Shortness of breath (dyspnea) is an uncomfortable feeling of having difficulty breathing, being unable to inhale enough air, breathlessness, needing to breathe more quickly or deeply, or feeling as if you need to breathe harder.
Shortness of breath is common even in healthy people on exertion, such as with strenuous exercise, high altitudes, or poor air quality, but shortness of breath can also be a sign there is an underlying medical problem.
If shortness of breath occurs suddenly and there is no obvious cause, see a doctor right away.
The main causes of shortness of breath include:
- Asthma attack (flare-up)
- Emotional distress or a panic attack
- Upper airway obstruction
- Heart attack
- Low blood pressure (hypotension)
- Pneumonia
- Carbon monoxide poisoning
- Blood clot in the lungs (pulmonary embolism)
If shortness of breath lasts four weeks or longer it may be considered chronic. The five main causes of chronic shortness of breath include:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Interstitial lung disease
- Heart dysfunction
- Obesity/deconditioning
Call 911 and get to a hospital’s emergency department right away (do not drive yourself) if you have shortness of breath accompanied by symptoms such as:
- Chest pain or pressure, blurred vision, and lightheadedness (signs of possible heart attack)
- Chest pain and leg swelling, especially after long travel (signs of possible pulmonary embolism)
- Fever and cough (signs of possible pneumonia)
- Itching, swelling, or rash (signs of possible allergic reaction)
- Wheezing (signs of possible asthma attack)
- Lips turning blue
- Trouble breathing when sleeping or lying down
- Swelling in the feet and ankles
- Breathing difficulty that comes on suddenly
- Breathing difficulty that is persistent or interferes with daily activities
- Dizziness
- Nausea
How Is Shortness of Breath Diagnosed?
The cause of shortness of breath is diagnosed with a patient history of symptoms and a physical examination. Testing will depend on the suspected cause and may include:
- Blood tests
- Spirometry pre and post inhaled bronchodilator
- Pulmonary function tests (PFTs)
- Pulse oximetry
- Chest X-ray
- Electrocardiogram (ECG)
- Bronchoscopy
- Lung biopsy
- Cardiopulmonary exercise test (CPET)
- Pulmonary artery catheterization
What Is the Treatment for Shortness of Breath?
Treatment for shortness of breath depends on the underlying cause.
Treatment for shortness of breath due to an asthma attack (flare-up) may include:
- Following the asthma action plan from your doctor
- Quick-relief medications, such as short-acting, rapid-onset beta2-agonists and/or anticholinergic bronchodilators
- Systemic corticosteroids for symptoms that persist
Treatment for shortness of breath due to emotional distress or a panic attack may include:
- Medications
- Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Beta-blockers
- Benzodiazepines
- Psychotherapy such as cognitive behavioral therapy (CBT) for panic disorder to help prevent or manage panic attacks
Treatment for shortness of breath due to upper airway obstruction may require hospitalization and may include:
- Removal of a foreign body
- Intubation
- Continuous Positive Airway Pressure (CPAP)
- Cricothyroidotomy
- Tracheostomy
Treatment for shortness of breath due to carbon monoxide poisoning may include:
- High dose oxygen
- Finding and removing the source of the CO
Treatment for shortness of breath due to heart attack may include:
- Angioplasty
- Artificial heart valve surgery
- Bypass surgery
- Cardiomyoplasty
- Radiofrequency ablation
- Stent procedure
- Dual antiplatelet therapy (DAPT)
- Medications
Treatment for shortness of breath due to pneumonia may include:
- Antibiotics if the cause is bacterial
- Antivirals if the cause is viral
- Home treatment
- Over-the-counter (OTC) pain medicines and fever reducers
- Drinking plenty of fluids
- Rest
- Use a humidifier
- In severe cases hospitalization may be needed
- Intravenous (IV) fluids and/or antibiotics
- Oxygen therapy
- Breathing treatments
Treatment for shortness of breath due to blood clot in the lungs (pulmonary embolism) may include:
- Blood thinners or anticoagulants
- Clot dissolvers (thrombolytics) used in life-threatening situations
- Removal of the clot via a catheter
Treatment for shortness of breath due to chronic obstructive pulmonary disease (COPD) may include:
- Medications
- Bronchodilators
- Anti-inflammatories
- Combination medicines such as corticosteroids, anticholinergics, and beta-agonists
- Antibiotics
- Vaccinations
- Pulmonary rehabilitation
- Supplemental oxygen
- Surgery
Treatment for shortness of breath due to interstitial lung disease may include:
- Medications such as corticosteroids
- Oxygen therapy
- Pulmonary rehabilitation
- Lung transplant
Treatment for shortness of breath due to obesity/deconditioning may include:
- Lifestyle changes such as diet, exercise, and weight loss
- Weight loss medications
- Bariatric surgery
From
https://www.uptodate.com/contents/approach-to-the-patient-with-dyspnea?search=Shortness%20of%20Breath%20&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H3413264743
https://www.lung.org/lung-health-diseases/warning-signs-of-lung-disease/shortness-of-breath/learn-about-shortness-of-breath
https://www.houstonmethodist.org/blog/articles/2021/jul/what-does-shortness-of-breath-feel-like-and-when-is-it-serious/
https://acaai.org/asthma/symptoms/asthma-attack/
https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms
https://www.ncbi.nlm.nih.gov/books/NBK564399/
https://www.uptodate.com/contents/carbon-monoxide-poisoning#H10
https://www.heart.org/en/health-topics/heart-attack/treatment-of-a-heart-attack
https://www.lung.org/
https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/treatment