SHORTNESS OF BREATH - BEYOND THE BASICS

SHORTNESS OF BREATH OVERVIEW — Feeling short of breath can be an uncomfortable or frightening experience, especially if it has never happened to you before. It can be caused by problems with the lungs or with the heart, or by a low blood count, but its specific cause can sometimes take a while to pinpoint. Luckily, most causes of shortness of breath can be treated quickly once the cause is identified.

Many cases of shortness of breath are caused by simple, short lived problems, such as respiratory tract infections or allergies. The medical term for shortness of breath is dyspnea.

This article will discuss the main causes of shortness of breath and tests that might be used. 

CAUSES OF SHORTNESS OF BREATH — Acute shortness of breath, which comes on suddenly, over the course of minutes or hours, usually has different causes than chronic shortness of breath, which develops over weeks or months.

Acute shortness of breath — Acute shortness of breath usually happens along with other symptoms. The most common causes of acute shortness of breath include:

  • Respiratory tract infections, such as pneumonia. These infections usually cause other symptoms, such as fever, cough, or coughing up sputum or mucus. 
  • A severe allergic reaction (anaphylaxis), which usually also causes itching, swelling, a rash, or other symptoms. 
  • Asthma, which often causes wheezing. 
  • A blockage in the respiratory tract, which could happen after accidentally inhaling a foreign object, such as a peanut or partially chewed meat.
  • A blood clot or other blockage in an artery in the lungs. 
  • A collapsed lung (pneumothorax). 
  • Interruptions in blood flow to the heart muscle, which might happen during a heart attack. When this is the cause of shortness of breath, there are often other symptoms, such as pain or pressure in the chest. 
  • Heart failure, a condition that affects the heart's ability to pump blood throughout the body.
  • Pregnancy changes a woman's circulatory and respiratory systems, even before the woman is visibly pregnant. This type of shortness of breath is a normal change that happens during pregnancy. 

Chronic shortness of breath — Some of the same things that cause acute shortness of breath can also cause chronic shortness of breath. For example, asthma symptoms can come and go over months or years. Heart failure can also continue to cause shortness of breath over months or years.

The most common causes of chronic shortness of breath include:

  • Asthma. 
  • Chronic obstructive pulmonary disease, a lung condition that often affects current or former smokers, includes conditions such as emphysema and chronic bronchitis.
  • Interstitial lung disease, a collection of lung disorders that involve damage or scarring of lung tissue. 
  • Cardiomyopathy, a heart condition that leads to changes in the heart's shape and size, and ability to pump blood to the rest of the body. 
  • Deconditioning, the technical term for being out of shape. For example, if you do not exercise regularly, you may develop shortness of breath when climbing stairs.
  • Obesity can cause shortness of breath as extra weight in the chest and abdomen presses on the lungs.
  • Pulmonary hypertension, which is high blood pressure in the arteries to your lungs.

SHORTNESS OF BREATH SYMPTOMS — People describe shortness of breath in different ways. Some people say they feel "hungry for air," others say they feel as though they "cannot breathe deeply enough."

These descriptions hold important clues about the possible cause of the problem. Here is a questionnaire your healthcare provider may ask you to complete to get a better sense of your symptoms.

WHEN TO SEEK HELP — Anyone who develops shortness of breath, particularly if it occurs or persists while at rest, should see a healthcare provider. If you have severe shortness of breath or also have chest pain or nausea, go to the closest emergency room. Shortness of breath is not a symptom to ignore.

SHORTNESS OF BREATH DIAGNOSIS — Your healthcare provider can learn a lot about your condition by listening to your description of the problem, and by asking about any other symptoms you may have. He or she can also learn a lot by listening to your heart and lungs with a stethoscope, and by checking your legs for swelling.

Tests — Your healthcare provider may also order one or more of the following tests to help diagnose the problem:

  • A blood test called a hematocrit can check for anemia, a condition that affects the blood's ability to carry oxygen.
  • A blood test called a BNP can indicate if you have fluid buildup in your lungs.
  • A chest x-ray to look for pneumonia, or lung inflammation or scarring.
  • An EKG is a test of your heart muscle that looks for signs of a heart attack.
  • Spirometry measures the amount of air your lungs can hold and how effectively your lungs can empty and fill with air. This test can also indicate if you have asthma or emphysema.
  • Oximetry measures the amount of oxygen in your blood.

SHORTNESS OF BREATH TREATMENT — The treatment for your shortness of breath will depend a lot on what is causing it. Shortness of breath caused by asthma, for example, will need one type of treatment, whereas shortness of breath caused by heart failure will need quite another.