Symptom: Shortness of Breath

    What is Breathing Difficulty?

    Breathing difficulty is a broad term that is used to describe discomfort when breathing, and the feeling that you cannot draw a breath. This can develop gradually, or your breathing may suddenly become more labored. Breathing difficulties make you feel as though you cannot get enough air. Mild breathing problems, such as fatigue following an aerobics class, are not a concern.

    Breathing difficulty can be caused by a number of different conditions, or it can develop as a result of stress and anxiety.

    Frequently occurring shortness of breath or sudden, intense breathing difficulty may be a sign of a serious health issue in need of medical attention.

    What Causes Breathing Difficulties?

    Breathing difficulties are often caused by simple environmental issues and/or common health concerns. These include:

  • allergies to dust, mold, or pollen
  • stress and anxiety
  • blocked air passages from a stuffy nose or throat phlegm
  • lowered oxygen intake from climbing to a high altitude
  • According to the experts at the Mayo Clinic, lung and heart conditions are the top two reasons for breathing difficulty (Mayo Clinic, 2010).

    Lung Conditions

    There are a number of lung conditions that can cause breathing difficulty. All of these require immediate medical attention, some more immediate than others:

  • Asthma is an inflammation and narrowing of the airways that can cause shortness of breath, wheezing, chest tightness, and coughing.
  • Pneumonia is lung inflammation that is caused by infection. Symptoms may include shortness of breath, cough, chest pain, chills, sweating, fever, muscle pain, and exhaustion. This condition, in some cases, can be life threatening.
  • COPD (chronic obstructive pulmonary disease) is the term used for a group of diseases that cause difficulty exhaling and other symptoms, such as wheezing, a constant cough, and chest tightness. Emphysema, often caused by years of smoking, is in this category of diseases.
  • Pulmonary embolism is a blockage in one or more of the arteries leading to the lungs. This is often caused by a blood clot from elsewhere, often a leg, which has travelled up to the lung arteries. This condition can be life threatening and requires immediate medical attention. Other symptoms include swelling of the leg, chest pain, cough, wheezing, profuse sweating, abnormal heart rate, dizziness, and/or a bluish tint to the skin.
  • Pulmonary hypertension is high blood pressure that affects the lung and heart arteries. This condition is often caused by the narrowing or hardening of the lung arteries. Symptoms of this condition are very similar to those of a pulmonary embolism. Immediate medical attention is needed.
  • Croup is a respiratory condition caused by an acute viral infection and is known for its distinctively loud, “barking” cough. Make an appointment with your doctor if you or your child has croup. Children under 5 are more susceptible to more serious complications with this condition (Mayo Clinic, 2010).
  • Epiglottitis is a swelling of the epiglottis (the tissue that covers the windpipe) due to infection. This is a life-threatening disease that requires immediate medical attention. Other symptoms include fever, sore throat, mouth drooling, blue skin, difficulty breathing and swallowing, strange breathing sounds, chills, and hoarseness. There are vaccinations to prevent this condition.
  • Hiatal hernia is the protrusion of the stomach through the diaphragm into the chest. Individuals with this condition may also experience chest pain, difficulty swallowing, and heartburn. Small hiatal hernias can often be treated with medications and lifestyle changes; larger hernias or smaller ones that do not respond to treatment may require surgery. 
  • Heart Conditions

    You may notice yourself getting out of breath more often if you suffer from a heart condition. This is due to the heart struggling to pump oxygen-rich blood out to the body. Possible conditions that can cause this problem include:

  • coronary artery disease (CAD): a disease that causes narrowing and hardening of the arteries connected to the heart. Symptoms also include chest pain (angina) or heart attack.
  • congenital heart disease: problems with the structure or functioning of the heart that were present at birth
  • arrhythmias: disorders of heart rhythm or heart rate, which can cause an irregular heartbeat or a heart that beats too fast or too slow
  • heart attack
  • heart failure
  • Breathing Difficulties in Young Children

    Babies and young children often have breathing difficulties when they suffer from respiratory viruses. Mild symptoms occur because small children do not know how to clear their noses and throats. There are several conditions that can lead to more severe breathing difficulties. Most children recover easily, however. These illnesses include:


    Croup is respiratory illness usually caused by a virus. Children between 3 months and 5 years are most likely to get croup, but it can develop in older children. Croup usually begins with symptoms similar to a cold, but the illness is characterized by a “barking” cough that sounds like a seal. Breathing difficulties can result from frequent coughing. This often occurs at night. Most cases of croup resolve within a week. The first and second nights of coughing are usually the worst. In some cases, a severe bacterial infection can develop in the upper airway.


    A viral lung infection, bronchiolitis usually affects babies between 3 and 6 months. The illness may appear like the common cold at first, but coughing, rapid breathing, and wheezing may follow after a few days. In most cases, babies get well in a week to 10 days.

    Home Care for Your Child

    The following may soothe the respiratory symptoms that are causing your child’s breathing problems:

  • cool or moist air. Take your child outside into the night air or into a steamy bathroom.
  • a cool mist humidifier while the child is sleeping
  • acetaminophen (check with your child’s doctor for infant dosage)
  • When to Call the Doctor

    Your child requires medical attention if:

  • Breathing difficulty is increased or persistent.
  • Breathing is rapid (more than 40 breaths in 1 minute).
  • The skin of the chest pulls into the ribs with each breath.
  • Your child must sit up to breathe.
  • Your child has heart disease.
  • Your child was born prematurely.
  • Who Is at Risk for Breathing Difficulties?

    You are at greater risk for breathing problems if you experience constant stress, suffer from allergies, or have a chronic lung or heart condition. Obesity also increases the risk of breathing difficulties. Extreme physical exertion can also put you at risk for breathing problems, particularly when you exercise in intense spurts or at high altitudes.

    What Are the Symptoms of Breathing Difficulties?

    You are having breathing problems when you feel as though you cannot breathe in enough oxygen. Here are some specific signs:

  • a faster breathing rate
  • wheezing (a whistling sound when exhaling and sometimes inhaling)
  • blue fingernails and/or mouth
  • pale or gray complexion
  • head sweat
  • flaring nostrils
  • When Is Emergency Care Needed for Breathing Difficulties?

    Contact an emergency doctor if breathing difficulty comes on suddenly. Seek immediate medical attention for anyone whose breathing appears to have slowed considerably or to have stopped. After you have called 911, perform emergency CPR if you are trained to do so.

    The following symptoms, along with breathing difficulty, can indicate a serious problem. These problems may indicate an angina attack, a lack of oxygen, or a heart attack. Symptoms to be aware of include:

  • fever
  • pain or pressure on the chest
  • wheezing
  • tightness in the throat
  • a barking cough
  • shortness of breath that requires you to sit up constantly
  • shortness of breath that wakes you up during the night
  • How Are Breathing Difficulties Diagnosed?

    To understand the cause of your breathing difficulties, your doctor will ask you how long you have had the problem, whether it is mild or intense, and whether physical exertion makes it worse. After reviewing your medical history, the doctor will examine your airway passages, lungs, and heart. Depending on the findings of your physical exam, your doctor might recommend one or more of the following tests:

  • blood tests to check for oxygen levels
  • chest X-ray and computed tomography (CT) scan to look for underlying medical conditions
  • electrocardiogram (ECG) to look for heart damage
  • echocardiogram to check for heart disease, a heart murmur, or infection
  • pulmonary (lung) function tests to measure how well your lungs are working
  • exercise testing to see how your heart and lungs react to physical exertion
  • Treatment Options for Breathing Difficulties

    Determining the cause is the key to treating breathing difficulties.

    Lifestyle Modification

    If having a stuffy nose, exercising too hard, or hiking at high altitudes causes your symptoms, your breathing is likely to return to normal if you are otherwise healthy. The temporary symptoms will resolve once your cold abates, you stop exercising, or you return to a lower altitude.

    Stress Reduction

    If stress causes your breathing problems, the remedy is to reduce the stresses in your life and/or develop coping mechanisms. Meditation, counseling, exercise, and laughter are a few strategies for coping with ongoing stress.


    Some breathing difficulties are symptoms of serious heart and lung illnesses. In these cases, your doctor will prescribe medication and other treatments. If you suffer from asthma, for example, you may be instructed to use an inhaler immediately after experiencing breathing problems. If allergies are the cause of your breathing difficulties, your doctor may presribe an anti-histamine to reduce nasal inflammation, and may also recommend avoiding triggers like dust or pollen. 

    In extreme cases, you may be placed on a breathing machine or monitored at a hospital.

    What Is the Outcome if Breathing Difficulty Is Left Untreated?

    Never ignore the symptom of feeling short of breath, especially if it occurs suddenly. Any unusual breathing difficulty should be checked out by a doctor immediately to ensure that it is not the sign of a serious medical condition.

    Left untreated, your breathing could worsen, and the condition could prove fatal.

    Do not hesitate to call 911 if you are struggling to breathe, especially if it has come on suddenly and/or is accompanied by other symptoms such as chest tightness, headache, wheezing, numbness, or fever.

    Can Difficulty Breathing Be Prevented?

    There are a number of ways you can prevent having difficulty breathing.

  • Avoid smoking.
  • Monitor your weight to prevent weight gain.
  • Take any medications your doctor has prescribed to help with your breathing.
  • Exercise regularly to strengthen the lungs. Avoid over-exerting yourself, which can make breathing difficulty worse. Make sure that you discuss any new exercise regimen with your doctor, especially if you have a heart or lung condition.
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