Dyspnea (patient information)
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Dyspnea On the Web
Editor-In-Chief: C. Michael Gibson, M.S., M.D.  ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. 
Breathing difficulty involves a sensation of difficult or uncomfortable breathing or a feeling of not getting enough air. No standard definition exists for difficulty breathing. Some people may feel breathless with only mild exercise (for example, climbing stairs), even though they do not have a medical condition. Others may have advanced lung disease but never feel short of breath. Wheezing is one form of breathing difficulty in which you make a high-pitched sound when you breathe out.
What causes Dyspnea?
Shortness of breath has many different causes:
- A blockage of the air passages in your nose, mouth, or throat may lead to difficulty breathing.
- Heart disease can cause breathlessness if your heart is unable to pump enough blood to supply oxygen to your body. If your brain, muscles, or other body organs do not receive enough oxygen, a sense of breathlessness may occur.
- Lung disease can cause breathlessness.
- Sometimes emotional distress, such as anxiety, can lead to difficulty breathing.
The following problems may cause breathing difficulty:
- Problems with the lungs:
- Blood clot in the arteries of the lungs (pulmonary embolism)
- Chronic obstructive pulmonary disease (COPD), asthma, and other chronic lung problems
- Pulmonary hypertension
- Problems with the airways leading to the lungs:
- Choking on something stuck in the airways
- Problems with the heart:
- Heart attack or angina
- Heart defects from birth (congenital heart disease)
- Heart failure
- Heart rhythm disturbances (arrhythmias)
- Other problems:
- Allergies (such as to mold, dander, or pollen)
- Climbing to high altitudes where there is less oxygen in the air
- Compression of the chest wall
- Dust in the environment
- Hiatal hernia
- Panic attacks
Your health care provider will take a detailed medical history and perform a physical examination.
- Medical history questions
- Do you notice shortness of breath?
- Do you make grunting or wheezing sounds while breathing?
- Do you have to work hard to breathe?
- How long have you had breathing difficulty?
- Did it slowly progress over weeks to months?
- Did it begin recently?
- Did it begin suddenly?
- Did it come on slowly (gradual onset)?
- Is there a sequence of separate episodes? How long does each last, and does each episode have a similar pattern?
- Has the breathing difficulty gotten worse recently?
- Does breathing difficulty cause you to wake up at night (paroxysmal nocturnal dyspnea)?
- Does the amount of breathing difficulty change over time?
- Does breathing difficulty occur while you are at rest?
- How long does each episode last?
- Is it worse when you lie flat (orthopnea)?
- Is it worse when you change body position?
- Did it develop within 4 to 6 hours after exposure to something that you are or may be allergic to (antigen)?
- Is it worse after exercise?
- Does shortness of breath occur only when you are wheezing?
- Is your breathing pattern irregular?
- Do you draw back the chest muscles with breathing (intercostal retractions)?
- What other symptoms do you have?
The physical examination will include examination of lungs, heart, and upper airway passages.
- Laboratory tests include the following
- Blood oxygen saturation (pulse oximetry)
- Blood tests (may include arterial blood gases)
- Chest x-ray
- CT scan of the chest
- Exercise testing
- Pulmonary function tests
If blood oxygen level is very low, oxygen is required. High doses of supplemental oxygen may be hazardous for some patients, however. Oxygen is not always needed for shortness of breath.
Where to find medical care for Dyspnea?
Directions to Hospitals Treating Dyspnea