Breathing Difficulties

Medically Reviewed By William C. Lloyd III, MD, FACS

What are breathing difficulties?

Breathing is a mechanical process in which rib bone muscles and the diaphragm pull air into the lungs and force it back out of the lungs. Healthy resting adults breathe 12-15 times per minute. Breathing is a critical component of respiration, a process in which oxygen from the air is taken into the body and carbon dioxide is removed from the body and released into the air.

Breathing difficulties are symptoms of a variety of mild to serious underlying disorders, diseases and conditions that interfere with normal respiration and breathing. Breathing difficulties, sometimes called dyspnea, can be caused by infection, inflammation, trauma, malignancy, airway obstruction and other abnormal processes.

Common breathing difficulties include:

  • Crackles, a bubbling, crackling or clicking sound made in the lower airways of the lungs. Crackles can be caused by pneumonia, pulmonary edema, pulmonary fibrosis, and acute bronchitis.

  • Shortness of breath or trouble catching your breath with or without exertion

  • Stridor, a high-pitched sound made during breathing, often caused by some kind of blockage in the throat. Stridor can be caused by epiglottitis, smoke inhalation, swelling of the throat, tonsils or adenoids, or choking on a foreign object, such as a bone.

  • Wheezing, a whistling sound made by narrowing of the air passages in the lungs. Wheezing can be caused by asthma, anaphylactic reaction, chronic obstructive pulmonary disease (COPD), acute bronchitis, bronchiolitis, heart failure, or pneumonia.

Breathing difficulties can occur in any age group or population. Breathing difficulties can be caused by a relatively mild condition that is simple to treat, such as wearing restrictive clothing around the abdomen. Breathing difficulties can also occur due to a moderate condition, such as viral pneumonia, or a serious or life-threatening condition, such as a severe asthma attack or heart failure.

Depending on the cause, breathing difficulties can be brief and disappear quickly, such as with hyperventilation. Breathing difficulties can occur in sudden, severe episodes, such as breathing difficulties that occur during sleep apnea or asthma. Breathing difficulties can also be chronic and ongoing over a long period of time, such as with COPD or lung cancer.

Breathing difficulties can be caused by serious or life-threatening conditions, such as asthma, heart failure, or heart attack. Seek immediate medical care (call 911) if you, or someone you are with, have breathing difficulties. Early diagnosis and treatment of underlying causes of breathing difficulties reduces the risk of life-threatening complications, such as respiratory failure and cardiopulmonary arrest.

What other symptoms might occur with breathing difficulties?

Breathing difficulties often occur in conjunction with other symptoms, which vary depending on the underlying disease, disorder or condition. For example, breathing difficulties caused by pneumonia can occur in conjunction with a fever and a loose cough that produces thick phlegm.

Symptoms that may occur along with breathing difficulties

Breathing difficulties often accompany other symptoms including:

  • Cough

  • Dizziness

  • Excess mucus secretion (phlegm)

  • Fever

  • Pallor (very pale or grayish skin and lips) or cyanosis (a bluish discoloration of the skin, lips or nails)

  • Restlessness and anxiety

  • Swelling of the extremities or abdomen (edema)

  • Weakness, fatigue and tiring easily with or without exertion

Serious symptoms that might indicate a life-threatening condition

In many cases, breathing difficulties can be caused by or indicate a serious or life-threatening underlying condition or disease. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms combined with breathing difficulties:

  • Bradypnea (an abnormally slow rate of breathing) or apnea (no breathing)

  • Change in behavior, feeding or alertness in an infant or toddler

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

  • Choking, possibly accompanied by inability to speak

  • Coughing-up blood (hemoptysis)

  • Dizziness

  • Pallor (very pale or grayish skin and lips) or cyanosis (a bluish discoloration of the skin, lips or nails)

  • Rapid heart rate (tachycardia) or pulse, generally more than about 100 beats per minute for an adult

  • Sudden swelling of the lips, mouth or face due to an allergic reaction

  • Swelling of the extremities or abdomen (edema)

  • Tachypnea, rapid breathing, generally more than about 16 breaths per minute for an adult

What causes breathing difficulties?

Breathing difficulties can occur as a symptom of diseases, disorders and conditions of the respiratory system, as well as other body systems.

Respiratory system causes of breathing difficulties

Breathing difficulties can be caused by diseases and conditions of the respiratory system including:

Other causes of breathing difficulties

Breathing difficulties can also be caused by diseases and conditions of body systems other than the respiratory system. For example, in the cardiovascular system, breathing difficulties can be a symptom of congestive heart failure or heart attack. In the nervous system, breathing difficulties can be a symptom of a neuromuscular disorder, such as Guillain-Barré syndrome, narcotic overdose, or post-polio syndrome. Breathing difficulties can also result from an anaphylactic reaction.

Other causes of breathing difficulties include:

  • Allergies and anaphylactic reaction

  • Anxiety attacks or panic attacks

  • Certain cancers, such as leukemia

  • Heart conditions, such as heart attack, cardiomyopathy, pericarditis, cardiac arrhythmias, and congestive heart failure

  • High altitudes

  • Hyperventilation

  • Neurological or neuromuscular conditions, such as Guillain-Barré syndrome, head trauma, narcotic overdose, or post-polio syndrome

  • Obesity or poor physical shape

  • Organ failure, such as liver or kidney failure

  • Sepsis (life-threatening bacterial blood infection)

  • Severe ascites (abnormal buildup of fluid in the abdomen)

  • Severe tonsillitis

  • Shock

  • Toxic (alcohol, medications, illicit drugs, poisons)

What are the potential complications of breathing difficulties?

Complications of breathing difficulties are life threatening. You can minimize the risk of serious complications of breathing difficulties by seeking early medical care and following the treatment plan you and your health care professional design specifically for you. Complications of breathing difficulties include:

  • Cyanosis (bluish color of the skin or mucus membranes due to low oxygen)

  • Hypoxia (low oxygen levels)

  • Respiratory acidosis (high carbon dioxide levels in the body resulting in abnormally acidic bodily fluids and blood)

  • Respiratory arrest and cardiopulmonary arrest

  • Respiratory failure

Was this helpful?
  1. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
  2. Breathing Difficulty. Medline Plus, a service of the National Library of Medicine National Institutes of Health.
  3. Collapsed Lung. PubMed Health.
  4. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
  5. COPD. National Heart Lung and Blood Institute, National Institutes of Health.
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 14
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