Shortness of Breath: Symptoms, Causes, and Treatment - Verywell Health
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Breathing is an automatic action that you perform without thinking, but it's not a reflex you should take for granted. If you've ever lost your breath, you know it can be a frightening event. The minute you have to think about breathing, you intuitively know that something is off. Shortness of breath can affect anyone, including healthy people. It's a subjective feeling, so its presentation differs from person to person.
Shortness of breath, clinically known as dyspnea, is sometimes described as difficulty catching your breath, wheezing, or breathlessness. The causes of shortness of breath range from very strenuous exercise and extreme temperatures to obesity and higher altitude.
This article discusses the symptoms, types, causes, diagnosis, and treatment of shortness of breath.
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Symptoms of Shortness of Breath
Shortness of breath is associated with a myriad of symptoms, depending on what brings it about. These symptoms include:
- Tightening of the chest
- Feeling of suffocation
- Wheezing
- Fatigue
- Fainting sensation
- Difficulty inhaling or exhaling
- Chest pain (on exertion or while breathing)
Types of Shortness of Breath
Abnormal respiration is often characterized by the feeling of suffocation or being short of breath. The following types of abnormal respiration are most commonly associated with the symptom of shortness of breath:
- Sleep apnea: Sleep apnea is a breathing disorder characterized by extended pauses in breathing during sleep. This occurs when throat muscles relax and block the airway, resulting in a feeling of breathlessness and lack of restorative sleep.
- Orthopnea: A feeling of breathlessness when you are lying down, orthopnea is often caused by heart failure or relieved by sitting or standing up.
- Paroxysmal nocturnal dyspnea (PND): PND is a sensation of shortness of breath that awakens a person, often after one or two hours of sleep, and is usually relieved in the upright position.
- Hyperventilation: Also known as overbreathing, hyperventilation is rapid or shallow breathing most commonly brought on by anxiety, panic, or chemical imbalances in the body.
- Hypoventilation or bradypnea: This is slow, shallow breathing.
- Tachypnea: Tachypnea is abnormally rapid breathing from a lack of oxygen or too much carbon dioxide in the body.
- Kussmaul respiration: This is deep, rapid, and labored breathing as seen in those with chemical imbalances in the body such as diabetic ketoacidosis.
- Cheyne-Stokes respiration: Cheyne-Stokes respiration is a rare type of abnormal breathing pattern that usually occurs in sleep and is characterized by cyclical episodes of apnea and hyperventilation. It is most commonly experienced as part of the dying process or when someone has heart failure.
Causes of Shortness of Breath
Almost any condition affecting the heart or lungs can cause shortness of breath but dyspnea can also be brought about by vascular, neuromuscular and metabolic disease.
If you are ill or your body senses danger, your brain and body may change how you breathe to correct for any chemical imbalances that are detected.
Oftentimes, either one or both of the following occur:
- Your brain detects a change in your breathing pattern.
- Your nerves signal that a change in your breathing pattern is needed to correct any chemical imbalances that you might be experiencing.
The following are the most common causes of shortness of breath:
What Medications Can Cause Shortness of Breath?
The side effect of shortness of breath from medications is quite common, as many drug classes can cause this symptom but should not be taken lightly. Ask your healthcare provider about the side effect of shortness of breath before taking medication in any one of the following drug classes:
- Angiotensin-converting enzyme (ACE) inhibitors
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Taking high amounts of aspirin and ibuprofen can cause bronchospasm. They have also been tied to heart attack and strokes so always take these common OTC medications as described.
- Anticonvulsants
- Heart failure medications such as beta-blockers, calcium channel blockers, digoxin, and cholinergics
- Antihypertensives
- Antibiotics
- Antifungals
- Antimicrobials
- Antiretrovirals
- Interferon
- Chemotherapy agents
Recreational drugs such as cocaine, codeine, heroin, methadone, and propoxyphene can also cause shortness of breath.
Shortness of breath is a serious medical complication and you should contact your healthcare professional immediately should you experience this symptom.
Medical management may include:
- Reevaluation of the type of medication you are using
- How much and how potent the drug may be (dosage)
- Any drug-drug interactions that may be occurring
- Careful monitoring of any subsequent medication changes
In the event that medications causing dyspnea are unavoidable, such as in pain management and palliative care (specialized care to relieve pain and symptoms), additional support services such as supplemental oxygen, respiratory therapy, and pulmonary rehabilitation, may be provided.
Tests to Diagnose the Cause of Shortness of Breath
Dyspnea has many causes, which can make it difficult to find a diagnosis. To determine what might be causing your shortness of breath, your healthcare provider may recommend/perform one of these tests:
- Noninvasive cardiopulmonary exercise testing: This testing requires using catheters during exercise—usually stationary cycling or running on a treadmill — to assess how the body is utilizing oxygen, and to measure heart and lung function. This type of advanced testing is not available in all hospitals, but it is the gold standard method to determine the cause of your shortness of breat.
- Electrocardiogram (ECG or EKG): Detecting abnormalities on an ECG—a test involving attaching small electrodes to your chest to measure electrical impulses of the heart—is helpful in diagnosing cardiac causes of shortness of breath. Common heart conditions that may be detected by ECG include arrhythmias, congestive heart failure, cardiac tamponade, and cardiomyopathy.
- Chest X-ray: This is helpful to identify obstructions or blockages (such as pneumonia, pulmonary embolism, tumors, and effusions) and anatomical abnormalities that may cause shortness of breath.
- Pulmonary function testing (PFT): A group or series of noninvasive tests that show how well air is moving in and out of the lungs and how well oxygen is being transferred from the lungs to the blood by measuring lung volume, capacity, rates of flow, and gas exchange.
How to Treat Shortness of Breath
There is no one-size-fits-all treatment for shortness of breath. Shortness of breath can range from mild to severe.
In mild cases, your shortness of breath may go away simply by changing your position or doing breathing exercises.
In moderate cases, your shortness of breath may go away after taking medications that open the airway (bronchodilators) or reduce inflammation (steroids).
No matter the case, never take shortness of breath lightly, and contact your healthcare provider immediately if you are struggling to breathe.
Medical management is specific to the cause of your shortness of breath. For example, if a medication you are taking is the cause of your shortness of breath your healthcare provider may suggest that you cut back or discontinue the use of the offending agent. They will likely take a thorough history checking for any potential drug interactions, allergic reactions, or even misunderstandings on how to take your medications.
If the cause of your shortness of breath is pleural effusion (a collection of excess fluid between the layers of the pleura outside the lungs), draining the effusion may result in the resolution of your symptoms. Resolving the underlying issue is always the most effective way to treat shortness of breath.
When to See a Healthcare Provider
If you experience any of the following contact a healthcare provider or head to the emergency room immediately:
- New shortness of breath
- Rapidly deteriorating ability to catch your breath for any reason your ability to breath
- Shortness of breath that is different from past episodes
- Shortness of breath that is accompanied by swelling in your feet and ankles
- Trouble breathing when you lie flat
- Shortness of breath accompanied by high fever, chills, cough, or wheezing
Summary
Shortness of breath (dyspnea) has many causes, which can make it difficult to find a diagnosis. It is a serious medical complication that is most commonly caused by lung and heart problems, medications, or vascular, neuromuscular and metabolic disease.
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