What is Dyspnea (shortness of Breath)?
Oxygen is the life-source for all living beings and is supplied to the body through the process of breathing. Intense physical activity demands more oxygen, so it automatically accelerates breathing. That is why, it’s natural to feel a slight shortness of breath – called Dyspnea – when one is exercising intensely, walking quickly, running, jumping, carrying heavy weight, etc. Also, at high altitudes the air is thinner as levels of oxygen available are lower, so activity at high altitudes can also cause shortness of breath.
However, when none of the above conditions exist and one is experiencing shortness of breath, it is cause for concern. It is indicative of larger health issues, and should not be ignored. There are various physiological conditions that cause shortness of breath and it’s important to be aware of them.
Causes of Shortness Breath
a) Breathing and Lungs related
- Covid-19: In the present context, it’s very important to note that shortness of breath is a prominent symptom of Covid-19
- Asthma and chronic bronchitis
- Blockage in the breathing passage
- Chronic obstructive pulmonary disease or COPD
- Lung cancer
- Excess fluid in the lungs
- Inflammation of the membrane surrounding the lungs
- Pulmonary hypertension
- Pulmonary fibrosis
- Tuberculosis
- Sarcoidosis
- Inhaling foreign objects, common in children
- Interstitial lung disease
- Collapsed lung
- Pneumonia and lung infections
- Blood clot in an artery in the lung
- Fungal infections such as coccidiomycosis, blastomycosis, aspergillosis
b) Heart-related
- Heart attack
- Irregular heartbeat or arrhythmia
- Heart failure
- Cardiomyopathy or a problem with the heart muscle
- Pericarditis or an inflammation of the layer around the heart
- Obesity, as it puts a strain on the heart’s ability to pump blood
c) Environment related
- Carbon mono-oxide poisoning from exposure to smoke
- Occupational toxicities such as minerals from mines, dust from quarries, chemicals from factories
- Air pollution in the city
- Allergies and allergic reactions to pollen and mold
d) Other ailments and conditions - Anemia
- Anxiety disorders
- Guillain-Barre syndrome
- Broken ribs and traumatic lung injury caused by an accident
- Epiglottitis or swelling of the “lid” of your windpipe
- Kyphoscoliosis which is a deformity in the chest wall
- Myasthenia gravis which causes muscle weakness
- Pregnancy
- A severe allergic reaction known as anaphylaxis
- Sudden blood loss due to an accident
- History of smoking
- Radiation therapy for cancer
- Nervous system diseases, such as paralysis
- Acidosis, such as from salicylate overdose (aspirin)
- Toxicity from drugs given for other ailments
- Hypotension or low BP
Symptoms of Shortness Breath
- Being out of breath or laboured breathing
- Rapid and shallow breathing
- Tightness in the chest
- Hungering for air
- Unable to breathe deeply
- Feeling suffocated
- Anxiousness
- Blood in the sputum
- Pain or tightness in the chest
- Dizziness, fatigue or fainting
- Wheezing and or coughing
- Palpitations in the heart
- Neck pain and or pain while inhaling
When to see a doctor
- Swelling in the feet and ankles
- Difficulty in breathing while lying flat
- High fever, chills and incessant cough
- Wheezing or whistling sound while breathing
- Worsening of an existing shortness of breath
Complications
If Dyspnea is not treated in time, it can cause
- Hypoxia or hypoxemia, which is low blood oxygen level; this in turn leads to more serious complications
- Temporary or permanent cognitive impairment, that is reduced brain function
- Onset of or worsening of other medical problems
Preventive Care
- Do not inhale, or avoid chemicals like paint fumes and car exhaust that can irritate your lungs
- Avoid extreme temperatures. Exerting yourself in very hot and humid or very cold weather can worsen dyspnea caused by chronic lung diseases
- Practicing breathing and/or relaxation techniques to improve your breathing function and strengthen your breathing muscles
- Quit smoking and if you do not smoke, do not start
- Reach and maintain a healthy weight
- Take all your medications for lung and heart conditions on time; else it can lead to poor control over dyspnea.
- Keep elevation in mind. When travelling to a hill stations or climbing tall structures, take time to adjust your breathing and avoid exertion until then
- Avoid air-pollution: If you have lung disease, observe air pollution alerts issued on radio, TV and Internet
Diagnosis
To begin with, the physician will understand the sequence of, and triggers for, your shortness of breath. He/she will also assess yours and your family’s medical history to rule out inherited conditions. Then he/she will conduct a series of tests:
- Physical exam: This physician will check your temperature and listen to your breathing. A fever could indicate an infection.
- Cardiopulmonary exercise testing: In this test, you will exercise on a treadmill or stationary bike, and then the volume of oxygen taken in and carbon dioxide let out will be measured
- Spirometry tests: This measures airflow and the patient’s lung capacity in normal conditions, without exertion. This can pinpoint the type and the extent of dyspnea
- Pulse oximetry: In this test, a finger sensor is used to see how much oxygen you have in your blood.
- Chest X-ray, CT scans or other special imaging tests: These would indicate a deeper cause of breathlessness if you are not already diagnosed with a chronic condition.
- Blood tests: These could show anemia, infections and other conditions.
- Lung function tests: These tests indicate how good is your breathing
Treatment for Shortness of Breath
The treatment varies according to the condition. After examination of the patient, the doctor will decide the right course of treatment.
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