Acute and Chronic Shortness of Breath

Symptoms, Causes, Diagnosis, and Treatment

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Shortness of breath is a common symptom that may come on rapidly or gradually. If you are experiencing shortness of breath, that does not mean you should necessarily be worried about lung cancer or serious conditions such as heart disease—but you should see your doctor as soon as you can.

A woman having trouble breathing
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There are many causes of shortness of breath, and they are treatable. You will need to talk to your doctor, have a physical examination, and probably diagnostic tests to learn why you are short of breath.

Symptoms

Most people describe this symptom as a subjective sensation of difficulty with breathing. You may have a feeling of being unable to get enough air in or that it takes more effort than usual to breathe. Some people also describe a sensation of chest tightness.

Shortness of breath can come on rapidly in a matter of minutes or hours, or it can wax and wane for days, weeks, months, or even years. 

When to See a Healthcare Provider

Sometimes it can be hard to know how serious your shortness of breath is. In fact, sometimes the most severe shortness of breath can be something that's not life-threatening—like hyperventilation or a panic attack, and the mildest symptoms can be related to serious causes.

Serious causes can be accompanied by other symptoms.

When to Call 911

Symptoms that suggest shortness of breath may be serious include:

  • Chest pain
  • A bluish tinge to your fingers or lips (cyanosis)
  • Swelling or a feeling of fullness in your throat or lips
  • Lightheadedness
  • Inability to talk due to difficulty breathing
  • Rapid worsening of your symptoms
  • Redness or swelling of your legs
  • Coughing up blood

If you are trying to decide whether to call 911, it's best to get urgent help.

Some of the causes of shortness of breath can be life-threatening and need immediate medical attention.

Medical Terms

You will see different terms used related to shortness of breath. A quick rundown of some of these terms include:

  • Dyspnea refers to the sensation of shortness of breath
  • Tachypnea refers to rapid breathing with or without a feeling of being short of breath
  • Bradypnea means a slow rate of breathing

Respiratory Rate

A normal respiratory rate in adults is considered to be between 12 and 20 breaths per minute at rest and varies with children depending on age.

It's important to note that you may feel short of breath with a normal respiratory rate. The opposite is also true, you could have an abnormal respiratory rate without any difficulty breathing.

Causes

In 85 percent of people, shortness of breath is due to a medical condition that affects the heart or the lungs.

Common

Some of the more common causes include:

Other common causes include:

  • Smoking
  • Anemia: With anemia, you may also experience fatigue, pale skin, and lightheadedness
  • Thyroid conditions: Both hyperthyroidism and hypothyroidism may cause breathlessness

Less Common

Less common, but important, causes of shortness of breath may include:

  • Benign and malignant tumors, including lung cancer
  • Anxiety and panic attacks
  • Objects inhaled accidentally into the lungs
  • Heart valve problems
  • Acid reflux
  • Anaphylaxis (a severe type of allergic reaction)
  • Neurological diseases such as multiple sclerosis
  • Other lung diseases such as sarcoidosis and bronchiectasis
  • Lack of regular exercise

Before dismissing shortness of breath as being due to inactivity, talk to your healthcare professional.

Diagnosis

It’s important to make an appointment to see your healthcare professional if you develop shortness of breath, even if you think you might know the reason to explain your symptoms. They will take a careful history and do a physical exam.

Some of the questions they may ask include:

  • When did you first experience shortness of breath and how did it first begin?
  • Do you have any other symptoms, such as chest pain, a cough, wheezing, fever, leg pain, unexplained weight loss, or fatigue?
  • Have you traveled recently by car or by plane?
  • Do your symptoms occur at rest or only with activity?
  • Which activities seem to cause your symptoms?
  • Do you feel more winded when you are sitting up or lying down?
  • Do you have a personal or family history of any heart or lung problems?
  • Have you ever smoked? If so, for how long?

Tests and Imaging

The diagnostic tests you may need will depend on your particular symptoms and physical findings.

Tests you might have include:

  • Pulse oximetry, a test performed by putting a clamp on your finger or earlobe to estimate the amount of oxygen in your blood
  • An electrocardiogram (EKG) to look for signs of a heart attack or irregular heart rhythms
  • A chest X-ray to look for infections or growths in your lungs
  • Blood work to look for anemia and other causes
  • Pulmonary function tests to look for signs of asthma or emphysema and other lung conditions

Other tests may include:

  • A computerized tomography (CT) scan of your chest
  • A stress test
  • An echocardiogram, which is an ultrasound of your heart to look for problems with your heart valves, and if you have any damaged areas in your heart
  • A bronchoscopy uses a flexible tube that is placed through your mouth and down into the bronchi to look for tumors or a foreign body. Bronchoscopy would be done for shortness of breath only if a concerning finding is present on chest imaging.

Dyspnea and COPD

Dyspnea is very common with COPD. Your doctor may use the modified Medical Research Council dyspnea scale to identify the severity of your dyspnea.

Treatment

The treatment of your shortness of breath will depend on the cause, but the most important first step is to make sure you are getting enough air to supply your tissues with the oxygen they need. This is referred to as the ABC's:

  • Airway
  • Breathing
  • Circulation
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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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