Breathing difficulty

• hyperventilation (often accompanied by mental depression or anxiety and a tingling sensation in the fingers)
• obesity
• rapid ascent to high altitudes
• airway obstruction
• cigarette smoking
• inhalation of a foreign object
• dust-laden environment
• medications (such as amphetamines)
• asthma
• emphysema
• lung disease
• allergies (such as mold, dander, pollen)
• anaphylaxis (extreme allergic reaction )
• congestive heart failure ( CHF )
• pulmonary alveolar proteinosis

Note: There may be other causes of breathing difficulty. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as location, quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for breathing difficulty, occurring alone or in combination with other problems.

Home Care:
Shortness of breath, whether sudden or long term, should always be taken seriously. While many causes are harmless and are easily corrected, shortness of breath requires a thorough medical evaluation.

Follow prescribed therapy to treat the underlying cause.

Rest and relaxation can help a person who has shortness of breath caused by hyperventilation .

Call Your Healthcare Provider If:

• there is shortness of breath after only slight exertion or while at rest.
• you awaken in the night out of breath or have to sleep propped up on several pillows to avoid becoming short of breath.
• there is any unexplained shortness of breath. If wheezing is present, the problem is probably not as serious, but attention is needed just as promptly. Wheezing is often an indication of asthma or early emphysema .
• a young child may have inhaled or choked on an object ( foreign object aspiration or ingestion ).
• there is tightness in the throat or a barking, croupy cough .

What to Expect:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting breathing difficulty in detail may include:

• quality
  • Does the person complain of shortness of breath?
  • Does the person make grunting sounds while breathing?
  • Do they appear to be having to work hard to breathe?

• time pattern
  • Has it been present for months or years?
  • Did it slowly progress over weeks to months?
  • Did it begin recently?
  • Did it begin suddenly?
  • Did it come on slowly (gradual onset)?
  • Is there a sequence of separate occurrences (episodic)?
    • How long does each last (for how many hours)?
    • Does each repeated episode have a similar pattern (recurrent)?

  • Has the breathing difficulty worsened recently ?
  • Does breathing difficulty cause the individual to awaken at night ( paroxysmal nocturnal dyspnea )?
  • Does the amount of breathing difficulty change (variable over hours)?
  • Does breathing difficulty occur at rest?
  • How long does each episode last?

• aggravating factors
  • Is it worse when lying flat ( orthopnea )?
  • Is it worse with a change in body position?
  • Did it develop within 4 to 6 hrs after exposure to something that the person is/may be allergic to ( antigen )?
  • Is it worse after exercise ?
  • Does shortness of breath occur only when wheezing ?

• other
  • Is the breathing pattern irregular?
  • Does the person draw back the chest muscles with breathing ( intercostal retractions )?
  • What other symptoms are also present?

The physical examination will include a thorough examination of the lungs, heart, and upper airway passages.

Diagnostic tests that may be performed include:

• blood tests including arterial blood gases
• ECG
• X-ray of the chest

Intervention:
Depending on the cause and the severity of the problem, fluid pills, heart pills, or asthma medications may be prescribed. In severe cases, hospitalization may be required. Supplemental oxygen is, in some cases, not very helpful; high doses of supplemental oxygen can be hazardous for patients with emphysema .

After seeing your health care provider:
You may want to add a diagnosis related to breathing difficulty to your personal medical record.


This is an illustration of the major features of the lungs and bronchial tree. The inset is of the alveoli. They are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.