Shortness of breath ( Dyspnea): Causes, Treatment & Prevention

 

Shortness of breath or dyspnea is the sensation that your lungs aren't getting enough air. You may feel as though your chest is tight, that you are having difficulty breathing, or that you are gasping for air. Dyspnea is frequently caused by heart and lung disorders.

Also Read: Heart attack: Symptoms, Causes, Treatment & Prevention

What is shortness of breath, or dyspnea?

 The term medical professionals use to describe feeling out of breath is dyspnea, which is pronounced "DISP-nee-uh."  You could characterize it as chest tightness, difficulty breathing, or an inability to get enough air ("air hunger").

 Shortness of breath is frequently a sign of lung and heart problems.  However, it may also indicate other illnesses like anxiety, allergies, or asthma.  Breathlessness can also be caused by a cold or vigorous exercise.

What causes dyspnea, or shortness of breath?

Shortness of breath can be brought on by physical activity, disease, and medical conditions. Heart and lung disorders are the most frequent causes of dyspnea.

How does shortness of breath result from lung and heart conditions?

Together, your heart and lungs remove carbon dioxide from your body and deliver oxygen to your blood and tissues. Your blood may contain too much carbon dioxide or too little oxygen if one or the other isn't functioning properly.

Your body will then tell you to breathe more forcefully to exhale more carbon dioxide or oxygen. This can also occur from anything that increases your body's need for oxygen, such as a vigorous workout or being at a high altitude.

Your lungs' malfunction can also be communicated to your brain. This may cause you to feel as though you are exerting more effort to breathe or that your chest is tightened. Among the reasons for this are:

• An irritation of the lungs.

• Restriction of the movement of your lungs during breathing.

• Airway blockage or narrowing that prevents air from entering your lungs.

Which medical conditions result in dyspnea, or shortness of breath?

Breathlessness can be caused by several conditions, including heart or lung disease.

Conditions of the lungs and airways

• Asthma

• Allergies

• COPD stands for chronic obstructive pulmonary disease

• Respiratory disease (such as the flu, COVID-19, bronchitis, or other bacterial or viral infections)

• Pneumonia

• Fluid (pleural effusion) or inflammation (pleurisy) surrounding your lungs

• Either scarring (fibrosis) or fluid (pulmonary edema) within your lungs

• Either pleural mesothelioma or lung cancer

• Hypertension of the lungs, or elevated blood pressure in the lungs

• Sarcoidosis

• TB

• Lung collapse, either partial or total (pneumothorax or atelectasis)

• Pulmonary embolism, or a blood clot

• Choking

Conditions of the heart and blood

• Anemia

• Heart failure

• Conditions known as cardiomyopathies that impact the heart muscle

• An abnormal heartbeat (arrhythmia)

• Inflammation of the endocardium, pericardium, or myocardium in or near the heart

Other circumstances

• Anxiety

• Injury that impairs breathing, such as a broken rib

• Medicine. Two drug classes that can cause dyspnea are beta-blockers, which are used to treat high blood pressure, and statins, which lower cholesterol.

• Extremes in temperature, either extremely hot or extremely cold

• BMI (body mass index) over thirty

• A lack of exercise (deconditioning of muscles)

• PND, or paroxysmal nocturnal dyspnea, is a complication of sleep apnea.

Diagnosis:

In addition to examining you, the doctor will pay close attention to your lungs. Spirometry, a lung function test, may be performed on you to gauge how quickly and how much air you can breathe in and out. This aids in the diagnosis of COPD and asthma.

You may also have additional tests, such as:

• Oximetry of the pulse. To measure the amount of oxygen in your blood, the doctor attaches a device to your finger or earlobe.

• Blood examinations. They can check for a blood clot or fluid in your lungs and indicate whether you have an infection or anemia.

• CT scan or chest X-ray. They determine whether you have a blood clot in your lung, pneumonia, or other lung conditions. A CT scan creates a comprehensive image by combining multiple X-rays taken from various angles.

• ECG. It measures your heart's electrical signals to determine whether you're having a heart attack, how quickly your heart beats, and whether your heart rhythm is healthy.

Treatment:

Methods for relaxation and breathing might be beneficial. However, the cause of your dyspnea will determine how you treat it. If you have asthma, for instance, you might be given an inhaler to use during flare-ups. The doctor may need to drain your lungs if there is fluid present. You may require medication if you are experiencing dyspnea due to an infection or a blood clot. You might also get oxygen. Always take your medications as directed by your doctor. Additionally, try to maintain a consistent exercise schedule if at all possible. Maintaining a healthy weight and engaging in regular physical activity are critical components of overall well-being.

How is dyspnea, or shortness of breath, treated?

The cause of shortness of breath determines how to treat it. To alleviate your symptoms, you will need to treat any underlying medical conditions.

The following treatments can help you breathe better:

• Exercise. Your heart and lungs won't have to work as hard if you exercise regularly.

• Techniques for relaxation. You can practice breathing exercises and relaxation techniques with your provider. These can alleviate anxiety and dyspnea caused by underlying respiratory disorders.

• Medications. Asthma and COPD patients are prescribed bronchodilators, which are inhaled medications that relax the airways. Breathlessness may be relieved by taking medication for pain or anxiety.

• Oxygen treatment. If your blood oxygen level is too low, your doctor will prescribe more oxygen. It enters your nose through a tube or mask.

Prevention:

Shortness of breath can be prevented by:

•  Together with your provider, create a care plan and follow it to manage any underlying conditions.  This covers the kinds of medications you should take, when to take them, exercise plans, breathing techniques, and any other treatments your doctor may recommend.

•  Steer clear of chemicals like paint fumes and vehicle exhaust that can irritate your lungs.

•  Using relaxation methods or breathing exercises.

•  Not smoking.

• Keeping your weight within a healthy range.

• Avoid activities in extremely hot or cold temperatures or when there is a lot of humidity.  Look for air pollution (ozone) alerts if you have lung disease; these are typically included in the weather forecast.  Steer clear of the outdoors during periods of high air pollution.

References:

• Viniol A, Beidatsch D, Frese T, et al. Studies of the symptom dyspnoea: a systematic review. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619993/) BMC Fam Pract. 2015;16:152. Accessed 11/11/2022.

• American Lung Association. Shortness of Breath Symptoms, Causes and Risk Factors. (https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/shortness-of-breath/shortness-breath-symptoms-risks.html) Accessed 11/11/2022.

• Baron RM. Dyspnea. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson JL, eds. Harrison's Principles of Internal Medicine 21e. McGraw Hill; 2022.