Dyspnea (Shortness of Breath)

What Is Dyspnea?

Dyspnea is a condition where you are experiencing shortness of breath, or breathlessness.

Dyspnea is also the uncomfortable sensation of breathing. Normally, our bodies will regulate the act of breathing without even having to think about it.

You may experience dyspnea at rest, or on exertion (when you perform any activity).

What are common causes of dyspnea?

Heart problems - including:

• Irregular heart beats
• Fluid accumulation around the heart
• A recent heart attack which may be blocking blood flow
• Heart failure- when your heart is not working as well as it should

Lung problems - including:

• A blockage by a foreign body in your upper or lower airway passages, by tumor, infection, or even may be caused by choking on a piece of food
• Constriction of your lung passages caused by secretions are common in acute (happening suddenly), or chronic (occurs for a long time) bronchitis, asthma, and Chronic Obstructive Lung Disease (COLD).
• Fluid accumulation in your lungs due to a tumor or infection (pleural effusion)
• Pneumonia
• Upper Respiratory Infection (URI)
• Pulmonary fibrosis - lung damage from radiation, chronic diseases, or chemotherapy
• Pneumonitis
• Pneumothorax - a collapsed lung from tumor or trauma (like a car accident, or a gunshot wound)
• Blood clots in your lungs (pulmonary emboli)

Other causes:

Anemia - Low blood hemoglobin (Hgb) counts that may occur with blood loss, if you are low in iron stores, or after chemotherapy

If you are hyperventilating, or breathing really fast due to fear, anxiety, or unknown causes

What are risk factors for developing dyspnea?

• Smoking cigarettes
• Environmental irritants, such as pollution, chemicals and hair spray
• If you are elderly, or have an altered immune system from chemotherapy, long-term steroid use, or chronic diseases

If your bronchitis, pneumonia or other cause of dyspnea are due to a virus, your symptoms may take 2 or more weeks to resolve, but antibiotics won't help. Treatment of a virus includes cough medications, drinking lots of fluids, and avoiding irritants.

Your dyspnea may be due to a chronic, or a long-term disease, such as pulmonary fibrosis, or chronic bronchitis. You may go through periods when you feel well, and then go through periods when you feel ill.

What are Dyspnea Symptoms?

• Chest tightness, difficulty getting a good breath, feelings of breathlessness, or that you are hungry for air.
• Wheezing, when you breathe.
• You may have fever, chills, or a headache.
• Pain in your muscles, or pain in your lungs when you take a deep breath, especially if you are coughing really hard, for long periods of time.
• You may be overly tired, or very weak (fatigued). It may be hard for you to do any kind of your normal activities.
• You may have sudden onset of coughing spells or a long-term (chronic) cough that may produce sputum of various colors.
• You may experience shortness of breath, either at rest or while performing any type of activity.
• You may have trouble lying flat in bed, and you may have to sleep on 2 or more pillows. Your shortness of breath may cause you to wake up in the middle of the night.

How can you manage your dyspnea?

• If you are smoking, you should quit. If you do not smoke, avoid smoke-filled rooms. Smoking first or second-hand can damage lung tissue, and make your dyspnea worse. Discuss with your healthcare provider techniques that can help you quit.
• Avoid people who are sick. Wash your hands often, with soap and water, for at least 15 seconds at a time. Use tissues when you sneeze or cough.
• Do not share eating or drinking utensils with anyone.
• If you are over the age of 65 years, or have an altered immune system due to chemotherapy, chronic disease or steroid use, the Centers for Disease Control (CDC) recommends that you receive a flu vaccine every year, and a pneumonia vaccine every 5 years. Discuss with your healthcare provider to see if this is right for you.
• People with lung problems need to circulate air from the bottom of their lungs and out of your lungs (oxygenation), to prevent infection and pneumonia. Using an incentive spirometer for 15 minutes a day, twice a day, can help promote oxygenation.
• Controlling secretions through coughing and deep breathing will help you to breathe easier. Remember, if you are dehydrated, your secretions will be thicker, and harder to bring up. Make sure to drink 2 to 3 liters of fluids (non-alcoholic, non-caffeinated) per day, to remain well hydrated.
• Taking warm showers or baths, and using a vaporizer, may help to thin out your secretions.
• Try to exercise, as tolerated, to promote air exchange (oxygenation), and to maintain your optimal level of functioning. Walking, swimming, or light aerobic activity may also help you to lose weight, and feel better. Make sure to exercise, under the supervision of your healthcare provider, and discuss with your healthcare provider how you can create a specific exercise program to suit your needs.
• Try to avoid "environmental allergens" (such as smoke, pollution, and common causes of seasonal allergies), as well as things that may cause allergies in your home (hair sprays, mold, dust mites, and pets). These may trigger an episode of coughing and dyspnea, and make your symptoms worse.
• Keep a diary of your any abnormal symptoms, such as excessive fatigue, shortness of breath or chest pain, if these are occurring regularly. Write down the foods that you have eaten, the exercise or activity you were undergoing when the symptoms occurred, and how you felt before they occurred. This diary may be valuable in determining the cause of your symptoms, and help you to identify certain "triggers" of your symptoms.

Drugs That May Be Prescribed by Your Doctor for Dyspnea:

• Antianxiety medications - If you are experiencing anxiety with your dyspnea, depending on the cause, your healthcare provider may prescribe an anti-anxiety medication, called an anxiolytic. These medications will help you to relax.
• Antibiotics - If your doctor or healthcare provider suspects that you have a lung infection, he or she may order antibiotic pills or intravenously (IV), depending on how severe your illness is, and your overall health status.
• Anticoagulants - These medications prevent your blood from clotting, or may be ordered by your healthcare provider if you have a blood clot.
• Anticholinergic agents - these drugs are given to persons with chronic bronchitis, emphysema, and chronic obstructive lung disease (COLD).
• Bronchodilators - These drugs work by opening (or dilating) the lung passages, and offering relief of symptoms, including shortness of breath. These drugs, typically given by inhalation (aerosol), but are also available in pill form.
• Beta-adrenergic receptor agonists (beta-agonists) - Beta-agonists can be considered bronchodilators, as these drugs relax airway smooth muscle, and block the release of substances that cause bronchoconstriction, or narrowing of your lungs, if you are having a lung spasm
• Corticosteroids - Steroids work by decreasing inflammation and swelling, which may be present with certain lung disorders. People may benefit from steroids, either inhaled, by pill form, or in the vein (IV).
• Cough medications/Decongestants - may help you to be more comfortable if you are coughing a lot.
• Diuretics - may be known as "water pills" as they work to prevent or treat lung congestion by making you urinate out extra fluid.
• Oxygen therapy - If you are experiencing shortness of breath at rest, or on exertion, your healthcare provider may see if oxygen therapy is right for you. You may take oxygen when your symptoms are at their worst. For example, some people are only on oxygen at nighttime, and not during the day. Some take oxygen when they are performing activities, but not all the time.

If you are ordered a medication to treat this disorder, do not stop taking any medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone.

If you miss a dose of your medication, discuss with your healthcare provider for what you should do.

If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.

Keep all of your appointments for your treatments.

Do not stop any medications abruptly, as serious side effects may occur.

When to Contact Your Doctor or Health Care Provider?

• Fever of 100.5º F (38º C), chills, sore throat (possible signs of infection if you are receiving chemotherapy).
• If you cough up blood
• Shortness of breath, chest pain or discomfort; swelling of your lips or throat should be evaluated immediately
• Feeling your heart beat rapidly, or have palpitations
• Any new rashes on your skin
• Any unusual swelling in your feet and legs
• Weight gain of greater than 3 to 5 pounds in 1 week.
• Any symptoms that worsen and do not improve

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.