Shortness of breath, also called dyspnea, is a feeling of not being able to get enough air into your lungs. It can occur at rest or with activity. Most healthy individuals only experience shortness of breath with intense physical exertion. However, some people may experience shortness of breath regularly, even when at rest. There are many potential causes of chronic or recurring shortness of breath, ranging from mild to severe. Determining if your daily shortness of breath is normal requires an evaluation of your symptoms and medical history.
What is considered normal shortness of breath?
Normal shortness of breath is brief and resolves quickly once the triggering activity ends. For example, you may experience shortness of breath when exerting a lot of effort, such as:
– Climbing several flights of stairs
– Jogging or running
– Lifting heavy objects
– Having sex
Once you stop the strenuous activity and rest for a few minutes, your breathing should return to normal. The shortness of breath does not linger or worsen.
Additionally, normal shortness of breath:
– Occurs only with intense physical exertion
– Lasts for a minute or two after stopping activity
– Resolves completely when you rest
– Does not limit your daily activities or function
– Does not occur at night or wake you from sleep
If you only experience shortness of breath with vigorous exercise, it is likely a normal response. However, if you regularly experience shortness of breath at rest or with mild exertion, it may indicate an underlying medical issue.
When is daily shortness of breath concerning?
Daily or regular shortness of breath at rest is not normal. You should see a doctor if you:
– Feel short of breath even when resting or doing minimal activities like getting dressed or walking across a room
– Wake up gasping for air or have difficulty breathing when lying down
– Experience tightness in your chest along with shortness of breath
– Have shortness of breath that persists for more than a few minutes after stopping activity
– Have wheezing, coughing, or chest tightness with shortness of breath
– Feel like you cannot take a deep breath or yawn fully
Recurring episodes of shortness of breath during routine daily life suggest an underlying heart or lung condition requiring medical evaluation. It is not normal to feel short of breath regularly throughout the day if you are not completing strenuous physical activity.
Seeking prompt medical care is crucial if you ever experience:
– Sudden, severe shortness of breath
– Shortness of breath combined with chest pain
– Blue tinge to lips or fingers
– Confusion or excessive drowsiness with difficulty breathing
These signs can indicate a medical emergency such as a pulmonary embolism, heart attack, or exacerbation of lung disease.
What causes daily shortness of breath?
There are many possible causes of dyspnea. Some of the most common include:
Heart conditions
– Heart failure: Shortness of breath when lying down is a common symptom. The heart cannot pump adequately to meet the body’s needs. Fluid may back up into the lungs.
– Coronary artery disease: Plaque buildup causes narrowing of heart arteries. This limits blood flow and oxygen to the heart muscle, which can trigger shortness of breath.
– Heart valve disease: Problems with heart valves, often from prior damage or abnormal development, can lead to fluid retention and shortness of breath.
– Arrhythmia: Irregular heart rhythms like atrial fibrillation reduce the heart’s efficiency and ability to provide sufficient oxygenated blood.
Lung diseases
– Asthma: This chronic lung disease inflames and narrows the airways of the lungs, making breathing difficult. Shortness of breath and wheezing are hallmark symptoms.
– COPD: Chronic obstructive pulmonary disease damages the air sacs and small airways over time, limiting oxygen exchange. Shortness of breath tends to worsen over years.
– Pulmonary hypertension: Increased blood pressure in the arteries of the lungs makes the right side of the heart work harder, causing shortness of breath.
– Pulmonary fibrosis: Scarring and thickening of lung tissue over time decreases elasticity and oxygenation. Shortness of breath develops gradually.
– Pneumonia: Lung infection by bacteria, viruses, or fungi causes inflammation that fills air sacs with fluid. This restricts oxygen flow.
Other medical causes
– Anemia: Low red blood cell counts reduce the amount of oxygen carried throughout your body, which can manifest as shortness of breath.
– Obesity: Excess weight presses on the diaphragm and chest wall, limiting breathing capacity and lung expansion. This triggers shortness of breath.
– Blood clots: A pulmonary embolism is a blood clot that blocks an artery in the lungs. This damages lung tissue and decreases oxygenation.
– Nutritional deficiencies: Low iron levels can exacerbate anemia while magnesium deficiency may induce bronchoconstriction, both contributing to shortness of breath.
– Deconditioning: Prolonged bed rest or sedentary lifestyle leads to loss of muscle tone, including the breathing muscles. This contributes to dyspnea.
When to see a doctor
You should make an appointment with your doctor if you experience any of the following:
– Shortness of breath that arises daily without intense exertion
– Episodes of shortness of breath that disrupt your sleep or wake you at night
– Inability to take a deep breath or yawn fully
– Shortness of breath lasting more than a few minutes after stopping exercise
– Wheezing, chest tightness, or coughing accompanying difficulty breathing
– Dizziness, headache, or confusion associated with shortness of breath
Sudden and severe shortness of breath requires prompt emergency care, even if it resolves. Seeking immediate medical attention is crucial if shortness of breath occurs alongside:
– Chest pain or pressure
– Fainting or near fainting
– Bluish tinge to lips or fingers
– Anxiety, sweating, or a feeling of impending doom
Call 911 or go to the nearest emergency room right away. These symptoms may indicate a heart attack, pulmonary embolism, or other life-threatening condition requiring urgent treatment.
Diagnosing causes of chronic shortness of breath
To diagnose the cause of daily shortness of breath, doctors use:
Medical history
Your doctor will ask about your symptoms, including when shortness of breath occurs and what makes it better or worse. They will also ask about chronic diseases, prescription medications, and family history of conditions like heart disease.
Physical exam
This involves listening to your breathing and heart sounds, checking for swelling, and evaluating your overall signs. Your doctor will observe how easily shortness of breath is triggered during the exam.
Chest x-ray
X-rays create images of your lungs, heart, blood vessels, and bones. This can help detect heart failure, lung disease, pneumonia, or other abnormalities.
Pulse oximetry
This non-invasive test measures oxygen saturation in your blood using a finger probe. Low oxygen levels often accompany shortness of breath.
Spirometry
Spirometry measures lung capacity and airflow. You breathe into a mouthpiece connected to a machine called a spirometer. Results can detect lung diseases like COPD.
Exercise stress testing
Also called a treadmill test, this monitors your heart rate and EKG while walking on a treadmill. It helps evaluate whether heart problems provoke shortness of breath.
Imaging tests
Chest CT scans, lung MRI, and echocardiograms (heart ultrasounds) allow detailed views of lung and heart structure and function. These help identify abnormalities.
Bloodwork
Blood tests check for anemia, electrolyte imbalances, kidney dysfunction, and infection. These systemic issues may contribute to or worsen shortness of breath.
Treatment options for chronic shortness of breath
Treatment focuses on the underlying cause of daily shortness of breath. Options may include:
Medications
– Bronchodilators open airways for conditions like COPD and asthma
– Diuretics reduce fluid buildup in people with heart failure or lung disease
– Blood thinners prevent clots for those at risk of pulmonary embolism
– Steroids decrease inflammation in some lung diseases
– Antibiotics treat bacterial lung infections
– Supplemental oxygen improves oxygenation
Lifestyle changes
– Quit smoking to prevent lung damage worsening shortness of breath
– Lose excess weight to reduce demand on lungs and heart
– Increase activity gradually under medical guidance if deconditioned
– Adopt positional strategies, like elevating the head of the bed, to facilitate breathing at night
Surgery
– Coronary bypass treats narrowed heart arteries limiting oxygenation
– Valve repair or replacement fixes heart valve defects
– Lung volume reduction removes damaged lung sections
– Lung transplant replaces severely diseased lungs
Pulmonary rehabilitation
Supervised exercise training, education, nutritional counseling, and coping strategies help improve long-term lung function and quality of life.
When is shortness of breath an emergency?
Some episodes of shortness of breath indicate a medical emergency requiring immediate treatment.
Seek emergency care if shortness of breath occurs with:
Chest pain
Chest pain with shortness of breath may signal a heart attack or pulmonary embolism. These require emergency diagnosis and management.
Coughing up blood
Coughing up blood (hemoptysis) along with difficulty breathing suggests bleeding in the lungs. Swift evaluation for causes like lung cancer is essential.
Wheezing or high pitched whistling sound
These signs indicate narrowed airways typical of asthma attacks or COPD exacerbations. Urgent treatment with bronchodilators is needed.
Rapid breathing and pulse
Shortness of breath along with a rapid respiratory rate greater than 25 breaths/minute and heart rate over 100bpm indicates compromised oxygenation.
Bluish lips, fingers, or toes
Cyanosis, or a bluish discoloration of the skin, means organs are not getting enough oxygen. This is a dangerous sign needing emergency care.
Dizziness, confusion, or loss of consciousness
Altered mental status with shortness of breath signals organs are not receiving sufficient oxygen. Immediate medical treatment is critical.
Do not try to tough it out or merely call your doctor if you have shortness of breath with any of the above signs. Call 911 or go to the nearest emergency department without delay.
When to call 911 for shortness of breath
The following scenarios indicate a potential life-threatening medical emergency. Do not hesitate to call 911 if you experience:
– Sudden, severe shortness of breath without explanation
– Shortness of breath combined with chest pressure or pain
– Confusion, lightheadedness, or loss of consciousness
– Cyanosis – blue coloration of the lips, fingers, or toes
– Inability to speak full sentences due to shortness of breath
– Persistent and severe wheezing or coughing with difficulty breathing
– Shortness of breath following trauma to the chest or from an injury
Waiting to call your doctor or go to urgent care may delay necessary resuscitation efforts. Call 911 so emergency medical services can evaluate you promptly and provide treatment during transport if needed.
Getting emergency care quickly offers the best chance for survival with critical conditions like pulmonary embolism, pneumothorax, acute heart failure, or myocardial infarction. Do not downplay or underestimate the severity of sudden, severe shortness of breath.
Preventing chronic shortness of breath
You may be able to reduce recurring shortness of breath by:
– Quitting smoking and avoiding secondhand smoke
– Limiting environmental pollutants if you have asthma or COPD
– Following your doctor’s treatment plan for chronic lung disease
– Taking medications as prescribed if you have heart disease
– Exercising regularly to avoid deconditioning
– Maintaining a healthy weight to limit strain on your cardio-respiratory system
– Adhering to oxygen therapy guidelines if prescribed for you
– Getting vaccinated against pneumonia and annual flu
– Learning proper breathing techniques and posture to optimize lung expansion
Discuss additional preventive strategies with your doctor if you experience frequent or worsening shortness of breath. Early intervention provides the best opportunity to slow lung or heart disease progression.
Using a peak flow meter to monitor shortness of breath
A peak flow meter is a small, inexpensive, hand-held device you blow into to check your exhaling speed. It measures peak expiratory flow rate (PEFR) in liters per minute. Results help evaluate breathing difficulties in people with asthma, COPD, or other lung conditions.
Checking your peak flow readings at the same times each day when you are well can give you a good baseline number. You can then compare future readings to detect significant drops in your PEFR that may signal worsening shortness of breath requiring medical intervention.
Here are some tips for using a peak flow meter properly:
– Stand up straight and take a deep breath to completely fill your lungs
– Place the mouthpiece into your mouth and close your lips tightly around it. Keep your tongue flat.
– Blow out as hard and fast as possible into the tube in a single, fast blast. This is more important than blowing out all your air.
– Note the number on the meter and repeat two more times. Record the highest value as your PEFR.
– Clean the meter after use as directed and store out of dust.
Discuss your peak flow results with your doctor to determine optimal monitoring frequency and dangerous low readings requiring urgent medical intervention.
Coping with chronic shortness of breath
Recurring shortness of breath can negatively impact your quality of life. Using coping strategies helps you manage symptoms:
– Practice pursed lip breathing: Breathe in through your nose and slowly out through pursed lips to avoid air trapping.
– Assume comfortable positions: Sit upright or raise your head with pillows to ease work of breathing.
– Learn breathing control techniques: Methods like breath stacking or rib cage expansion help maximize your lung capacity.
– Stay hydrated: Drink plenty of water, which thins mucus and facilitates air flow.
– Use oxygen as needed: Use your supplemental oxygen as your doctor prescribes.
– Humidify air: Use a humidifier to add moisture to the air, which can provide relief.
– Consider anxiety treatment: Medication or counseling may help if breathing difficulty spikes your anxiety.
– Know your limitations: Pace your activities to avoid exceeding your abilities and causing shortness of breath.
– Join a support group: Connecting with others experiencing chronic shortness of breath can validate your challenges.
– Communicate your needs: Tell loved ones how they can best assist you when short of breath.
Coping well with chronic shortness of breath involves patience, planning, and employing strategies to function as normally as possible. Work closely with your healthcare providers to optimize relief and quality of life. Seek emergency care if symptoms suddenly worsen and become severe.
Conclusion
Experiencing shortness of breath only occasionally with intense physical activity is normal. However, recurrent shortness of breath at rest or with minimal exertion is not normal and requires prompt medical evaluation.
Chronic shortness of breath has numerous potential causes, including lung diseases like COPD, heart conditions, blood clots, respiratory infections, and chronic anemia. Identifying and treating the underlying cause is essential.
If you develop daily or frequent shortness of breath, make an appointment with your doctor for an evaluation. Diagnostic tests like chest x-rays, lung function tests, heart ultrasound, and CT scans can pinpoint causes.
Treatment aims to alleviate symptoms and slow disease progression through medications, surgery, pulmonary rehabilitation, oxygen therapy, and lifestyle changes. Learning coping techniques assists with managing chronic shortness of breath.
Seek emergency care immediately if sudden severe shortness of breath occurs, especially alongside other potentially life-threatening symptoms like chest pain. Calling 911 ensures prompt evaluation and treatment that could save your life.
