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School of Medicine
Shortness of Breath
Difficulty breathing or shortness of breath, also called dyspnea, can sometimes be harmless as the result of exercise or nasal congestion. In other situations, it may be a sign of a more serious heart or lung disease.
Cases of frequent breathlessness should be evaluated by a physician to determine the cause.
When to Call Your Doctor
If you experience frequent breathlessness, are awakened at night by shortness of breath, or experience wheezing or tightness in the throat, contact your physician for further evaluation.
Whether it is sudden or long term, difficulty breathing should always be taken seriously. If you experience shortness of breath, be sure to take note of when it occurs, how often it occurs and other related symptomatic information to assist your doctor in reviewing your case.
If breathlessness is sudden and severe, it may be the result of air around the lung or a blood clot in the lung—both emergency conditions that require urgent and immediate medical attention.
- Heart disease or heart attack (in this case, shortness of breath may be accompanied by swelling of the feet/ankles).
- Lung disease.
- Pneumonia (breathlessness often accompanied by high fever, cough and mucus).
- Asthma or allergies.
- Anemia (other symptoms characterized by fatigue and pale skin color).
- Panic attacks.
- Airway obstructions, exposure to cigarette smoke or extreme exposure to dust or fumes.
- Obesity or lack of exercise.
- High altitudes.
- Blood flow disruption in getting oxygen to the brain.
- Intense emotional anxiety or stress.
When breathlessness is accompanied by chest pressure, tingling in the hands or around the mouth, the cause may be hyperventilation, an episode of over breathing from exercise or emotional stress. Hyperventilation can be brought under control by breathing into a paper bag until the episode passes, usually in less than 15 minutes.
Prevention recommendations are based on the cause of the condition. Your physician will be able to suggest techniques or lifestyle changes, such as a healthy diet and regular exercise, which may help control the occurrence of breathlessness.
- Physical exam. Your physician will review patient history and symptoms. The diagnosis will sometimes be made immediately by a doctor or emergency response technician but frequently requires further blood tests to confirm.
- Blood tests. Arterial blood gases and blood oxygen saturation may be measured.
- Exercise tests. Blood pressure, heart rate and changes to breathing rate can be measured during exercise and at rest.
- Electrocardiogram. An ECG or EKG records the electrical activity of the heart and shows abnormal rhythms (arrhythmias or dysrhythmias).
- Ambulatory cardiac monitoring. A Holter monitor may be used for 24 hours. Other monitors may be worn in excess of two weeks.
- Echocardiogram. An “echo” uses ultrasound waves to produce a moving picture of the heart and heart valves.
- Chest X-ray. An X-ray will help assess lung condition.
- CT scan of the chest.