Shortness of Breath

Shortness of breath (dyspnea) is a symptom with a great many possible causes. When patients experience shortness of breath, they feel as if they cannot take in enough air. This difficulty in breathing can be the result of myriad conditions, some relatively benign and some life-threatening. While occasional, explicable bouts of shortness of breath are normal, when they are intense, prolonged or recurrent, their root causes can only be determined through comprehensive medical examination.

In general, shortness of breath accompanied by any of the following symptoms demands immediate attention:
• Chest pain
• Coughing or wheezing
• Choking
• Fainting or loss of consciousness
• Heart irregularities
• Bleeding or injury
Shortness of breath associated with digestive problems such as difficulty swallowing, heartburn, or pain in the upper back should also be promptly investigated.

Causes of Shortness of Breath
Shortness of breath can have its origins in many of the body’s systems. The most serious causes of shortness of breath are usually pulmonary or cardiovascular.

Pulmonary Causes
Because the lungs are involved in transporting oxygen to, and removing carbon dioxide from, the tissues, problems with the lungs and other parts of the respiratory system can interfere with breathing. Reasons for lung dysfunction include the following:
• Asthma
• Carbon-monoxide poisoning
• Croup, pneumonia or tuberculosis
• Pleurisy, emphysema or COPD
• Lung cancer
• Pneumothorax (collapsed lung)
• Pulmonary edema
• Pulmonary fibrosis
• Sarcoidosis or tuberculosis
• Interstitial lung disease
Shortness of breath can also be caused by inhaling certain substances, or swallowing an object that then blocks an upper airway. Anything that interferes with the breathing process requires urgent care.

Cardiovascular Causes
Serious underlying causes for shortness of breath may be cardiovascular, and include the following:
• Cardiomyopathy
• Cardiac tamponade
• Congestive heart failure
• Heart arrhythmia
• Heart attack
• Hypotension or hypertension
• Pericarditis
Once an underlying cardiovascular cause has been determined, medication or surgical intervention may be necessary.

Digestive Causes
Patients with gastroesophageal reflux disease (GERD) or ascites (accumulation of abdominal fluid) are also prone to shortness of breath. With GERD, stomach acid makes its way into the esophagus, narrowing it and making breathing more difficult. With ascites, the swollen abdomen can push against the diaphragm, affecting its ability to assist with breathing.

Other Causes
Shortness of breath can also result from the following miscellaneous causes:
• Overexertion
• Obesity
• Anemia
• Blocked airway
• Reaction to allergen or pollutant
• Hormone or enzyme imbalance
• Anxiety disorder
• Panic attack
• Broken ribs or other traumatic injury
Pregnancy, particularly in the third trimester, can produce shortness of breath, because the expanding uterus puts pressure on the diaphragm. Patients with some systemic illnesses, such as myasthenia gravis and Guillain-Barré syndrome, can also experience shortness of breath.

If shortness of breath is due to the temporary congestion associated with an upper-respiratory infection, it usually resolves on its own in a matter of days. However, with severe upper-respiratory infections that are bacterial in nature, antibiotics and, even, oxygen may be necessary.