What Is Dyspnea?

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Dyspnea is a medical term that describes shortness of breath—the uncomfortable sensation of having difficulty breathing. It's common to experience short episodes of dyspnea. For example, you might experience it during an intense workout or when you have a stuffy nose. However, shortness of breath can be a sign of an underlying medical condition, such as heart disease, asthma, or chronic obstructive pulmonary disease (COPD).

Healthcare providers diagnose dyspnea by asking about your symptoms, evaluating your breathing pattern, and ordering various diagnostic tests. Treatment options vary depending on the severity of symptoms and the underlying cause.

Types

There are two types of dyspnea: acute and chronic. How often you experience shortness of breath, as well as how long you've experienced it over time, determines the type of dyspnea you have:

  • Acute dyspnea: Lasts several hours to several days 
  • Chronic dyspnea: Lasts more than four to eight weeks 

Most people experience occasional dyspneic episodes. Factors like strenuous exercise, extreme temperatures, poor air quality, and high altitudes can cause temporary shortness of breath. These episodes usually resolve quickly. Sudden, severe, or unexplained shortness of breath requires immediate medical attention.

If your shortness of breath persists for weeks, reach out to a healthcare provider for evaluation to determine the underlying cause. 

Dyspnea Symptoms 

Dyspnea can cause various symptoms, ranging from mild to severe. Chronic dyspnea symptoms tend to occur gradually and may worsen over time. Acute dyspnea comes on suddenly, and you may feel agitated and frightened while experiencing shortness of breath. 

Common dyspnea symptoms include:

  • Feeling like you can't breathe fast enough or deeply enough
  • Rapid breathing
  • Shallow breathing
  • Feeling winded or out of breath with minimal exertion 
  • Chest tightness 

Dyspnea symptoms that warrant medical attention include:

  • Sudden shortness of breath
  • Shortness of breath during rest 
  • Bluish-colored lips or fingernails 
  • Chest pain 
  • Swelling in ankles or feet
  • Heart palpitations
  • Confusion or altered mental state
  • Fainting
  • Nausea 
  • Unusually excessive sweating or cold sweats
  • Fever

Causes

Dyspnea is a symptom of many conditions that can cause shortness of breath. While heart and lung conditions are the most common causes, other conditions can also lead to dyspnea.  

Common causes of acute dyspnea include:

  • Respiratory tract infections: Infections of body parts involved in breathing (for example, lungs, sinuses, or throat), such as pneumonia (a lung infection)
  • Anaphylaxis: A severe allergic reaction 
  • Airway obstruction: A blockage in your airway (for example, caused by inhaling and choking on food)
  • Pulmonary embolism: A blood clot in a lung that can block the flow of blood and oxygen
  • Pneumothorax: A collapsed lung
  • Anemia: Low red blood cell count

Pregnancy, high altitude, COVID-19, a heart attack, and anxiety—especially a panic attack—can also cause sudden shortness of breath. Asthma, a chronic lung condition that causes airways to become inflamed and narrowed, can cause both acute and chronic dyspnea.

Other common causes of chronic dyspnea include:

You may also experience dyspnea symptoms with advanced kidney or liver conditions, as well as with nerve and muscle disorders that affect breathing muscles.

Risk Factors

Anyone can experience dyspnea, but certain risk factors increase the likelihood of shortness of breath.

Risk factors for dyspnea include:

  • Smoking 
  • A family history of dyspnea, high cholesterol, high blood pressure, or heart disease 
  • Exposure to dust, chemicals, and other lung irritants at work or home 
  • Lung cancer 
  • Low fitness level or a sedentary lifestyle

Diagnosis

Diagnosing dyspnea involves evaluating your breathing pattern, airways, and circulation. Your healthcare provider will do a physical examination, medical history review, and diagnostic testing to determine the cause of dyspnea.

During the physical exam, a healthcare provider will listen to your lungs and heart and check your lungs for signs of swelling. They may place a sensor called a pulse oximeter on your finger to measure your blood oxygen level.

Your medical history will likely include the following information:

  • When did your shortness of breath start?
  • How long and how often do you experience shortness of breath?
  • Do certain activities or triggers—such as exercise or exposure to allergens—make it worse?
  • Do you have any heart or lung conditions?
  • Do you have any family history of heart disease?
  • Do you smoke?
  • Are you regularly exposed to any possible irritants at home or at work?

Diagnostic tests can help determine the underlying cause of dyspnea. Common diagnostic tests include:

  • Pulmonary function tests: Tests that measure lung function, including how much air your lungs can hold, how quickly air you can exhale air, and how well your lungs transfer oxygen and carbon dioxide
  • Chest imaging: X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) scans that provide images of the lungs and heart to help identify any structural abnormalities
  • Electrocardiogram (EKG or ECG): A test that measures your heart's electrical activity
  • Blood tests: Tests that measure the levels of oxygen and carbon dioxide in your blood, as well as other markers that may indicate underlying diseases or conditions, such as blood clots, anemia, and infections
  • Echocardiogram: An ultrasound that shows blood flow through the heart and can help identify structural or functional abnormalities

Dyspnea Treatment

In urgent situations, dyspnea treatment focuses on helping you breathe and maintain healthy oxygen levels. You may need supplemental oxygen therapy using a nasal cannula (silicon prongs in your nostrils) or face mask. In severe cases, mechanical ventilation may be necessary. This means connecting you to a machine that helps you breathe.

Once your oxygen levels are stable, dyspnea treatment addresses the underlying cause. Treatments may include medication, oxygen therapy, pulmonary rehabilitation, lifestyle modifications, or surgery.

Medication

Medications will address the underlying cause of dyspnea. For example, if COPD or an asthma attack is causing shortness of breath, treatment might include medications such as bronchodilators or corticosteroids. These medications reduce inflammation and open your airways to make breathing easier.

Infections like pneumonia may be treated with antibiotics. Heart failure-related dyspnea may be treated with diuretics (water pills) to help the body eliminate excess fluid and nitrates to improve blood flow to the heart.

Oxygen Therapy 

If your blood oxygen levels are low, you may need oxygen therapy to help you breathe and ensure your body gets the oxygen it needs. Oxygen therapy is a treatment that provides your body with extra oxygen using a machine attached to a nasal cannula or face mask.

Acute dyspnea may be treated with oxygen at the hospital. At-home oxygen equipment, such as portable oxygen tanks, may be a component of chronic dyspnea treatment.

Pulmonary Rehabilitation

Pulmonary rehabilitation is a structured exercise program that helps improve respiratory function, reduce shortness of breath, and increase physical activity levels.

It might include:

  • Breathing exercises
  • Education about your condition
  • Exercises focused on building strength, flexibility, and stamina
  • Nutritional counseling

Surgery

In some cases, surgery may be required to treat structural abnormalities that cause dyspnea, such as a lung tumor or a damaged heart. For example, lung volume reduction surgery (LVRS) may help reduce or eliminate dyspnea in people with severe COPD. With LVRS, a surgeon removes damaged areas of your lung to help your lungs function more effectively.

Prevention

Preventing dyspnea involves managing the underlying cause and avoiding certain triggers that cause shortness of breath.

Dyspnea may not be entirely preventable, but you can take steps to lower your risk:

  • Don't smoke: Smoking is a major risk factor for shortness of breath and respiratory diseases. Consider smoking cessation programs or talking to a healthcare provider to help you quit. 
  • Avoid exposure to irritants: Environmental irritants, such as air pollution and chemicals, can trigger dyspnea. Consider wearing a mask to filter out irritants if you work in an environment with chemicals, dust, or pollutants.
  • Exercise regularly: Regular exercise can help improve cardiovascular and respiratory functioning. 
  • Maintain a healthy weight: Managing your weight can prevent you from experiencing obesity-related shortness of breath, called obesity hypoventilation syndrome (OHS).
  • Manage underlying conditions: If you have a health condition that can cause dyspnea, such as asthma or heart disease, work with a healthcare provider to manage your condition.

Living With Dyspnea  

Living with shortness of breath or the risk of an episode can be distressing. While coping looks different for everyone, finding healthy coping strategies that work for you can reduce exposure to possible triggers and increase your overall quality of life. 

A willingness to adapt, ongoing medical care, and effective stress management techniques can help. Things like meditation and breathing exercises may reduce anxiety and help you maintain healthy breathing patterns.

Rather than avoiding activities that lead to shortness of breath, consider adapting your daily activities and pacing yourself to prevent dyspnea episodes. Assistive devices, such as a wheelchair or walker, can help conserve energy and reduce dyspnea during physical activity.

If you experience a sudden onset or persistent shortness of breath, reach out to a healthcare provider to determine the cause and effective treatment options.

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