Shortness of breath (dyspnea) is an uncomfortable feeling of being unable to breathe in enough air or feeling as if it’s difficult to breathe or you need to breathe harder.
It commonly occurs even in healthy people on exertion, such as with strenuous exercise, climbing stairs, high altitude, or bad air quality, but shortness of breath can also mean there is a serious underlying medical problem.
If shortness of breath occurs suddenly and there is no obvious cause, see a doctor right away.
Causes of shortness of breath include:
- Asthma attack (flare-up)
- Emotional distress or a panic attack
- Upper airway obstruction
- Carbon monoxide poisoning
- Heart attack
- Low blood pressure (hypotension)
- Pneumonia
- Blood clot in the lungs (pulmonary embolism)
If shortness of breath lasts for four weeks or longer it may be considered chronic.
The five most common causes of chronic shortness of breath include:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Interstitial lung disease
- Heart dysfunction
- Obesity/deconditioning
What Are Symptoms of Shortness of Breath?
Shortness of breath is a symptom itself that may be characterized by:
- Feeling unable to get enough air (“air hunger”)
- Difficulty breathing
- Breathlessness
- Needing to breathe more quickly or deeply
Call 911 and get to a hospital’s emergency department right away (do not drive yourself) if you have shortness of breath accompanied by:
- 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)
- Nausea
- Dizziness
- 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
How Is Shortness of Breath Diagnosed?
The cause of shortness of breath (dyspnea) is diagnosed with a patient history of symptoms and a physical examination. Tests used depend on the suspected diagnosis and may include:
- Blood tests
- Complete blood count (CBC)
- Glucose
- Blood urea nitrogen (BUN)
- Creatinine
- Electrolytes
- Thyroid stimulating hormone (TSH)
- Plasma BNP or NT-pro BNP
- 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 (dyspnea) depends on the underlying cause.
Treatment for shortness of breath due to an asthma attack (flare-up) may include:
- Following your asthma action plan filled out by your doctor
- Quick-relief medications, often administered via an inhaler, such as short-acting, rapid-onset beta2-agonist 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:
- Medication
- Selective serotonin reuptake inhibitors (SSRIs)
- 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
- Cricothyroidotomy
- Tracheostomy
- Continuous Positive Airway Pressure (CPAP)
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
- Anticoagulants
- Antiplatelet agents
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (ARBs)
- Angiotensin receptor neprilysin inhibitor
- Beta-blockers
- Calcium channel blocker
- Cholesterol-lowering medications
- Digitalis
- Diuretics
- Vasodilators
Treatment for shortness of breath due to pneumonia may include:
- Antibiotics if the cause is bacterial
- Antivirals if the cause is viral
- Home treatment
- In severe cases hospitalization may be needed
- Intravenous (IV) fluids
- Intravenous (IV) 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 combined into one inhaler or nebulizer solution
- 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
- Healthy diet
- Weight loss
- Regular exercise
- Physical therapy
- 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
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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