Shortness of Breath

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Introduction

What is shortness of breath?

Shortness of breath is a common symptom of allergy, infection, inflammation, injury, or certain metabolic conditions. The medical term for shortness of breath is dyspnea. Shortness of breath results when a signal from the brain causes the lungs to increase breathing frequency. You may also experience shortness of breath because of conditions affecting the lungs or entire pulmonary system, or in association with more generalized conditions, such as obesity or low blood pressure (hypotension).

Inflammation of the lungs and bronchial tubes are also common causes of shortness of breath, as is injury to the respiratory tract caused by smoking or other toxins. Shortness of breath may occur with injury to the lungs, such as a collapsed lung (pneumothorax). Numerous heart conditions that lead to low oxygen levels in the blood (hypoxia) also result in shortness of breath. Depending on the cause, you may experience shortness of breath only while lying down or when either lying down or sitting up. Shortness of breath can be accompanied by sputum production, sneezing, wheezing, or rapid heart rate (tachycardia).

Allergic asthma reactions lead to shortness of breath, which can be severe and even life threatening. Most, if not all, lung diseases involve shortness of breath and, in rare cases, shortness of breath may present as a symptom of serious infections of the lungs or bronchial tubes, such as pneumonia or bronchiolitis in young children. Congestive cardiac failure, a heart condition, may be accompanied by shortness of breath in addition to other symptoms, including pink, frothy mucus, rapid breathing (tachypnea), wheezing, and rapid heartbeat. Shortness of breath can also be an indication of lung cancer, especially if accompanied by hemoptysis (coughing up blood).

Seek imm ediate medical care (call 911) if you have shortness of breath accompanied by any life-threatening symptoms, including bluish coloration of lips, fingernails or skin, confusion or loss of consciousness for even a brief moment, high fever (higher than 101 degrees Fahrenheit), sudden swelling of the face, tongue or lips, chest pain or pressure, or rapid heart rate (tachycardia).

If your shortness of breath persists, worsens, or causes you concern, seek prompt medical care.

Symptoms

What other symptoms might occur with shortness of breath?

Shortness of breath may accompany other symptoms, which can vary depending on the underlying disease, disorder or condition. Symptoms known to commonly affect the respiratory system may also involve other body systems.

Respiratory symptoms that may occur along with shortness of breath

Shortness of breath may accompany other symptoms affecting the respiratory system including:

  • Cough that gets more severe over time
  • Coughing up blood (hemoptysis)
  • Coughing up clear, yellow, light brown, or green mucus
  • Sneezing
  • Sore throat
  • Stuffy nose or nasal congestion
  • Wheezing (whistling sound made with breathing)

Cardiovascular symptoms that may occur along with shortness of breath

Shortness of breath may accompany symptoms related to the cardiovascular system including:

  • Bluish coloration of the lips, fingernails or skin (cyanosis)
  • Chest pain or pressure
  • Heart murmur
  • Irregular heart beat (arrhythmia)
  • Rapid heart rate (tachycardia)

Serious symptoms that might indicate a life-threatening condition

In some cases, shortness of breath may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:

  • Bluish coloration of the lips, fingernails or skin
  • Chest pain or pressure
  • Confusion or loss of consciousness for even a brief moment
  • Heart palpitations
  • High fever (higher than 101 degrees Fahrenheit)
  • Rapid heart rate (tachycardia)
  • Sudden swelling of the face, lips or tongue
Causes

What causes shortness of breath?

Shortness of breath is a common symptom of allergy, infection, inflammation, injury, or certain metabolic conditions. Shortness of breath may occur in various conditions affecting the lungs or entire pulmonary system, or in association with more generalized conditions, such as hypotension (low blood pressure) or obesity.

Asthma reactions triggered by allergies lead to shortness of breath, and in severe cases, such reactions can be life threatening. The majority of lung diseases result in shortness of breath. In rare cases, shortness of breath may be a symptom of serious lung or bronchial tube infections, such as pneumonia or bronchiolitis in young children. Certain heart conditions, such as congestive cardiac failure, may be accompanied by shortness of breath. Shortness of breath can also be a sign of lung cancer, particularly when accompanied by hemoptysis (coughing up blood).

Respiratory causes of shortness of breath

Shortness of breath may be caused by respiratory conditions including:

  • Airway obstruction
  • Asthma and allergies
  • Bronchiolitis (inflammation of the small airways known as bronchioles) or bronchitis
  • Bronchiectasis (dilation of the airways)
  • Chronic obstructive pulmonary disease (COPD; includes emphysema and chronic bronchitis)
  • Empyema (accumulation of pus around the lungs)
  • Hemothorax (blood in the lung)
  • High altitude
  • Inhalation injury
  • Lung cancer
  • Pneumonia
  • Pneumothorax (collapsed lung)
  • Pulmonary edema
  • Pulmonary embolism (blockage of a pulmonary artery due to a blood clot)
  • Pulmonary hypertension (high blood pressure in the arteries of the lungs)
  • Tuberculosis (serious infection affecting the lungs and other organs)

Cardiovascular causes of shortness of breath

Shortness of breath can also be caused by cardiovascular disorders including:

  • Arrhythmia (irregular heart beat)
  • Cardiogenic shock (shock caused by heart damage and ineffective heart function)
  • Cardiomyopathy (weakened or abnormal heart muscle and function)
  • Cardiovascular disease (due to atherosclerosis, or hardening of the arteries, or other causes)
  • Congenital heart defects
  • Congestive heart failure (deterioration of the heart’s ability to pump blood)
  • Myocardial infarction (heart attack)

Other causes of shortness of breath

Shortness of breath can also have other causes including:

Serious or life-threatening causes of shortness of breath

In some cases, shortness of breath may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Anaphylaxis (severe allergic reaction)
  • Cardiogenic shock (shock caused by heart damage and ineffective heart function)
  • Dehydration (loss of body fluids and electrolytes, which can be life threatening when severe and untreated)
  • Diabetic ketoacidosis (life-threatening complication of diabetes)
  • Pneumonia
  • Pulmonary embolism (blockage of a pulmonary artery due to a blood clot)
  • Sepsis (life-threatening bacterial blood infection)

Questions for diagnosing the cause of shortness of breath

In order to diagnose your condition, your health care provider will ask you a series of questions related to your shortness of breath including:

  • How long have you felt shortness of breath?
  • Do you have any other symptoms?
  • What medications are you taking?
  • Do any particular activities cause you to feel shortness of breath?
  • How much exercise can you do before you become short of breath?

What are the potential complications of shortness of breath?

It is vital to seek prompt treatment if you experience shortness of breath as it can be a sign of a serious disease and, left untreated, may put you at risk of serious complications and even permanent damage. Once your doctor has diagnosed the underlying cause, you should make every effort to follow the recommended treatment plan precisely in order to minimize risk of potential complications including:

  • Adverse effects of treatment
  • Brain damage
  • Heart failure
  • Progression of symptoms
  • Respiratory failure
  • Spread of cancer
  • Spread of infection
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 21
  1. Breathing difficulty. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm
  2. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
  3. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.
  4. Shortness of breath. FamilyDoctor.org. http://familydoctor.org/online/famdocen/home/tools/symptom/521.html
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