If you’re a healthy adult, you breathe in and out up to 20 times a minute. That’s nearly 30,000 breaths a day. A vigorous workout or the common cold might throw a kink in that pattern from time to time, but generally you should never feel short of breath.
Shortness of breath, or dyspnea, can be a warning sign of a health problem that needs treatment right away.
Most cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.
Shortness of breath that comes on suddenly (called acute) has a limited number of causes, including:
- Asthma (bronchospasm)
- Carbon monoxide poisoning
- Cardiac tamponade (excess fluid around the heart)
- Hiatal hernia
- Heart failure
- Low blood pressure (hypotension)
- Pulmonary embolism (blood clot in an artery in the lung)
- Pneumothorax (collapsed lung)
- Pneumonia (pulmonary infection)
- Sudden blood loss
- Upper airway obstruction (blockage in the breathing passage)
In the case of shortness of breath that has lasted for weeks or longer (called chronic), the condition is most often due to:
- COPD (chronic obstructive pulmonary disease)
- Heart dysfunction
- Interstitial lung disease
A number of other health conditions also can make it hard to get enough air. These include:
- Croup (in young children)
- Lung cancer
- Pleurisy (inflammation of the membrane lining the chest)
- Pulmonary edema (excess fluid in the lungs)
- (scarred and damaged lungs)
- Pulmonary hypertension (high blood pressure within the lungs’ blood vessels)
- Sarcoidosis (collections of inflammatory cells in the body)
- Cardiomyopathy (problem with the heart muscle)
- Heart arrhythmias (rhythm problems)
- Heart failure
- Pericarditis (swelling of the membrane surrounding the heart)
- Broken ribs
- Choking: First aid
- Epiglottitis (swelling of part of the windpipe)
- Foreign object inhaled
- Generalized anxiety disorder
- Guillain-Barre syndrome
- Myasthenia gravis (condition causing muscle weakness)
Dyspnea is the feeling that you can’t catch your breath or get enough air in your lungs. You might feel:
- Tightness in your chest
- “Hungry” for air (air hunger)
- Unable to breathe deeply
It can be acute (sudden) or chronic (long-lasting). Acute dyspnea starts within a few minutes or hours. It can happen with other symptoms like a fever, rash, or cough. Chronic dyspnea can make you feel out of breath with everyday tasks, such as walking from room to room or standing up from a sitting position.
When to call a doctor
You should call your doctor immediately if you have sudden shortness of breath, as there may be a problem with your airways or heart.
Your doctor will assess you over the phone, and may either visit you at home or admit you to hospital.
If your shortness of breath is the result of anxiety, you may be asked to come to the surgery rather than having a home visit.
If you’ve struggled with your breathing for a while, don’t ignore it. See your doctor as it’s likely you have a long-term condition that needs to be managed properly, such as obesity, asthma or chronic obstructive pulmonary disease (COPD).
Your doctor may ask you some questions, such as:
- Did the breathlessness come on suddenly or gradually?
- Did anything trigger it, such as exercise?
- How bad is it? Does it only happen when you’ve been active, or when you’re not doing anything?
- Is there any pain when you breathe?
- Do you have a cough?
- Do certain positions make it worse – for example, are you unable to lie down?
Feeling like you can’t get enough air can be terrifying, but doctors are well trained in managing this. You may be given extra oxygen to breathe if this is needed.