Shortness of Breath: Causes, Symptoms, Diagnosis And Treatment

Shortness of breath or dyspnea means you find it difficult to breathe properly. Most people describe it as feeling hungry for oxygen/air. You can become out of breath when you exert your body. So, you can experience the condition with strenuous exercise. The problem also affects people who suffer from underlying medical problems like obesity, lung disease, obesity, anxiety/stress or heart disease. The condition makes you uncomfortable. At times, it can trigger severe pain. If you experience sudden, recurrent, or severe dyspnea, then you need to see a doctor immediately. It requires immediate medical intervention to avoid any complications. Depending on the underlying cause of the problem, you need long-term management for managing breathlessness.

Shortness Of Breath Symptoms

As the name indicates, you have issues breathing properly. Taking a breath properly gradually worsens and interrupts your physical activity or daily life. Dyspnea can also occur suddenly, which can make you feel worried, overwhelmed or frightened. Depending on the person and the underlying cause, the cases range in severity. The symptoms of the problem include breathing with the following features

• Rapid
• Short
• Labored/Effortful
• Shallow
• Effortful, labored
• Slow
• Uncomfortable or painful

Other Signs Associated With Shortness Of Breath

Some people also experience severe signs due to dyspnea like:

• Pressure feeling in the chest
• Experience suffocation
• Heaviness or tightness in the chest
• Difficulty to breathe altogether

Sudden or extreme cases of breathlessness are dangerous that requires immediate medical attention

When To See A Doctor

There are times when you can see people showing signs of dyspnea. In such cases, you need to provide them assistance. Breathlessness, very loud breath sounds, or choking can cause people to experience severe results. So, you need to take immediate action and call for medical help when you see the following signs:

• Labored breathing
• Flaring nostrils
• Clear, audible, and loud breathing
• Distressed facial expression
• Abdominal protrusion
• Protrusion of chest
• Gasping for breath
• Cyanosis (blue or pale lips, mouth, face or other extremities)

Remember, the person suffering from the condition may not know the severity of the situation or have a confused state. So, they are in no position to get help. Get them the medical assistance needed to avoid any fatal complications.

Complications Due To Shortness Of Breath

Due to issues with breathing, you can experience oxygen-deprivation, which causes loss of consciousness or confusion. Some of the severe complications associated with the condition are:

Hypoxemia

When you have trouble breathing properly, it can lead to the oxygen levels in the blood going down.

Hypoxia

When you suffer from dyspnea, your body gets deprived of oxygen. It results in hypoxia. It is the condition caused in the particular region of the body suffering from oxygen deprivation. The lack of oxygen supply at the tissue level can cause the problem.

Other Serious Complications

Due to the lack of oxygen, you can also experience severe complications like kidney failure and brain damage.

Types Of Shortness Of Breath

In most people, physical exertion like exercise triggers dyspnea. It is the most common and harmless cause of the condition in a healthy person. As you exert, it makes you breathe faster. It is because your lungs work faster to complete the intense activity that your body is not used to. It is not a serious condition and eases without any intervention after a few minutes of rest. But, medical problems can also trigger the condition. Depending on the severity, you can classify breathlessness into two types.

Acute Dyspnea

Certain illnesses can trigger sudden episodes of shortness of breath. Due to the health conditions, you breathe normally between the episodes of dyspnea. People suffering from the following health issues develop acute or intermittent dyspnea.

• Lung infections (like pneumonia)
• Asthma
• Panic attacks
• Aspiration (a condition where phlegm or food gets stuck in the lungs)
• Anxiety
• Lodging of foreign objects in the airway when people inhale
• GERD (Gastroesophageal Reflux Disease)
• Allergies
• Chest trauma
• Pulmonary effusion (accumulation of fluid in the lungs)
• Pulmonary embolus (developing blood clot in the lungs)
• Pneumothorax (collapsed lung)

Chronic Dyspnea

Chronic shortness of breath generally progresses over time. So, it starts acute and worsens as time passes. Ultimately, you feel out of breath with moderate physical activities like climbing stairs. The common causes of chronic dyspnea include:

Shortness Of Breath Due To Heart Diseases

Underlying heart disease can interfere with your body’s oxygen supply. So, you can feel out of breath when you suffer from conditions like:

• Arrhythmias
• Congestive heart failure
• Heart attack
• Other problems affecting the heart

Lung Diseases

As with heart, disease to your lungs can also obstruct the oxygen supply to different parts of the body. So, people suffering from the following conditions suffer from chronic dyspnea:

• Lung cancer
• Pulmonary hypertension
• Chronic obstructive pulmonary disease (COPD)
• Respiratory Infection

Obesity

Obesity and systemic illnesses increase your body’s oxygen demands, which can also make you feel short of breath.

Exposure To Pollutants

Chronic dyspnea flares up when you get exposed to environmental pollution or cigarette smoke.

Chronic Illness Causing Shortness Of Breath

Other severe health issues can also breathlessness. So, people who suffer from the following experience the problem:

• Anemia
• Kidney failure
• Cancer

Nocturnal Dyspnea

In some people, breathlessness occurs only at night. It is common among people who suffer from chronic illnesses. So, you feel out of breath at night when your muscles are more relaxed.

Body Position

It is observed dyspnea affects people with certain body positions. For example, people with heart disease experience breathlessness when they bend over. It is due to the changes in airflow dynamics due to body position.

Risk Factors Associated With Shortness Of Breath

Is shortness of breath a common problem? While most people can suffer from acute dyspnea due to physical exertion, some people are more at risk of the condition. Elderly adults, young babies, and people with underlying health problems, even small issues like mild respiratory infection are susceptible to dyspnea. Pregnant women are also at risk of developing dyspnea. So, they experience breathing problems with mild exertion or at rest. During pregnancy, the body demands high levels of oxygen. It puts physical pressure on the lungs. It is due to the hormonal fluctuations and growing uterus.

Grading Of Dyspnea

The Medical Research Council (MRC) has developed a scale to detect the severity of dyspnea. So, based on the signs you experience, you get graded for the conditions. The grading system can help the doctor determine the treatment. The grading is also essential to understand the impact of the treatment suggested by the doctor. So, the grade based on the symptoms are:

Grade 1 In The MRC Scale

You feel breathless during physical exertion like exercise. It is not a serious condition.

Grade 2 In The MRC Scale

You feel shortness of breath when you hurry on the level ground. People who feel breathless while walking a slight hill also come under the category.

Grade 3 In The MRC Scale

People feel out of breath while they walk slower on the level ground. The breathlessness occurs frequently compared to other people of the same age group. These people tend to stop after walking for fifteen minutes or after one mile.

Grade 4 In The MRC Scale

After walking for a few minutes, people tend to stop for breath. They manage to walk just 100 yards on the level ground.

Grade 5 In The MRC Scale

People coming under the category cannot leave their house due to breathlessness from a simple activity like dressing/undressing.

The healthcare professional uses the MRC grade as a part of the BODE index score. Using it, the doctors can calculate the risk of the affected person succumbing to death based on the following:

• Body mass index (BMI)
• Obstruction
• Dyspnea in MRC scale
• Exercise ability of the patient (six-minute walking distance)

Diagnostic Tests To Detect Reasons For Shortness Of Breath

If you suffer dyspnea regularly or the severity of the issue prohibits you from completing your routine tasks, then you need to make an appointment with the doctor. It is important to seek medical help as only a doctor can detect the actual underlying issue triggering the problem. When you make an appointment with the doctor, you need to undergo certain tests for conclusive detection:

Urgent Assessment Of Shortness Of Breath

The main concern of the doctors is to stabilize the situation. In some cases, a patient suffers from dyspnea. It makes them unable to function properly. Due to the distress suffered, immediate medical attention is required. In such cases, the doctor performs an urgent medical evaluation. The doctor performs a quick physical assessment when the patient fails to answer the question regarding medical history. During the assessment, your doctor checks the following factors:

• The patient’s breathing rate
• The heart rate of the patient
• Pulse intensity

While examining the doctor checks if the patient gasps for air or he/she uses accessory muscles to breathe. After the patient stabilizes, the doctor diagnoses the actual problem.

If you want to understand the reasons for dyspnea, then you need to consult a doctor to assess lung health. With medical evaluation, it is possible to not just detect lung issues, but also find underlying medical illness triggering dyspnea. Your doctor can suggest the following tests to detect the problem conclusively:

Medical History

A patient who experiences dyspnea needs to contact a medical team as early as possible. During the assessment, your doctor asks the experience during activity or rest. You need to inform if the breathing problem comes suddenly or slowly. You need to inform regarding prior exposure like food or pollen before developing dyspnea. It reveals any allergic trigger or any external agent you have a sensitivity to. You need to inform regarding the smoking history to rule out certain conditions triggering the problem. It helps with the detection of the actual problem causing breathing problems.

Measure Breathing Rate

The first test suggested checking the underlying problem is measuring your normal breathing rate. The doctors use an arterial blood gas or pulse oximetry to measure it.

Blood Tests

If inflammatory disease or infection causes dyspnea, then blood tests can detect it. You just need to offer a sample of your blood to know if you suffer from any infection or inflammation.

Chest Imaging Tests

In some cases, patients suffering from pneumonia can suffer from dyspnea. So, doctors suggest taking an x-ray to detect the condition. Chest CT (Computerized Tomography) and MRI (Magnetic Resonance Imaging) of the chest can help identify lung disease causing dyspnea.

Spirometry

It is the test used to assess the volume of air you breathe. The test helps detect several lung conditions that affect breathing (like Chronic Obstructive Pulmonary Disease). Your doctor can also use it to check the effectiveness of the treatment suggested by the doctor for your lung condition and how it is helping you breathe better.

Pulmonary Function Testing (PFT)

It is the diagnostic testing used to evaluate your breathing capabilities in a more detailed manner compared to spirometry. The noninvasive test shows the working of your lungs, including how much air you breathe inhale and exhale and the quickness. The test can measure your lung volume along with the rates of flow, capacity, and gas exchange. Using the information is essential to diagnose and find the right treatment.

Electrocardiogram (ECG/EKG)

It is the test used to detect your heart’s function. It measures the electrical activity of your heart to detect the working. As your heart beats, an electrical impulse travels through your heart, which is printed to check for abnormal waves.

Echocardiography

Heart failure occurs when your heart finds it difficult to pump oxygen-rich blood to all parts of the body. It can result in abnormal EKG results. So, your doctor orders other tests. If shortness of breath occurs due to underlying heart conditions, then your doctor suggests echo (echocardiography). The doctor suggests the test when they find other signs like swelling in the legs.

Exercise Treadmill Test

Also known as a stress test or exercise test, it evaluates your breathing as well as heart function when faced with increased oxygen demands. Based on the test results, your doctor can determine how well your heart handles strenuous work. The concept behind the test is as you work harder, your heart needs more oxygen. To satisfy the oxygen demand, the heart pumps more blood. Using the test, your doctor can determine the reduced supply of blood in the arteries of your heart.

Treatment For Shortness Of Breath

Depending on the underlying cause of shortness of breath, your doctor can decide on the treatment method to manage the problem. In simple cases, breathing exercises and relaxation methods can offer you much-needed relief.

Maintain Oxygen Levels

When a patient suffers sudden dyspnea, they need immediate medical intervention before detecting the actual cause. So, the treatment focuses on maintaining the proper oxygen levels. After stabilizing the patient, the doctor detects the actual cause of the problem and offers treatment.

Medications For Shortness Of Breath

People suffering from a COPD exacerbation or asthma attack find it difficult to breathe. To deal with such issues of dyspnea, your doctor prescribes medications. In most cases, you need to take steroids and short-acting bronchodilators as per the suggestion from the doctor. These medications reduce inflammation in the lungs and open the airways to alleviate the problem. In the case of asthma, you have prescribed an inhaler. You need to use it when you experience a flare. Doctors also prescribe medications for people suffering from a blood clot.

The doctor suggests antibiotics for people developing dyspnea due to issues like pneumonia. Antibiotics heal lung problems caused by bacteria. If you suffer from dyspnea due to an underlying heart problem, then you need to take diuretics. Diuretics are medications used to flush out the excess fluid accumulated in your body. Remember, you need to take medications prescribed by the doctor as suggested. Follow the doctor’s orders as failure to do so can cause severe complications.

Invasive Procedures For Managing Shortness Of Breath

In some cases, you need to undergo an invasive procedure to eliminate the actual cause of the distress. So, you need to undergo invasive procedures for the following:

• If fluid accumulation in the lungs triggers dyspnea, then your doctor drains it.
• Structural problems like pneumothorax or chest trauma need surgery to eliminate the distress caused due to it. So, you need to undergo procedures to relieve pressure caused (like placing a chest tube).
• You need extensive surgery to remove the tumor developed in the lung or to drain blood accumulated due to severe chest trauma.

Other Interventions For Shortness Of Breath

In other cases, your doctor adopts approaches to deal with the problem causing dyspnea with intervention techniques. The doctor decides the techniques based on the issue you develop. So, intervention techniques used to deal with dyspnea are:

Intravenous Medications

Your doctor can suggest intravenous medication and interventional treatment to deal with severe problems like pulmonary embolus. It requires giving blood thinners through your veins. You also need to undergo a procedure with thrombolytics to break the blood clots.

Oxygen and Respiratory Assistance

Some severe cases of dyspnea need respiratory support while recovering. So, the doctor ensures adequate oxygen supplementation while you recover. When you are unable to breathe on your own, the doctors opt for mechanically assisted breathing like intubation or non-invasive pressure ventilation.

Lifestyle Management For Shortness Of Breath

In cases where you suffer from shortness of breath due to manageable issues, then you can tweak your lifestyle for better results. Lifestyle management can help people naturally deal with dyspnea.

Weight Management

It is observed that people with excess body weight can suffer from dyspnea. Weight loss can make a big difference in people who suffer breathing issues. Losing weight helps you breathe easier. So, try some effective workouts to enhance your muscle strength as well as avoid declining of lung and heart conditions. So, you can overcome the problems caused due to dyspnea without taking any medications.

Avoid Overexposure To Pollutants

Some people suffer from breathing problems due to inhaling pollutants. So, to avoid breathing issues due to environmental chemicals, wear a mask. Using the appropriate mask offers you protection from the harmful chemicals and pollutants.

Quit Smoking

People who smoke tend to have severe health problems, including breathing issues. Smoking can trigger heart disease, asthma attacks, COPD, COPD exacerbations.

Build Endurance

People who experience breathing problems when they are active need to build physical endurance. Consistent training will help you build endurance. So, you can exercise with intensity without becoming out of breath.

Regulate Stress

Stress can trigger anxiety. Some people experience panic attacks or anxiety disorders. It can lead to shortness of breath. People experience breathing problems due to excess stress need to manage it effectively. Many people do not realize that stress can play an important role in making dyspnea worse. So, people try to live with the condition. They feel the fear of social exclusion, exercise, and the decline of your condition can lead to the progression of the disease. It amplifies the acute episode more severe. To manage stress, you can perform the following:

• Counseling
• Cognitive-behavioral therapy
• Medications
• Behavioral management

You can also try relaxation techniques like yoga or breathing exercise to reduce the impact of anxiety on your health.

Preventing Shortness Of Breath

Is it possible to prevent dyspnea? The breathing problems caused due to simple problems are easy to manage, others need caution and care. Here are some of the steps to prevent the condition:

Take Medications

If you have chronic dyspnea due to a condition such as heart failure, lung disease, or obesity, then the strategy for preventing yourself from developing dyspnea (or making your dyspnea worse) is centered on disease management, typically with prescription medication.

Avoid Triggers

Breathing problems caused due to allergic reactions are easy to control by avoiding triggers. So, you need to learn your body’s reaction to allergies. Also, know what causes asthma attacks or panic attacks. Make an effort to avoid any triggers to prevent episodes of dyspnea.

In most cases, a combination of preventive strategies can help you avoid shortness of breath and the distress caused by it.

Conclusion

The outlook of shortness of breath depends on the underlying cause of the problem. If the problem occurs due to a chronic disease or serious issues, then it needs immediate medical treatment. With proper care and treatment, you can manage several issues. Never ignore the problem as it can lead to fatal complications. Therefore, get emergency medical care when you observe dyspnea. For people with a chronic condition, a long-term treatment and prevention plan is necessary for predisposing the issue. For less severe cases, lifestyle management and following the guidelines from the doctor can offer effective results.

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