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Doctor's Tip: Shortness Of Breath Is A Common Complaint

A frequent complaint that brings patients to primary care doctors is shortness of breath. Often the cause is weight gain or poor aerobic conditioning. This column is about more serious causes.

Lung infections: Pneumonia usually occurs as a complication of a viral upper respiratory infection such as influenza. Classic symptoms in addition to shortness of breath are moderate to severe cough, fever, chills and sometimes chest pain with a deep breath. Symptoms may be less severe in "walking pneumonia," but pneumonia can be serious, and people still die from it. Viral pneumonia does not respond to antibiotics, but bacterial pneumonia does. If you have any symptoms of pneumonia, the sooner you get diagnosed and receive appropriate treatment, the better.

One of the hallmarks of severe COVID-19 disease is low oxygen, which causes shortness of breath. Again, the sooner you're diagnosed and treated, the better. Even better is prevention, through immunization and, when appropriate, social distancing and masking.

Asthma is an inflammatory condition that causes spasm of the breathing tubes in the lungs, resulting in wheezing and shortness of breath. Asthma can be fatal, so if you think you might have it, seek professional help.

Emphysema is caused by loss of alveoli (small, delicate air sacs in the lungs where oxygen enters the blood). Smoking, second hand smoke and air pollution all play a role in this chronic and progressive disease. Exertion causes oxygen levels to drop, resulting in shortness of breath. You can check your oxygen level by buying a finger oximeter at any pharmacy and wearing it while walking briskly up some stairs (normal oxygen level is greater than 90% at all times).

Coronary artery disease (atherosclerotic plaque in your heart arteries) can cause shortness of breath. Especially in women, shortness of breath with or without exertion can be a symptom of a pending or actual heart attack.

Heart arrythmias: In atrial fibrillation and other heart irregularities, the heart beats irregularly and/or very fast. This results in inefficient delivery of oxygen to organs and tissues, causing shortness of breath with exertion and sometimes at rest.

Congestive heart failure occurs when the heart muscle becomes weakened by conditions such as atherosclerosis or tight or leaky heart valves. Blood and fluid back up into the lungs, causing shortness of breath.

Blood clots in the lung: The medical term for this is pulmonary emboli, which can cause shortness of breath at rest or exertion. Usually they are associated with chest pain, but not always, and they can be fatal.

Anemia refers to a low red blood cell count. The most common cause is iron deficiency, from loss of iron due to conditions such as heavy menstrual periods in premenopausal women; or loss from the GI tract from bleeding ulcers, colon polyps or colon cancer. Red blood cells carry oxygen to organs and tissues, and a low red count causes shortness of breath with exertion.

Mental health factors: A common symptom of anxiety is the feeling that the sufferer can't get a deep enough breath. In severe anxiety such as panic attacks, people start to breath rapidly, which causes the level of carbon dioxide in the blood to fall, which in turn causes numbness and tingling in extremities. Although nobody dies from panic attacks, the sufferer feels like they're going to die. Treatment is to breathe into a paper sack, which brings CO2 levels back to normal.

The take-home message is this: Many causes of shortness of breath are serious. If you have this condition, see a medical provider on an urgent basis.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People's Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.Net.

Shortness Of Breath: What It Is And When To Contact A Doctor

Shortness of breath, or dyspnea, occurs when a person feels that they are unable, or less able than usual, to take enough air into the lungs.

The sensation of shortness of breath is subjective. For instance, some people may describe the feeling as a sensation of suffocating. For others, they may feel unable to take a deep breath.

Regardless of the exact description, experiencing shortness of breath is uncomfortable and may lead to additional symptoms or complications.

Shortness of breath may occur occasionally or frequently, and it has many different potential causes.

Keep reading to learn more about the causes, treatment, and prevention methods associated with shortness of breath.

Some people experience shortness of breath during pregnancy.

According to the March of Dimes, shortness of breath may develop in both early and late pregnancy, but for different reasons.

During early pregnancy, shortness of breath may develop due to an increase in progesterone. This increase in progesterone can cause a person to breathe more often. An increased respiratory rate may lead to a sensation of shortness of breath.

In later pregnancy, as the uterus grows, it can push up on the lungs. This growth of the uterus can lead to a decrease in full lung expansion and a feeling of shortness of breath.

When to contact a doctor

A person should contact a doctor if they are pregnant and experiencing shortness of breath alongside:

Getting older does not, in itself, lead to shortness of breath.

However, older adults have an increased risk of developing certain conditions that may lead to shortness of breath.

For example, increased age is a risk factor for conditions such as congestive heart failure and COPD, both of which may cause shortness of breath.

When to contact a doctor

chest pain or discomfort

dizziness or fainting

difficulty breathing at night

significant or worsening edema

coughing up blood

A doctor will make a diagnosis of shortness of breath based on a physical exam and a person's report of their symptoms.

The doctor will also note other symptoms that provide a clue as to the cause. For example, wheezing, coughing, and chest tightness may signify a respiratory condition as the cause.

In other instances, the doctor may order additional tests. These diagnostic tests may include:

Shortness of breath involves a feeling of difficulty getting enough air into the lungs. In some cases, this occurs as a result of exercise. However, sometimes, shortness of breath is a symptom of a medical problem.

Although shortness of breath may be mild, it can also become severe and lead to a life threatening situation.

Usually, treating shortness of breath involves treating the underlying condition, if one is present.

Shortness Of Breath (Dyspnea) - University Of Utah Health

If dyspnea comes on suddenly and is persistent, go to the nearest emergency room or call 911.  

Some people may blame shortness of breath on getting older or being out of shape. However, dyspnea can be a sign of more serious health problems. See a doctor if you have shortness of breath, especially if you notice it getting worse over time. 

You should also see a specialist if you wake up several times during the night with shortness of breath or you are extremely tired and cannot stay awake during the day. These may be signs of an obstructive sleep disorder.

Oxygen Levels & Shortness of Breath

You can measure oxygen levels at home with a low-cost device called a pulse oximetry meter (or pulse oximeter). These devices are available online or at your local pharmacy. 

A pulse oximeter clips on the end of your finger. After a few seconds, it gives a reading of how well your blood is pumping oxygen to your body, up to 100 percent (complete oxygen saturation). Healthy adults should have oxygen levels above 92 percent, and ideally above 95 percent. If your oximeter reading is 90 percent or below, see a doctor. 

How Do I Know If My Shortness of Breath Is Heart-Related? 

It can be difficult for you to know whether your dyspnea is the result of a problem with your heart, your lungs, or both. The first step to finding the cause of your dyspnea is to get the correct tests and an accurate diagnosis from a cardiology or pulmonary specialist.

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