unexpected or severe shortness of breath can be a sign of a serious medical condition.

Shortness of breath can be acute (sudden onset) or chronic (developing over time). The cause can be related to the heart, lungs, or other systems. Understanding when shortness of breath is an emergency versus when it can wait for a doctor's appointment is important.

Shortness of breath may feel like:

• Difficulty Catching Breath: Feeling like you can't get enough air
• Tightness in Chest: Feeling of constriction
• Rapid Breathing: Breathing faster than normal
• Shallow Breathing: Can't take deep breaths
• Feeling of Suffocation: Severe cases
• Wheezing: Whistling sound when breathing
• Coughing: May accompany shortness of breath

Associated Symptoms (depending on cause):

• Chest pain
• Dizziness or lightheadedness
• Rapid heart rate
• Sweating
• Blue lips or fingernails
• Confusion

Call Emergency Services (112 in Sweden) immediately if:

• Sudden, severe shortness of breath
• Shortness of breath with chest pain
• Difficulty breathing with blue lips or fingernails
• Rapid breathing with confusion
• Shortness of breath after exposure to allergen
• Inability to speak in full sentences
• Feeling of suffocation

For Mild, Known Causes:

1. Rest: Stop activity and rest
2. Sit Upright: Helps expand lungs
3. Pursed-Lip Breathing:
   • Breathe in through nose
   • Exhale slowly through pursed lips
   • Helps with some conditions
4. Relaxation: Anxiety can worsen breathing
5. Avoid Triggers: If you know what causes it

Important: Never ignore new or worsening shortness of breath. Even if mild, it should be evaluated if it's new or different.

• Sudden, severe shortness of breath
• Shortness of breath with chest pain
• Blue lips or fingernails
• Rapid breathing with confusion
• After exposure to known allergen
• Inability to speak
• Severe difficulty breathing

• New or worsening shortness of breath
• Shortness of breath with exertion (if new)
• Waking up short of breath
• Shortness of breath with swelling (legs, ankles)
• Chronic cough with shortness of breath
• Shortness of breath that interferes with daily activities

• Mild shortness of breath after known exertion
• Well-controlled with current treatment
• Following treatment plan for known condition

Evaluation may include:

1. Medical History and Physical Exam:

   • Description of symptoms
   • When it occurs
   • Risk factors
   • Listening to heart and lungs
   • Checking oxygen levels

2. Pulse Oximetry:

   • Measures blood oxygen level
   • Quick, non-invasive test

3. Chest X-ray:

   • Looks at heart and lungs
   • Can show many causes

4. Blood Tests:

   • Complete blood count
   • BNP (heart failure marker)
   • D-dimer (blood clot marker)

5. Lung Function Tests:

   • Spirometry
   • Measures lung capacity
   • Helps diagnose lung conditions

6. Additional Tests (if indicated):

   • ECG (heart test)
   • CT scan
   • Echocardiogram (heart ultrasound)
   • Stress test

Treatment depends on cause:

Heart-Related:

• Medications (diuretics, heart medications)
• Oxygen therapy
• Lifestyle changes
• Procedures or surgery if needed

Lung-Related:

• Bronchodilators (asthma, COPD)
• Steroids (inflammation)
• Antibiotics (infections)
• Oxygen therapy
• Pulmonary rehabilitation

Other Causes:

• Anemia: Iron supplements, diet changes
• Anxiety: Therapy, medications, relaxation
• Obesity: Weight loss, exercise

Prevent causes of shortness of breath:

• Don't Smoke: Major cause of lung disease
• Avoid Pollutants: Air pollution, chemicals
• Maintain Healthy Weight: Reduces strain on heart and lungs
• Exercise Regularly: Improves cardiovascular and lung health
• Manage Chronic Conditions: Heart disease, lung disease, anemia
• Get Vaccinated: Flu, pneumonia vaccines
• Know Your Triggers: If you have asthma or allergies

Shortness of breath can result from:

Heart Problems:

• Heart can't pump effectively
• Fluid backs up into lungs
• Reduced oxygen delivery

Lung Problems:

• Airways narrowed (asthma, COPD)
• Lung tissue damaged
• Reduced surface area for gas exchange
• Fluid in lungs (pneumonia, heart failure)

Other Causes:

• Anemia: Less oxygen-carrying capacity
• Anxiety: Hyperventilation, muscle tension
• Obesity: Extra work for breathing muscles
• Deconditioning: Poor fitness

• Higher risk of heart and lung causes
• May have multiple conditions
• Medications may contribute
• Less obvious symptoms sometimes

• Most common causes: heart, lung, anxiety
• Lifestyle factors important
• Work-related causes possible

• Often asthma or infections
• May have different presentations
• Rapid breathing more noticeable
• Higher risk of complications

Not always, but it should always be evaluated, especially if it's new, worsening, or severe. Even mild shortness of breath can indicate a serious condition.

Yes. Anxiety can cause hyperventilation and a feeling of breathlessness. However, it's important to rule out physical causes first, especially if it's new or severe.

If it's sudden and severe, accompanied by chest pain, blue lips, confusion, or inability to speak, it's an emergency. When in doubt, seek immediate care.

Yes, deconditioning can cause shortness of breath with exertion. However, if it's new, worsening, or severe, it should be evaluated to rule out other causes.

Treatment depends entirely on the cause. It may involve medications, oxygen therapy, lifestyle changes, or procedures. Your doctor will determine the best approach based on the underlying cause.