Shortness of Breath

Overview

Shortness of breath, or dyspnoea, is the uncomfortable sensation of not getting enough air or having to work harder to breathe. It is a symptom rather than a diagnosis, and it can come from the lungs, the heart, the blood, or sometimes anxiety. Because the causes range from mild and reversible to serious, new or worsening breathlessness always needs assessment. This page covers breathlessness as a symptom; for a more severe presentation see Difficulty Breathing, and for wheezing see Wheezing.

Common causes

• Asthma and COPD — common reversible and chronic airway causes.
• Respiratory infections such as pneumonia or acute bronchitis.
• Heart-related causes — heart failure, ischaemic heart disease, arrhythmia.
• Anaemia — low haemoglobin reduces oxygen-carrying capacity.
• Obesity and poor physical conditioning — breathlessness on exertion.
• Anxiety and panic-related breathlessness.
• Pulmonary embolism — a clot in the lung (emergency).
• Acid reflux triggering airway irritation.

Reading the pattern

The pattern of breathlessness guides the cause. Breathlessness that comes on with exertion and settles with rest may point to heart or lung disease, anaemia or poor fitness. Breathlessness at rest, at night, or that wakes you from sleep can indicate heart failure or asthma. Sudden breathlessness suggests a pulmonary embolism, an asthma attack or a heart problem. How long it has been present, what brings it on, and what eases it are all important clues.

Evaluation

Evaluation combines history and examination with selected tests: a chest examination, pulse oximetry, a chest X-ray, spirometry, an ECG, blood tests (including haemoglobin), and, where indicated, echocardiography or further cardiac and lung tests. The aim is to distinguish lung from heart from other causes so treatment is directed correctly.

Management

Management treats the underlying cause: inhalers for asthma and COPD, cardiac treatment for heart-related breathlessness, iron for anaemia, weight management for obesity-related breathlessness, and treatment of anxiety or reflux where relevant. Oxygen and hospital care are needed for severe or emergency presentations.

Warning signs — seek urgent care

• Sudden or severe breathlessness at rest.
• Breathlessness with chest pain, sweating or fainting.
• Bluish lips or very low oxygen on a pulse oximeter.
• Breathlessness that wakes you from sleep and forces you to sit up.
• Breathlessness with confusion or drowsiness.

How we help

Dr. Nayak identifies whether breathlessness is lung, heart or another cause, orders the right tests, and treats specifically — while directing emergency cases to hospital. Consultations are available in-clinic in Bhubaneswar and over teleconsultation.

Related conditions and patient concerns

• Difficulty Breathing
• Wheezing
• Asthma
• COPD
• Chest Tightness
• Hypertension & Cardiovascular Risk
• Palpitations & Cardiovascular Symptoms
• Anaemia & Blood Problems
• Obesity & Weight Management