What is Shortness of Breath?
Shortness of breath, or dyspnea, is the feeling that you can’t get enough air. It might feel like you’re gasping, working harder to breathe, or tight in the chest. Everyone experiences this differently—some describe it as an uncomfortable awareness of breathing, while others say it feels like suffocating.
While it’s normal to feel breathless after intense exercise, if this sensation comes on suddenly or without a clear reason, it may signal an underlying health issue.
Did you know?
Shortness of breath accounts for around 3–5% of all emergency department visits each year worldwide. It’s a symptom, not a disease—and it can be a clue pointing to problems with your lungs, heart, blood, or even anxiety levels.
How Does Shortness of Breath Happen?
Imagine your lungs as a pair of balloons that fill with air every time you inhale. Your heart pumps oxygen-rich blood from the lungs to the rest of your body. If something interrupts this process—whether it’s narrowed airways, fluid in the lungs, a weak heart, or low blood oxygen—your body panics. That panic shows up as shortness of breath.
To simplify:
- If your lungs are blocked, inflamed, or filled with fluid, you’ll struggle to breathe.
- If your heart can’t pump efficiently, fluid backs up in your lungs.
- If your blood doesn’t carry enough oxygen, your brain signals you to breathe more.
What Causes Shortness of Breath?
Shortness of breath can stem from many different causes. Some are harmless, others life-threatening. Here’s a breakdown:
1. Lung-Related Causes (most common)
- Asthma – inflammation narrows airways; affects ~300 million people worldwide.
- Chronic Obstructive Pulmonary Disease (COPD) – usually from smoking.
- Pneumonia – infection fills lungs with fluid.
- Pulmonary embolism – a blood clot blocks blood flow in the lungs.
- COVID-19 – can cause lung inflammation and damage.
2. Heart-Related Causes
- Heart failure – the heart can’t pump well, so fluid backs up into the lungs.
- Heart attack – reduces blood flow to the heart and lungs.
- Arrhythmias – irregular heartbeats can reduce oxygen delivery.
3. Other Causes
- Anaemia – low red blood cells mean less oxygen to the body.
- Anxiety or panic attacks – your brain thinks you’re suffocating even when you’re not.
- Obesity – extra weight compresses the lungs and diaphragm.
- High altitude – thinner air means less oxygen per breath.
Stat Breakdown:
- About 85% of dyspnea cases seen in hospitals are due to lung or heart issues.
- 15% are from non-cardiac or non-pulmonary causes like anaemia or anxiety.
Risk Factors
Anyone can experience breathlessness, but certain factors raise your risk. Here’s who’s more likely to develop it:
- Smokers – due to lung damage (COPD, cancer).
- Older adults – age-related heart and lung changes.
- People with chronic conditions like asthma, heart failure, or diabetes.
- Sedentary individuals – low fitness makes physical activity harder.
- Those with mental health conditions – anxiety can mimic physical illness.
Other Symptoms That May Appear
Shortness of breath rarely comes alone. Often, it’s accompanied by other symptoms that provide clues about the cause.
Mild to moderate cases may include:
- Chest tightness or wheezing (common in asthma)
- Coughing (seen in infections and chronic lung disease)
- Fatigue
In more severe conditions, look out for:
- Blue lips or fingertips (low oxygen)
- Rapid heartbeat
- Swelling in legs or abdomen (suggests heart failure)
- Dizziness or fainting
These can point to a more serious underlying issue and require immediate medical attention.
Tests to Identify the Cause
To find out why you’re breathless, doctors use a combination of history, physical exams, and tests.
Gold Standard Test:
- Chest X-ray or CT scan – helps identify lung conditions like pneumonia, collapse, or fluid buildup.
Other tests may include:
- ECG – checks for heart rhythm problems.
- Blood tests – to detect anaemia, infections, or heart failure markers.
- Pulmonary function tests – measure how well your lungs are working.
- Echocardiogram – uses ultrasound to evaluate heart function.
- Oxygen saturation – a simple clip-on device measures how much oxygen is in your blood.
Treatment for Shortness of Breath
Treatment depends entirely on the underlying cause.
Mainstream (Gold Standard) Treatments:
- Asthma or COPD: Inhalers (bronchodilators and steroids), oxygen if needed.
- Heart failure: Diuretics (to remove fluid), ACE inhibitors, lifestyle changes.
- Pneumonia: Antibiotics and rest.
- Pulmonary embolism: Blood thinners and hospitalization.
- Anaemia: Iron supplements, or sometimes blood transfusion.
- Anxiety: Breathing techniques, counselling, and sometimes medication.
If first-line treatment doesn’t help, doctors may escalate care with:
- Hospital admission for oxygen or ventilatory support.
- Specialist referrals (e.g., cardiologist or pulmonologist).
- Lifestyle interventions: quitting smoking, weight loss, or cardiac rehab.
Never ignore ongoing breathlessness—it’s your body’s red flag that something’s off.
Final Thoughts
Shortness of breath can be scary—but it’s also a signal worth listening to. Whether it’s due to anxiety or something more serious like heart or lung disease, don’t wait too long to get it checked. Your body is asking for help—and the earlier the cause is found, the better the chances of effective treatment.
References
- “Dyspnea: Evaluation and Management.” American Family Physician, AAFP, 2022. https://www.aafp.org/pubs/afp/issues/2022/0500/p541.html
- “Shortness of Breath.” Mayo Clinic, 2023. https://www.mayoclinic.org/symptoms/shortness-of-breath/basics/definition/sym-20050890
- “Assessment of Dyspnea in the Emergency Department.” BMJ Best Practice, 2024. https://bestpractice.bmj.com/topics/en-us/3000081