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Breathing difficulty

Shortness of breath; Breathlessness; Difficulty breathing; Dyspnea

 

Breathing difficulty may involve:

  • Difficult breathing
  • Uncomfortable breathing
  • Feeling like you are not getting enough air

Considerations

 

There is no standard definition for difficulty breathing. Some people feel breathless with only mild exercise (for example, climbing stairs), even though they do not have a medical condition. Others may have advanced lung disease but may never feel short of breath.

Wheezing is one form of breathing difficulty in which you make a high-pitched sound when you breathe out.

 

Causes

 

Shortness of breath has many different causes. For example, heart disease can cause breathlessness if your heart is unable to pump enough blood to supply oxygen to your body. If your brain, muscles, or other body organs do not get enough oxygen, a sense of breathlessness may occur.

Breathing difficulty may also be due to problems with the lungs, airways, or other health problems.

Problems with the lungs:

  • Blood clot in the arteries of the lungs ( pulmonary embolism )
  • Bronchiolitis
  • Chronic obstructive pulmonary disease (COPD), such as chronic bronchitis or emphysema
  • Other lung disease
  • Pneumonia
  • Pulmonary hypertension

Problems with the airways leading to the lungs:

  • Blockage of the air passages in your nose, mouth, or throat
  • Choking on something stuck in the airways
  • Croup
  • Epiglottitis

Problems with the heart:

  • Angina
  • Heart attack
  • Heart defects from birth ( congenital heart disease )
  • Heart failure
  • Heart rhythm disturbances ( arrhythmias )

Other causes:

  • Allergies (such as to mold, dander, or pollen)
  • High altitudes where there is less oxygen in the air
  • Compression of the chest wall
  • Dust in the environment
  • Emotional distress, such as anxiety
  • Hiatal hernia
  • Obesity
  • Panic attacks

 

Home Care

 

Sometimes, mild breathing difficulty may be normal and is not a cause for concern. A very stuffy nose is one example. Strenuous exercise, especially when you do not exercise often, is another example.

If breathing difficulty is new or is getting worse, it may be due to a serious problem. Though many causes are not dangerous and are easily treated, call your health care provider for any breathing difficulty.

If you are being treated for a long-term problem with your lungs or heart, follow your provider's directions to help with that problem.

 

When to Contact a Medical Professional

 

Go to the emergency room or call the local emergency number (such as 911) if:

  • Breathing difficulty comes on suddenly or seriously interferes with your breathing
  • Someone completely stops breathing

See your provider if any of the following occur with breathing difficulties:

  • Chest discomfort, pain, or pressure. These are symptoms of angina.
  • Fever
  • Shortness of breath after only slight activity or while at rest
  • Shortness of breath that wakes you up at night or requires you to sleep propped up to breathe
  • Tightness in the throat or a barking, croupy cough
  • You have breathed in or choked on an object (foreign object aspiration or ingestion)
  • Wheezing

 

What to Expect at Your Office Visit

 

The health care provider will examine you and ask about your medical history and symptoms:

  • How long have you had breathing difficulty? Did it start suddenly? Has it gotten worse recently?
  • Is there a sequence of separate episodes? How long does each last, and does each episode have a similar pattern?
  • Does breathing difficulty cause you to wake up at night ( paroxysmal nocturnal dyspnea )?
  • Is it worse when you change body position?
  • Did it develop within 4 to 6 hours after exposure to something that you are or may be allergic to ( antigen )?
  • Is it worse after exercise?
  • Do you make grunting or wheezing sounds while breathing?

Tests that may be ordered include:

  • Blood oxygen saturation (pulse oximetry)
  • Blood tests (may include arterial blood gases )
  • Chest x-ray
  • CT scan of the chest
  • ECG
  • Echocardiogram
  • Exercise testing
  • Pulmonary function tests

If the breathing difficulty is severe, you may need to go to a hospital. You may receive medicines to treat the cause of breathing difficulty.

If your blood oxygen level is very low, you may need oxygen.

 

 

Open References

References

Kraft M. Approach to the patient with respiratory disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 83.

Schwartzstein RM, Adams L. Dyspnea. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 29.

 
  • What causes wheezing?

    What causes wheezing?

    Animation

    •  

    What causes wheezing? - Animation

    Dr. Alan Greene explains the causes of wheezing, when it's a healthy response and when it's not.

  • Lungs

    Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Emphysema

    Emphysema - illustration

    Emphysema is a lung disease involving damage to the air sacs (alveoli).There is progressive destruction of alveoli and the surrounding tissue that supports the alveoli. With more advanced disease, large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to lack of supportive tissue which decreases oxygenation.

    Emphysema

    illustration

  • What causes wheezing?

    Animation

    •  

    What causes wheezing? - Animation

    Dr. Alan Greene explains the causes of wheezing, when it's a healthy response and when it's not.

  • Lungs

    Lungs - illustration

    The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.

    Lungs

    illustration

  • Emphysema

    Emphysema - illustration

    Emphysema is a lung disease involving damage to the air sacs (alveoli).There is progressive destruction of alveoli and the surrounding tissue that supports the alveoli. With more advanced disease, large air cysts develop where normal lung tissue used to be. Air is trapped in the lungs due to lack of supportive tissue which decreases oxygenation.

    Emphysema

    illustration

A Closer Look

 

    Talking to your MD

     

      Self Care

       

        Tests for Breathing difficulty

         
           

          Review Date: 6/22/2015

          Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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