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Dyspnea (Shortness Of Breath): Symptoms, Causes, Diagnosis And Treatment

Dyspnea is a condition that causes shortness of breath [1] . Most of the time people experience shortness of breath after a strenuous exercise. However, a severe form of this can occur due to carrying excess weight, a panic attack, illnesses such as asthma, etc. When a person has this condition, the breathing is rapid and uncomfortable [1] . The person experiences tightness in the chest with an accompanied feeling of suffocation. One should meet a doctor when he or she experiences recurrent, sudden or severe dyspnea. The treatment approach depends on the cause of your shortness of breath.

Read on to know more about dyspnea, its causes, symptoms, diagnosis and treatment.

What Is Dyspnea?

If you have ever felt like you could not breathe in enough air, then the condition that you have experienced is medically known as dyspnea [2] . This symptom can be a sign of other health problems that can be related to heart or lung diseases. However, one can also experience temporary dyspnea after an intense workout.

Sometimes described as 'air hunger', dyspnea can be a very uncomfortable feeling [2] . This condition can be mild and temporary at times, whereas in some cases, it can be quite serious and long-lasting.

Symptoms Of Dyspnea

When you cannot get enough air in your lungs due to dyspnea, you might feel the following [3] :

  • Tightness in your chest
  • Breathless
  • Suffocated
  • Unable to breathe deeply/ rapid, shallow breathing
  • Hungry for air
  • Heart palpitations
  • Wheezing
  • Coughing

Dyspnea can be acute (sudden) or chronic (long-lasting). The acute form of this condition can start within a few minutes or hours [4] . It can be accompanied by other symptoms such as rash, cough or fever. On the other hand, chronic dyspnea can make you feel out of breath even after you do the regular, daily tasks such as standing up from a sitting position [5] .

Shortness of breath can get worse due to certain body positions such as lying down flat.

Causes Of Dyspnea

Many health conditions can cause dyspnea. The following are the most common causes of acute dyspnea [6] [7] :

  • Collapsed lung
  • Heart attack
  • Heart failure
  • Pregnancy
  • Severe allergic reactions
  • Choking
  • Pneumonia
  • A blood clot in the lungs
  • Hiatal hernia

The following are some of the common causes of chronic dyspnea [8] :

  • Obesity
  • Asthma
  • Being out of shape
  • High blood pressure in the lungs
  • Scarring of the lungs
  • Heart diseases
  • Stiff or swollen heart muscle
  • Chronic obstructive pulmonary disease

Other common reasons that can make you feel out of breath are lung cancer, panic attacks and anaemia. Environmental pollutants such as dust, chemical fumes and smoke [9] can make it even more difficult for people with dyspnea to breathe.

Complications Associated With Dyspnea

Shortness of breath can be associated with hypoxia or hypoxemia (low blood oxygen levels) [10] . This can lead to a decreased level of consciousness. In case dyspnea continues for long without being treated, then there is a risk of either temporary or permanent cognitive impairment.

Diagnosis Of Dyspnea

A complete physical examination of the person along with a complete description of the experiences should be sufficient for a doctor to diagnose dyspnea.

The patient would be asked the following questions [11] :

  • How and when the dyspnea attacks started
  • How long do the attacks last
  • How frequently do the attacks occur
  • How severe are the attacks

To reach a more specific diagnosis of dyspnea, the doctor might advice chest X-rays and CT images. This is to evaluate the health of the patient's lungs, heart, etc.

In some cases, an electrocardiogram can be quite helpful in showing signs of a heart attack. Spirometry [12] tests are carried out to measure the airflow and the patient's lung capacity. This test helps in identifying the extent of an individual's breathing problems. Additional tests can be done to look at the level of oxygen in a patient's blood.

Treatment For Dyspnea

Treating dyspnea ideally involves treating its underlying cause. The following are some of the treatment approaches used:

  • Diet and exercise: Obesity and poor fitness can be the prime cause of dyspnea. In such cases, eating healthier meals and exercising frequently is highly essential. However, if this medical condition is limiting your activity level, then you should meet your doctor and find out how you can begin a safe exercise routine [13] .
  • Pulmonary rehabilitation: Lung problems would need the care of a pulmonologist. Few people might need supplemental oxygen in a portable tank to prevent them from feeling out of breath. In such cases, pulmonary rehabilitation is extremely useful [14] . This kind of rehabilitation involves supervised exercise and education about breathing techniques that can help you overcome lung diseases.

  • Cardiac rehabilitation: All heart-related ailments would be treated by a cardiologist. When a person suffers from heart failure, it indicates that the heart is too weak to pump enough oxygenated blood to meet the body's requirements. One of the symptoms of heart failure is dyspnea. Heart failures can be managed through cardiac rehabilitation [15] . When heart failure is quite severe, the use of an artificial pump might become necessary to fulfill the blood pumping duties.

Prevention Of Dyspnea

One of the most common risk factors for shortness of breath is smoking [16] . Hence, a person with this condition should seek ample help to get himself out of the smoking habit. It is said that a person's lung and heart health starts to improve within hours of having the last cigarette.

If you work in an environment with poor air quality, consider the use of masks to filter out lung irritants [17] . Also, ensuring that the workplace is well-ventilated can be quite helpful.

In case you are obese, consulting a nutritionist or dietitian can help you set your meal plans and change your eating style.

View Article References
  1. [1] Manning, H. L., & Schwartzstein, R. M. (1995). Pathophysiology of dyspnea.New England Journal of Medicine,333(23), 1547-1553.
  2. [2] Mahler, D. A., Weinberg, D. H., Wells, C. K., & Feinstein, A. R. (1984). The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes.Chest,85(6), 751-758.
  3. [3] Nudel, D. B., Diamant, S., Brady, T., Jarenwattananon, M., Buckley, B. J., & Gootman, N. (1987). Chest pain, dyspnea on exertion, and exercise induced asthma in children and adolescents.Clinical pediatrics,26(8), 388-392.
  4. [4] Totten, R. S., Reid, D. H., & Moran, T. J. (1958). Farmer's lung: Report of two cases in which lung biopsies were performed.The American journal of medicine,25(5), 803-809.
  5. [5] Pratter, M. R., Curley, F. J., Dubois, J., & Irwin, R. S. (1989). Cause and evaluation of chronic dyspnea in a pulmonary disease clinic.Archives of internal medicine,149(10), 2277-2282.
  6. [6] Pratter, M. R., Curley, F. J., Dubois, J., & Irwin, R. S. (1989). Cause and evaluation of chronic dyspnea in a pulmonary disease clinic.Archives of internal medicine,149(10), 2277-2282.
  7. [7] Karnani, N. G., Reisfield, G. M., & Wilson, G. R. (2005). Evaluation of chronic dyspnea.Brain,100, 25.
  8. [8] Mulrow, C. D., Lucey, C. R., & Farnett, L. E. (1993). Discriminating causes of dyspnea through clinical examination.Journal of general internal medicine,8(7), 383-392.
  9. [9] Gorguner, M., & Akgun, M. (2010). Acute inhalation injury.The Eurasian journal of medicine,42(1), 28–35.
  10. [10] Sarkar, M., Niranjan, N., & Banyal, P. K. (2017). Mechanisms of hypoxemia.Lung India : official organ of Indian Chest Society,34(1), 47–60.
  11. [11] Berliner, D., Schneider, N., Welte, T., & Bauersachs, J. (2016). The Differential Diagnosis of Dyspnea.Deutsches Arzteblatt international,113(49), 834–845.
  12. [12] Redelmeier, D. A., Goldstein, R. S., Min, S. T., & Hyland, R. H. (1996). Spirometry and dyspnea in patients with COPD: when small differences mean little.Chest,109(5), 1163-1168.
  13. [13] Bernhardt, V., & Babb, T. G. (2014). Weight loss reduces dyspnea on exertion in obese women.Respiratory physiology & neurobiology,204, 86–92.
  14. [14] Olson, A. L., Graney, B., Baird, S., Churney, T., Fier, K., Korn, M., … Swigris, J. J. (2017). Tracking dyspnea up to supplemental oxygen prescription among patients with pulmonary fibrosis.BMC pulmonary medicine,17(1), 152.
  15. [15] Tsai, M. F., Hwang, S. L., Tsay, S. L., Wang, C. L., Tsai, F. C., Chen, C. C., & Huang, T. Y. (2013). Predicting Trends in Dyspnea and Fatigue in Heart Failure Patients' Outcomes.Acta Cardiologica Sinica,29(6), 488–495.
  16. [16] Rosi, E., & Scano, G. (2004). Cigarette Smoking and Dyspnea Perception.Tobacco Induced Diseases,2(1), 3.
  17. [17] Pirovano, M., Maltoni, M., Nanni, O., Marinari, M., Indelli, M., Zaninetta, G., ... & Labianca, R. (1999). A new palliative prognostic score: a first step for the staging of terminally ill cancer patients.Journal of pain and symptom management,17(4), 231-239.

Read more about: breathing lungs exercise air oxygen
Story first published: Thursday, June 27, 2019, 19:30 [IST]
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