Shortness of breath is a common symptom that leads people to visit their doctor. This symptom can appear quickly or so slowly that it is not recognized at first. If you experience shortness of breath, this does not mean that you need to worry about lung cancer or serious medical conditions such as heart disease.
There are many causes of shortness of breath. However, since less common causes of shortness of breath are often overlooked, it is important to schedule an appointment with your doctor to determine the cause.
We don't have a clear definition of shortness of breath, but most people describe this symptom as a subjective feeling of shortness of breath. You may feel like you can't breathe enough air or that it takes more effort than usual to breathe. Some people also describe chest tightness .
Shortness of breath can occur in minutes or hours; or chronically over days, weeks, months, or even years.
When to contact a healthcare provider
Sometimes it can be hard to tell how severe your shortness of breath is, and that's when it's important to be guided by your intuition. In fact, sometimes the most severe breathlessness can be somewhat benign, such as hyperventilation or a panic attack, but the milder symptoms can be associated with very serious causes.
When to call 911
Symptoms that suggest shortness of breath can be serious :
- Chest pain
- Bluish tint to fingers and lips (cyanosis)
- Swelling or a feeling of fullness in the throat and lips.
- Inability to speak due to shortness of breath.
- Rapid increase in symptoms.
- Redness of the lower extremities.
If you are not sure about calling 911, please do so. If you don't need help, that's fine. But if you do, you don't want to wait too long.
Some of the causes of shortness of breath can be life-threatening and require immediate medical attention. If you are not sure if you need urgent help, be careful.
You will see different terms associated with shortness of breath. A summary of some of these terms includes:
- Shortness of breath refers to the feeling of shortness of breath.
- Tachypnea refers to rapid breathing with or without a sensation of shortness of breath.
- Bradypnea means slow breathing
The normal respiratory rate in adults is believed to be 12 to 20 breaths per minute at rest for adults and varies in children with age.
It is important to note that you may feel short of breath with a normal respiratory rate. The reverse is also true – you may have an abnormal breathing rate, but you won't notice shortness of breath.
Breathing rate is considered by some to be a "forgotten" vital sign and can sometimes give your healthcare provider more information than your blood pressure or heart rate about the severity of your illness.
In 85% of people, shortness of breath is caused by conditions related to the heart and lungs. While most of us think of our lungs first, if we are short of breath, heart disease needs careful consideration .
One study that looked at people who had shortness of breath as the only symptom of heart disease were more likely to die than those with typical chest pain .
Some of the more common reasons include:
Other common reasons include:
- Of smoking
- Anemia : With anemia, you may also notice fatigue, pale skin, and dizziness.
- Thyroid disease: Both hyperthyroidism and hypothyroidism can cause shortness of breath.
Used less frequently
Less common but important causes of shortness of breath can include:
- Benign and malignant tumors, including lung cancer.
- Anxiety and panic attacks
- Items accidentally trapped in the lungs
- Heart valve problems
- Acid reflux
- Allergic reactions (anaphylaxis)
- Neurological conditions such as multiple sclerosis.
- Other lung diseases such as sarcoidosis and bronchiectasis.
- Lack of regular exercise: Before considering shortness of breath as a result of inactivity, talk to your doctor.
Lung cancer and shortness of breath.
The most common cause of lung cancer today, adenocarcinoma of the lung, often causes shortness of breath as the first sign. In the past, a persistent cough or coughing up blood was the most common symptom of lung cancer. Most people diagnosed with lung cancer today do not smoke (they have never smoked or have stopped smoking at some point).
If you experience shortness of breath, it is important to make an appointment with your doctor, even if you think there is a clear reason for your symptoms. When you visit your doctor, you will have a complete medical history and physical exam. These are some of the questions you might ask:
- When did you first experience shortness of breath and how did it first appear?
- Do your symptoms appear at rest or only when you are active? If you only feel short of breath with physical activity, what activities are causing your symptoms?
- Do you feel more out of breath when you sit or lie down?
- Do you have other symptoms such as chest pain, cough, wheezing, fever, leg pain, unexplained weight loss, or fatigue?
- Do you have a personal or family history of heart or lung problems?
- Have you ever smoked? If so, how long?
- Have you recently traveled by car or plane?
Testing and visualization
The tests your healthcare provider recommends will depend on your specific symptoms and physical condition, but can generally include:
- Pulse oximetry is a test performed by placing a clip on a finger or earlobe to determine the amount of oxygen in the blood.
- An electrocardiogram (ECG) to look for signs of a heart attack or an irregular heartbeat.
- Chest X-ray to look for infections or growths in the lungs (note that plain chest X-rays may not detect lung cancer in the early stages)
- Blood tests to look for anemia and other causes.
- Pulmonary function tests for asthma, emphysema, and other lung diseases.
Other tests may include:
- Computed tomography (CT) scan of the breast
- Stress test
- Echocardiogram. This is an ultrasound of your heart to check for problems with your heart valves, how strong your heart is, and if you have damaged areas on your heart.
- Bronchoscopy. Bronchoscopy is a flexible tube that is inserted through the mouth into the bronchi to look for tumors or foreign bodies.
Difficulty breathing and COPD
For people with COPD, shortness of breath is very common, and the degree of shortness of breath can provide a lot of information about the severity of your illness or flare. To do this, healthcare providers often use the Medical Research Council's Modified Dyspnea Scale .
Treatment for shortness of breath will depend on the cause, but the most important first step is to make sure you are getting enough air to supply your tissues with the oxygen they need. In emergency medicine, this is called ABC, where A means airway, B means breathing, and C means circulation .