Shortness of breath, medically known as dyspnea, is described as a strong tightening in the chest, a feeling of suffocation or air hunger. The description of shortness of breath varies depending on its cause.
Maximum cases of shortness of breath are observed in patients suffering from any heart or lung conditions. Since, both heart and lungs perform the major function of transport of oxygen to the tissues and brings about the removal of carbon dioxide from the body, thus any complexity to any of these systems would definitely affect the breathing process.
It can be caused by very strenuous exercise, massive obesity, extreme temperatures and high altitude. These causes however, seldom cause discomfort. On the other hand, excluding these causes, shortness of breath is an indication of a medical condition such as chronic obstructive pulmonary disease (COPD), asthma, croup and tuberculosis.
Causes of Acute Shortness of Breath:
Sudden occurrence of Shortness of Breath, commonly known as Acute, arises due to a number of causes. This includes:
• Asthma or Bronchospasm
• Congestial Heart Failure
• Carbon Monoxide poisoning
• Cardiac tamponade or Pericardialtamponade (a condition when the heart becomes compressed due to the excess build up of fluid in the pericardial space).
• Hiatal hernia (caused due to obesity)
• Low Blood Pressure or Hypotension
• Sudden Blood Loss
• Pneumonia (Lung or Pulmonary Infection)
• Pneumothorax (collapsed or punctured lung)
• Pulmonary embolism (arteries in the lungs becomes obstructed by a blood clot)
• Breathing or upper airway faces hindrance or blockage
• Lung Cancer
With shortness of breath, faster breathing comes with the feeling of running out of air. People experience as if they cannot breathe deeply enough or fast enough. A more effort to expand the chest while breathing in and out of air is noticed. Also, they may have an uncomfortable sensation that inspiration is quickly needed before expiration is completed.
Cough and chest pain may also be experienced by a person with shortness of breath depending on the cause.
Causes of Chronic Shortness of Breath:
If the shortness of breath remains for several weeks or for a longer period of time, it falls into the Chronic category and may arise due to the following:
• Heart Dysfunction
• Obesity or overweight
• COPD (Chronic Obstructive Pulmonary Disease)
Apart from these, a number of other health issues may also be responsible for this issue of Dyspnea, where it becomes difficult for an individual to get enough air. The major reasons include:
• Croup (young children)
• Pleurisy (a condition in which the membranal linings of the lungs and the chest cavity (pleura) becomes inflamed)
• Pulmonary edema (excess fluid accumulates in the air sacs of the lungs)
• Tuberculosis (infectious lung disease)
• Pulmonary Hypertension (high blood pressure within the arteries of the lungs and the heart)
• Sarcoidosis (accumulation of inflammatory cells in different body regions, but mainly affects the lungs and the lymph glands)
• Lung Damage making them scarred and responsible for their malfunctioning.
• Pericarditis (inflammation of the pericardium, the fibrous sac surrounding the heart)
• Cardiomyopathy (an acquired or inherited disease where the heart muscles are primarily targeted)
• Heart arrhythmia (irregular heart beating, either too fast or too slow)
• Anaemia (loss of RBC's from the blood)
• Epiglottitis (a condition when the epiglottis or the windpipe becomes swelled, and the airway becomes blocked)
• Chocking or inhalation of any foreign substance
• Guillain-Barre Syndrome (a rare disorder in which the immune system makes an attack on the nerves, thereby leading to muscular weakness or even paralysis)
• Myasthenia gravis (a neuromuscular disorder in which the skeletal muscles losses voluntary control and experiences fatigue)
• Generalised Anxiety Disorder (a psychological condition in which the victim develops extreme worry and stress with respect to the activities associated with the regular life).
A person with an unexplained shortness of breath, particularly if it’s severe and comes suddenly, must see a doctor as soon as possible.
Below are some symptoms which can be a concern in people with shortness of breath:
Shortness of breath at rest
Decreased level of consciousness
Confusion or agitation
Chest discomfort or Pain in the chest
Feeling that the heart is pounding (palpitations)
Feeling of chills and cough
When to Seek for Emergency Medical Care?
If you experience shortness of breath that happened suddenly that it affects your capability to function, go to the emergency room or call 911. In addition, if your shortness of breath is accompanied by fainting, chest pain or nausea, seek emergency medical help as these can be indications of a pulmonary embolism or a heart attack.
When to See a Doctor for Shortness of Breath?
See your doctor as soon as possible if your shortness of breath is accompanied by:
Swelling in the ankles and feet
Worsening of shortness of breath
Trouble breathing when lying flat
Immediate testing, management and sometimes hospital admission is needed. The doctor will determine how fast a person needs to be examined base on the nature and severity of symptoms, age, and other underlying health condition.
During doctor’s evaluation, the patient’s medical history and symptoms will be asked. Questions regarding the patient’s past medical history (heart or lung diseases), history of smoking, risk factors for pulmonary embolism (surgery, recent hospitalization, long distance travel) and family history of high blood pressure and high levels of cholesterol will also be asked. After that, a physical examination is performed. Physical examination will focus on the heart and lungs. The doctor will listen to the lungs for wheezing, crackles and congestion. On the other hand, the doctor will listen to the heart for murmurs which can suggest of a heart valve disorder. Swelling of the legs will also be checked.
When all pertinent data are gathered, the cause may now be determined or if not, these will help the doctor recommend further tests to be done. The most common procedure used in diagnosing the cause of shortness of breath is through spirometry.