Shortness of Breath: Symptoms, Signs, Causes, Treatment and Prevention

Shortness of breath or dyspnea is a discomforting condition where people face difficulty with their breathing. Heart and lung disorders can inhibit the air from getting fully into the lungs and cause trouble breathing.

The problem of dyspnea varies from person to person and the duration of this condition can last for about a few hours to a few days and sometimes to about a few weeks. It is usually a warning sign of a serious medical condition. If you are experiencing shortness of breath, contact a physician right away.

Most of the times shortness of breath occurs as a side effect of another medical emergency. Aside from heart and lung disorders shortness of breath can occur as a result of anemia, as a result of hyperventilation or because of smoking habits or pollutants in the air that cause irritation. Dyspnea can also occur as a result of chronic conditions such as pneumonia, bronchitis and pulmonary fibrosis.

A person with dyspnea (shortness of breath) may experience the following signs and symptoms:

• Out of breath
• A sensation of tightness in the chest
• Unable to get enough oxygen quickly
• Hungry for air (also called air hunger)
• Suffocation
• Wheezing
• Chest tightness
• Fevers
• Chills
• Feelings of breathlessness
• Headaches
• Muscle and lung pain
• Fatigue
• Bloating
• Swollen limbs (legs)

If you experience these symptoms it is advised that you seek help from your healthcare provider right away, then on consultation with him/her you notify the doctor of your medical history. Avoid smoking and environmental pollutants, do not share eating utensils with anyone and take warms baths.

Shortness of breath has been classified into two types:

• Sudden Dyspnea (Acute Dyspnea): This usually starts in a matter of minutes or hours. It can accompany other symptoms like a rash, cough or fever.
• Long-lasting dyspnea (Chronic Dyspnea): This can make a person feel out of breath even while doing simple things such as walking or standing up.

Certain body positions can improve or worsen the symptoms of shortness of breath in some people. People with certain types of cardiovascular and pulmonary disease may experience worsened symptoms while lying down flat.

When a person experiences sudden shortness of breath, then the condition is known as acute dyspnea. Conditions that can cause acute dyspnea (sudden shortness of breath) include:

• Asthma
• Heart attack
• Blockage in the breathing passage (Upper airway obstruction)
• Severe allergic reaction (Anaphylaxis)
• Heart failure
• Pneumonia
• COPD (chronic obstructive pulmonary disease)
• Sudden blood loss
• Heart arrhythmias
• A collapsed lung (Pneumothorax)
• A blood clot in a lung artery (Pulmonary embolism)
• Carbon monoxide poisoning

COVID-19 Symptoms: Shortness of breath is one of the significant symptoms of Coronavirus Disease (COVID-19) . The other common symptoms are dry cough, fever and fatigue.

When the shortness of breath lasts for weeks, then it is known as chronic dyspnea. The following conditions may cause chronic dyspnea:

• Asthma
• Heart dysfunction
• COPD
• Interstitial lung disease
• Obesity
• Accumulation of fluids around the lungs (pleural effusion)
• Deconditioning
• Sarcoidosis (Accumulation of inflammatory cells in the body)
• Heart disease
• Cardiomyopathy (swollen heart muscle)
• Pulmonary fibrosis (scarring of the lungs)
• Pulmonary hypertension (high blood pressure in the lungs)

Besides the aforementioned conditions, a number of other medical conditions may also adversely affect normal breathing. These include Anxiety disorder, Lung cancer, Tuberculosis, Myasthenia gravis (a condition causing muscle weakness), Croup (usually in young children), Pericarditis (inflammation of the tissue around the heart), Guillain-Barre syndrome, Epiglottitis, and Kyphoscoliosis (a chest wall deformity).

A physician will ask you to share your symptoms and medical history. He may perform spirometry, a lung function test that helps in measuring the amount of air your lungs can blow in and blow out. It also tracks the speed with which your lungs perform this task. This test is usually performed to diagnose COPD and asthma.

Some of the tests that he may ask you to undergo include:

• Pulse oximetry: The test helps the amount of oxygen in the blood.
• Blood tests: The test can help determine if you have medical conditions such as anaemia and infection. It may also look for the presence of a blood clot or fluid around the lungs.
• CT scan or Chest X-ray: These imaging tests are performed to see if you have pneumonia, pulmonary embolism (a blood clot in the lung), or any other lung disease.
• Electrocardiogram (EKG): The test is performed to check if a person is experiencing shortness of breath because of a heart attack by measuring the electrical signals from the heart.

• For people experiencing shortness of breath due to asthma and COPD (Chronic Obstructive Lung Disease), treatments involve taking drugs include bronchodilators such as atrovent, albuterol, spiriva and serevent. The bronchodilator medications are effective for shortness of breath when a shrinking of the muscles happens and causes narrowing of the lungs.
• For people experiencing shortness of breath because of poor haemoglobin levels in the blood (anaemia), a physician may prescribe supplements to raise increase iron levels.
• When shortness of breath is caused by a bacterial infection, antibiotics will be prescribed to get relief.
• A physician may ask people with chronic lung conditions, such as COPD, to practice breathing exercises such as pursed-lip breathing and breathing muscle strengthening exercises.
• For people experiencing shortness of breath due lack of oxygen within themselves, supplemental oxygen will be recommended for people with severe case of dyspnea. Doctors may also prescribe taking corticosteroids, anti-coagulant and diuretics.
• If a serious underlying medication condition is causing shortness of breath, then the physician may recommend treatment accordingly.

Patients who have been prescribed bronchodilator medications such as beta-2 agonists are likely to experience side effects such as muscle aches, headaches, trembling sensations, sudden palpitations and nervous tension.

Anticholinergics can produce side effects such as constipation, dryness of mouth, headaches, trouble swallowing, heartburn and throat irritation.

Theophylline, another bronchodilator can produce side effects such as vomiting, nausea, diarrhoea, palpitations and insomnia.

Side effects of corticosteroids if used for long can cause side effects such as high blood pressure, weight gain, diabetes, easy bruising, osteoporosis, mood swings, muscle weakness and eye disorders.

In order to prevent any future attack of dyspnea you need to adhere to certain post-treatment guidelines such as quitting the habit of smoking both first-hand and second-hand and losing weight (as that reduces stress on the lungs and heart). Also, it is advised that you try to take precaution against inhaling environmental pollutants.

Dyspnea is usually associated with low oxygen levels in the blood (a condition known as hypoxia or hypoxemia). Poor oxygen levels in the blood can adversely affect levels of consciousness. Severe dyspnea that continues for a long time can lead to temporary or permanent cognitive impairment. It may also worsen symptoms of other medical problems.

The results of this treatment can be permanent if the patients adhere to the post-treatment guidelines well. Environmental triggers and other lung infections can once again lead to dyspnea.

Shortness of breath is a condition that may result from multiple factors. Therefore, it may not be possible to prevent this condition in certain circumstances. However, a person can follow the below-mentioned measures to reduce the likelihood of chronic shortness of breath from getting worse.

• Quit smoking: Smoking is known to damage the lungs. It is also a risk factor for conditions such as COPD and lung cancer. People with COPD can delay the progression of this chronic condition and prevent complications from worsening.
• Avoid exposure to pollutants: Avoid breathing allergens such as pollens and environmental pollutants, such as smoke and chemical fumes.
• Avoid extremes in temperature: Exposure to extreme temperatures (such as very hot and humid or very cold conditions) can increase the risk of shortness of breath in people with chronic lung conditions.
• Exercise regularly: Regular exercise has a positive effect on lung function. People with obesity are at an increased risk of developing chronic lung conditions. Therefore, obese people should exercise regularly.
• Keep altitude in mind: Avoid physical activity and take time to adjust when travelling to places located at high altitudes.
• Take your medications: People with chronic lung and cardiac conditions should not skip medications as that can increase the risk of dyspnea.
• Regularly check your equipment: If you use supplemental oxygen, regularly check your breathing equipment and ensure that your oxygen supply is adequate.

Some alternative treatment methods include some breathing muscle strengthening exercises and homeopathy.

• The homeopathic medications for dyspnea includes Arsenic album for people suffering from asthma
• Antimonium Tart and Ipecac homeopathic medication for shortness of breath that is experienced during coughing
• Ammonium Carb and Stannum Met homeopathic medications for shortness of breath experienced by people during walking
• Carbo veg and Silicea homeopathic medication for the aged
• Lachesis and Grindelia medication for dyspnea experienced by people during the process of sleep.