Shortness of breath (dyspnoea)

Specialty of Internal medicine

What is shortness of breath?

Shortness of breath (also known as breathlessness or dyspnoea) is a very noticeable symptom where the patient finds it difficult to breathe properly, tiring out quickly, and not taking in enough oxygen with each breath. The patient’s breaths usually become quick and shallow, perhaps even hyperventilating, and may be accompanied by wheezing, coughing, or chest pain.

What symptoms are associated with shortness of breath?

Shortness of breath is a symptom rather than a diagnosis, and can be symptomatic of many underlying problems. As such, breathlessness may be accompanied by a number of symptoms, including:

  • Fatigue
  • Wheezing
  • Coughing
  • Hyperventilation
  • Chest pain
  • Pleurisy (pain with inspiration)
  • Dizziness
  • Fainting
  • Neck pain
  • Feelings of anxiety

By analysing when the shortness of breath occurs (for example at rest or when doing exercise), and the other symptoms that accompany it, doctors can diagnose the root cause.

What causes shortness of breath?

There are many things that can cause dyspnoea, many of which can be serious, and some of which are even life-threatening, such as lung cancer and chronic obstructive pulmonary disease (COPD).

If you have sudden shortness of breath and are struggling to breathe, your chest feels tight or heavy, and you are experiencing pain which spreads to your neck, back, arms, and/or jaw, these are signs that you are having a heart attack or have a serious problem with your airways, and you should immediately call 999, as you will need hospital treatment.

Breathlessness can be symptomatic of:

Lung problems

  • Asthma
  • Croup
  • Interstitial lung disease
  • Pulmonary oedema
  • Pulmonary fibrosis
  • Pleurisy
  • Sarcoidosis
  • Tuberculosis

Heart problems

  • Arrhythmia
  • Cardiomyopathy
  • Heart failure
  • Pericarditis

Other problems

  • Inhaling a foreign object
  • Low blood pressure
  • Anaemia
  • Carbon monoxide poisoning
  • Anxiety disorder

When to see a doctor

You should never feel you cannot consult a doctor – even if the problem does not seem serious, you are not wasting anyone’s time getting it checked out. You should definitely see a doctor for shortness of breath in the following circumstances:

  • It has been going on for over a month
  • You have swelling around your feet and ankles
  • You have been coughing for three weeks or more
  • You experience fevers and/or chills
  • Your breathlessness is worse when you lie down or do exercise

What is the treatment for shortness of breath?

The treatment for breathlessness depends entirely on the cause. The possible causes of dyspnoea are numerous and diverse, and therefore, so are the possible treatments. General advice, especially for chronic shortness of breath, would be to stop smoking, lose weight, and avoid exposure to allergens and pollutants that could make it worse.

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