Dyspnea: Symptoms, Causes, Types & Treatment

Dyspnea is the sensation of shortness of breath that usually occurs during physical activity but can also be triggered by anxiety. It is often accompanied by other symptoms such as fatigue, chest tightness, or rapid and irregular breathing.

Dyspnea may also be caused by heart or lung conditions, including asthma, pneumonia, and chronic obstructive pulmonary disease (COPD).

Treatment for dyspnea should be managed by a primary care provider, pulmonologist, or cardiologist, depending on the cause and type of shortness of breath. Treatment may include physical exercise, medications, oxygen therapy, or respiratory therapy.

Common symptoms

The main symptoms of dyspnea include:

• Difficulty breathing;

• Fatigue;

• Rapid or irregular breathing;

• Cough.

In most cases, dyspnea is temporary and improves within a few minutes. However, it can sometimes persist, worsen, or be accompanied by other symptoms such as severe chest tightness, bluish lips or fingertips, or pain that radiates to the back, neck, or jaw.

In these cases, seeking immediate medical care is essential.

Confirming a diagnosis

A diagnosis of dyspnea is made by a primary care provider, pulmonologist, or cardiologist based on an evaluation of symptoms, medical history, and physical exam.

The doctor may also request specific tests to determine whether dyspnea is related to a heart or lung condition. These tests may include:

• Pulse oximetry;

• Chest X-ray;

• Pulmonary function tests;

• Exercise stress test;

• Chest CT scan.

In some cases, blood tests may also be ordered to check for anemia.

Main causes

Dyspnea can result from several different conditions affecting the heart or lungs. Dyspnea is considered acute when it appears suddenly and lasts only a few days, while chronic dyspnea persists for one month or longer.

Acute dyspnea

The main causes of acute dyspnea, which comes on suddenly and may disappear after a few days, include:

• Anaphylaxis (a severe allergic reaction);

• Stress or anxiety;

• Choking;

• Pulmonary embolism;

• Heart attack;

• Lung infections, such as pneumonia or bronchitis;

• Rib injury;

• Use of certain medications, such as statins or beta-blockers;

• Exposure to extreme temperatures.

COVID-19 can also cause difficulty breathing or shortness of breath.

Chronic dyspnea

Chronic dyspnea usually lasts for at least a month and may be caused by:

• Asthma;

• Bronchitis;

• Heart failure;

• Lung diseases, such as COPD, tuberculosis, or lung cancer;

• Obesity;

• Lack of physical conditioning.

Other health problems that can cause chronic dyspnea include anemia, Guillain-Barré syndrome, and myasthenia gravis, a condition that leads to muscle weakness and can affect lung function.

Different types

Dyspnea can be classified according to whether it is associated with heart or lung problems. The main types of dyspnea include:

Exertional dyspnea

Exertional dyspnea occurs when a person has trouble breathing during activities that were previously easy to perform. This type is most common in people with heart or lung disease.

Orthopnea

Orthopnea, also known as decubitus dyspnea, occurs when a person has difficulty breathing immediately after lying down. This type of dyspnea is often related to heart or lung problems.

Paroxysmal dyspnea

Paroxysmal dyspnea, also called paroxysmal nocturnal dyspnea, is difficulty breathing that happens during sleep. A person may wake up suddenly at night with shortness of breath, sometimes accompanied by coughing or wheezing. These symptoms usually improve when sitting or standing.

Treatment options

Treatment for dyspnea should be managed by a doctor or other healthcare professional and depends on the underlying cause. The main treatment options include:

1. Physical exercise

Physical exercise should be performed under the supervision of an exercise specialist and can help with weight loss in people whose dyspnea is related to excess body weight.

Regular exercise also strengthens the muscles of the lungs and heart, helping improve breathing and reducing episodes of shortness of breath.

2. Respiratory therapy

Respiratory therapy helps improve oxygen flow throughout the body and is recommended in order to enhance breathing and overall quality of life in people with dyspnea caused by asthma, bronchitis, or tuberculosis.

3. Oxygen therapy

Oxygen therapy involves using a mask or nasal cannula to increase oxygen levels in the lungs and bloodstream. It helps improve breathing in people with COPD, asthma, or pneumonia.

4. Medications

Certain medications may be prescribed depending on the cause of dyspnea. Bronchodilators and corticosteroids help relax the airways and reduce inflammation in cases of asthma or COPD. Anxiolytics (anxiety medication) and pain relievers may be prescribed for dyspnea related to stress or anxiety.

Antibiotics, antihistamines, and decongestants are commonly used to treat sinusitis, flu, or respiratory infections that lead to shortness of breath.

Diuretics may be recommended when dyspnea is associated with heart failure.