Shortness of breath is a common symptom that leads people to see their doctor. This symptom may appear quickly or appear so slowly that it is not recognized at first. If you experience shortness of breath, that doesn’t necessarily mean you need to worry about lung cancer or serious illnesses, such as heart disease.
There are many causes of shortness of breath. However, because less common causes shortness of breath is often overlooked, it is important to make an appointment with your health care provider 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 that you do not have enough air or that you need more effort to breathe than normal. Some people also describe a feeling of tightness in the chest.
Shortness of breath can occur acutely in minutes or hours; or chronically for days, weeks, months, or even years.
When to see a doctor
Sometimes it can be difficult to know 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 shortness of breath can be something benign, such as hyperventilation or a panic attack, but the milder symptoms can be due to very serious causes.
When to call 911
Symptoms that suggest shortness of breath may be severe include:
- Chest pain
- The bluish tone of your fingers and lips (cyanosis)
- Swelling or fullness in the throat and lips.
- Inability to speak due to shortness of breath
- Rapid increase in your symptoms
- Redness of the lower extremities
- Coughing up blood
If you have any questions about calling 911, go ahead and do so. If you didn’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 you need emergency care, be careful.
You will see several terms used in connection 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 difficulty breathing
- Bradypnea means slow breathing rate
It is believed that normal breathing rate in adults, there are between 12 and 20 breaths per minute at rest for adults and varies in children with age.
It is important to keep in mind that you may have difficulty breathing at a normal breathing rate. The opposite is also true: you may have an abnormal breathing rate, but you won’t notice any difficulty breathing.
Breathing rate is, according to some, a “forgotten” vital indicator and can sometimes give your health care provider more information than your blood pressure or pulse regarding the severity of the disease.
In 85% of people, conditions related to the heart and lungs are the cause of shortness of breath. Although most of us think first of our lungs, if we feel difficulty breathing, the condition of the heart should be carefully considered.
The study, which looked at people who had difficulty breathing as the only symptom of heart disease, were more likely to die than those who had typical chest pain.
Some of the most common causes include:
Other common causes include:
- Anemia: With anemia, you may also notice fatigue, pale skin, and dizziness
- Thyroid disorders: How to hyperthyroidism and hypothyroidism may cause shortness of breath
Less common but important causes of shortness of breath may include:
- Benign and malignant tumors, including lung cancer
- Anxiety and panic attacks
- Accidentally inhaled objects in the lungs
- Heart valve problems
- Acid reflux
- Allergic reactions (anaphylaxis)
- Neurological diseases such as multiple sclerosis
- Other lung diseases, such as sarcoidosis and bronchiectasis
- Lack of regular exercise: Before ruling out shortness of breath due to lack of activity, talk to your health care provider.
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, persistent coughing or coughing up blood were the most common symptoms of lung cancer. Most people diagnosed with lung cancer today do not smoke (have never smoked or quit at some point in the past).
It is important to make an appointment with your health care provider if you develop shortness of breath, even if you think there is a clear reason to explain your symptoms. When you visit your treating doctor, he or she will carefully review your medical history and perform a physical exam. Some of the questions you can ask include:
- When did you first experience shortness of breath and how did it begin?
- Do your symptoms appear at rest or only when they are active? If you only have difficulty breathing with physical activity, what activities seem to be causing your symptoms?
- Do you feel more breathless when sitting or lying down?
- Do you have any other symptoms, such as chest pain, cough, shortness of breath, fever, leg pain, unexplained weight loss or fatigue?
- Do you have any heart or lung problems in your personal or family history?
- Have you ever smoked? If so, how long?
- Have you recently traveled by car or plane?
Testing and visualization
The tests your health care provider recommends will depend on your specific symptoms and physical data, but can usually include:
- Pulse oximetry, a test done by placing a clip on your finger or earlobe to assess the amount of oxygen in your blood
- Electrocardiogram (ECG) to look for signs of heart attack or irregular heart rhythms
- Chest X-rays to look for infections or neoplasms in the lungs (keep in mind that a normal chest X-ray may miss lung cancer in its early stages)
- Blood tests to check for anemia and other causes
- Lung function tests to detect asthma or emphysema and other lung diseases
Other tests may include:
- Computed tomography (CT) scan of your chest
- Stress test
- Echocardiogram. This is an ultrasound of your heart to reveal problems with your heart valves, how strong your heart is, and if you have damaged areas in your heart.
- Bronchoscopy. Bronchoscopy is a flexible tube that is inserted through the mouth and sinks into the bronchi to look for tumors or a foreign body.
Shortness of breath and COPD
For those suffering from COPD, shortness of breath is very common and the degree of shortness of breath you have can provide a lot of information about the severity of your disease or exacerbation. To do this, doctors often use the so-called medical research Council modified dyspnea scale.
Treating your shortness of breath will depend on the cause, but the most important first step is to make sure you get enough air to provide your tissues with the necessary oxygen. In emergency medicine, it is called ABC with A denotes airways, B denotes respiration, and C denotes blood circulation.