Five Common Causes of Shortness of Breath

Written by Sarah Thebarge, Physician Assistant

Shortness of breath (or, dyspnea) causes patients to feel out of breath, or feel like they must work harder to breathe. Since shortness of breath can indicate a potentially serious condition, it’s important to be aware of the common causes of this symptom.

1) Pulmonary Embolism

A pulmonary embolism (PE) occurs when a blood clot lodges in an artery that supplies blood to the lungs. If a PE is not quickly diagnosed and treated, it can be fatal. In fact, as many as one in three people with an undiagnosed or untreated PE die from this condition.

Common symptoms of a PE include shortness of breath, chest pain, and coughing up blood (or, hemoptysis). Patients also usually have a fast heart rate, a fast respiratory rate, and a low oxygen saturation. Anyone with these symptoms should seek immediate medical attention.

2) Myocardial Infarction

A myocardial infarction (MI) is commonly called a “heart attack.” MI’s typically happen when a blood clot lodges in a coronary artery that supplies blood to the heart muscle. If this clot is not quickly dissolved with medication or removed in a procedure called an angioplasty, the heart muscle can die due to lack of oxygen. An MI is a dangerous medical condition that has a 30% mortality rate.

Symptoms of an MI can include chest pain, shortness of breath, dizziness, nausea, jaw pain, and a rapid or irregular heart rate. Any patients with these symptoms should call 911 or immediately go to the nearest emergency department.

3) Asthma

Asthma is a medical condition that causes inflammation and spasms in the airway. Some patients experience mild symptoms; other patients experience life-threatening asthma attacks. Symptoms of an asthma exacerbation include wheezing, chest tightness, shortness of breath, dizziness, and a rapid heart rate.

Asthma is most commonly treated with inhaled medication. Rapid-acting inhalers also called “rescue inhalers,” contain albuterol, which relaxes the smooth muscles that control the airway and makes it easier for a patient to breathe. Inhaled, oral, or injected steroids are also commonly used to reduce inflammation. Patients with severe asthma attacks are also typically given epinephrine and supplemental oxygen.

It’s important for patients with asthma to control their asthma with maintenance medications, avoid known triggers, and seek immediate medical attention for severe symptoms.

4) Pneumonia

Pneumonia is an infection in one or both lungs. Infected air sacs can fill with fluid or pus, making it difficult for patients to breathe.

Common symptoms of pneumonia include a productive cough, fever, chest pain, fatigue, and shortness of breath. Patients also usually have a fast heart rate, a fast respiratory rate, and a low oxygen saturation.

Bacterial pneumonia requires treatment with oral or I.V. antibiotics. Fungal pneumonia requires treatment with anti-fungal medications. The treatment of viral pneumonia depends on what virus is causing the infection and how severe a patient’s symptoms are.

Patients who are younger than 2 years old, older than 65, immunocompromised or those with chronic health conditions are at the highest risk for contracting pneumonia.

5) Anxiety

Patients who are anxious or have a panic attack commonly experience shortness of breath. This happens because anxiety prompts the release of stress hormones like adrenaline and cortisol, which trigger the sympathetic nervous system’s “fight-flight-or-flee” response.

In this state, the body prepares to respond to danger by increasing its intake of oxygen. This can lead to feelings of shortness of breath or of “air hunger,” which happens when patients feel like they aren’t getting enough oxygen no matter how hard they breathe.

Deep breathing exercises often help alleviate these symptoms, because deep breaths activate the vagus nerve, which lowers stress hormones, slows the heart rate, and slows the rate of breathing.

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