Symptoms, Causes, Diagnosis and Treatment of Dyspnea

Man getting an oxygen mask
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Dyspnea ("air hunger") is shortness of breath. Many people experience it as a result of the demands strenuous exercise puts on the body, but it can also result from carrying excess weight, a panic attack, illnesses such as asthma or pneumonia, or several other causes. Breathing may be rapid, uncomfortable, or painful, and you may feel tightness in your chest, experience labored breathing, or even feel suffocated. If you experience recurrent, sudden, or severe dyspnea, you should see a doctor. You may need medical intervention, and your treatment will depend on the cause of your shortness of breath. 

Signs and Symptoms

There are a variety of ways that dyspnea can make you feel, and it can range in severity. It can be chronic, usually worsening over time, or it can be acute and severe. Sudden or extreme dyspnea is dangerous and requires emergency medical attention. 

Breathing may be:

  • Short
  • Rapid
  • Shallow
  • Effortful, labored
  • Slow
  • Painful or uncomfortable

You may also experience:

  • Chest pressure, tightness, or heaviness
  • An inability to breathe altogether

There are times when you, as an observer, may be able to notice dyspnea even before the person it is affecting. Keep an eye out for the following signs of an emergency and call for medical attention if you notice them:

  • Clearly audible, loud, labored breathing
  • An anxious, distressed facial expression
  • Flaring nostrils
  • Protrusion of the abdomen and/or chest
  • Gasping
  • Cyanosis (pale or blue face, mouth, lips, or extremities)

Causes

The most benign cause of dyspnea is exercise; the increased oxygen demands cause you to breathe faster, especially if the activity is more intense than what you are used to. This type of shortness of breath is nothing to worry about, and it should improve after a few minutes.

But dyspnea can also be a result of some health concerns. In fact, it is almost always caused by illness.

In general, any illness that affects the heart or lungs is likely to result in dyspnea. And, often, systemic illnesses cause dyspnea as well, typically due to increased oxygen demands or low oxygen supply. 

The list of potential causes of dyspnea is extensive. Causes of intermittent or acute dyspnea include:

The most common causes of chronic dyspnea include:

Young babies, elderly individuals, or people who have major health problems are more susceptible to shortness of breath, even from a mild respiratory infection.

Pregnant women, on the other hand, may experience dyspnea even when there is no respiratory infection. This is because they have increased oxygen demands and usually experience physical pressure on the lungs as a result of the growing uterus.

Diagnosis

The way a person describes dyspnea can be a clue as to its underlying cause. Different illnesses may result in different types and severity of dyspnea, though this is not always the case.

Dyspnea is a common cause of medical visits. If you go for this reason, your doctor will begin looking for the cause of your symptoms with a history and physical exam. Questions such as whether you experience dyspnea mostly during activity or at rest, and whether it comes on suddenly or slowly will be important in assessing your condition.

Certain risk factors, such as a history of smoking, can help your doctor rule out some conditions and give more weight to others. Further diagnostic testing may be needed. Tests that may be helpful in diagnosing the cause of dyspnea include:

  • Blood tests: Used to help diagnose infections and inflammatory disease
  • Chest X-ray: Usually used to identify lung disease
  • Electrocardiogram (EKG): Used if your doctor thinks you may have heart disease
  • Screening spirometry: Can assess how much air you can breathe
  • Complete pulmonary function testing: Can evaluate your breathing capabilities in more detail than screening spirometry by measuring how much air you can breathe in and out, as well as how quickly
  • Arterial blood gas measurement: Provides a measure of the oxygen content of your blood, which alerts your doctors if you are becoming low in oxygen
  • Echocardiography: May be ordered if your EKG suggests that you have heart disease
  • Standard exercise treadmill testing: Evaluates your breathing when you have increased oxygen demands
  • Complete cardiopulmonary exercise testing: Evaluates your heart and lung function in detail

Treatment

Treatments for dyspnea depends on the underlying cause.

For example, for those who are short of breath when exercising, building up physical endurance with training will, in the long term, prevent dyspnea from occurring with strenuous activity. 

If asthma is making it difficult to breathe, initiating or adjusting medications such as bronchodilators and steroids can alleviate shortness of breath. If an anxiety or panic disorder is to blame, cognitive behavioral therapy and/or medication can prevent attacks. When COPD is to blame, specialized breathing techniques and oxygen supplementation are usually necessary.

In some cases, you may need to employ more than one strategy to reduce dyspnea in a meaningful way, such as losing weight and taking medication.

Prevention

In general, the strategy for prevention of dyspnea involves controlling illnesses that cause it as well as avoiding being short of breath if you know you are prone to it.

For example, if you already know that you have asthma or allergies, or you experience panic attacks, taking medication to manage your condition and making an effort to avoid triggers whenever possible will help prevent episodes of dyspnea.

If you develop an infection such as pneumonia, your doctors will work to prevent you from experiencing dyspnea by treating your infection and closely monitoring your lungs with physical examination and X-rays.

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.

To help prevent some of the illnesses that can cause dyspnea, consider these measures:

  • Try to determine your ideal weight and work toward reaching it.
  • If you smoke, quit. The habit can cause COPD and heart disease.
  • Manage your blood pressure and cholesterol to prevent heart attacks and arrhythmias.
  • Avoid frequently breathing pollutants by wearing an appropriate mask if you work with environmental chemicals.

A Word From Verywell

While dyspnea does not always indicate the presence of an abnormal condition, it can. If you notice severe and sudden shortness of breath that is accompanied by chest pain, nausea, or lightheadedness, you should call 911 or have someone drive you to the closest emergency department. Try not to panic, as your reaction can make breathing even more difficult. Generally, dyspnea can be treated.

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View Article Sources
  • Donald A. Mahler; Denis E. O'Donnell (20 January 2014). Dyspnea: Mechanisms, Measurement, and Management, Third Edition. CRC Press. 
  • Wills CP, Young M, White DW (February 2010). "Pitfalls in the evaluation of shortness of breath". Emerg. Med. Clin. North Am.