Most of us have felt short of breath at some point in our lives. It could have been caused by an intense workout, chasing after the bus or maybe a bout of anxiety. It’s normal to feel out of breath for a short period after strenuous activity or sudden exposure to a temperature change for example, but if you struggle to get through basic tasks like climbing a short flight of stairs without huffing and puffing or experience prolonged shortness of breath in general, it might be your body’s way of signalling something more serious.

In my practice, we call this dyspnea, a medical term used to describe shortness of breath. Many patients describe it as an uncomfortable feeling. I should add that an episode of dyspnea is not really a reflection or direct correlation of an individual’s health; sometimes an individual can experience shortness of breath through activities like physical exertion, as mentioned above. However, as with most patients I see, dyspnea usually relates to a health problem that requires attention. Sometimes it could just be a case of being out of shape, other times it could be something more serious like chronic obstructive pulmonary disease (COPD). If it occurs suddenly, I would see it as a warning sign.

Do you experience shortness of breath, and when should you see a doctor? Read on to find out more.

Symptoms to look out for

Even if it doesn’t last long, shortness of breath that’s sudden and severe is usually a sign that you need immediate medical care. I advise patients to look out for the following accompanying symptoms:

Chest pain or discomfort

Chest pain can signal a heart attack, tear in the aorta or blood clot in the lungs.

Swollen ankles and feet

To many patients’ surprise, swollen ankles can actually be an indication of heart failure. This is due to a buildup of excess fluid in the body’s tissues. With heart failure, as blood that flows out of the heart slows down, blood that returns to the heart through the veins back up as well, causing fluid to accumulate in the tissues.

Fever

As with many conditions, a fever may be a result of infections.

Unusual fatigue

All things kept equal (e.g. sleep, stress levels), I would keep a lookout for fatigue during regular everyday activities. Do you feel exceptionally tired and experience difficulty managing everyday activities, such as shopping, carrying the groceries or walking? It could be a sign that your heart cannot pump enough blood to meet the needs of your body.

Pain when coughing with blood or reddish mucus

Coughing out blood could mean pneumonia, a blood clot in the lungs or lung cancer.

Wheezing and coughing

You may be experiencing an asthma attack or lung infection.

Short term vs long term breathlessness: What’s the difference?

Sudden and unexpected breathlessness (short term breathlessness) is usually caused by conditions that require immediate action, with the most common being:

A problem with the lungs or airways

For patients with asthma, this could mean an asthma attack. Always ensure you have an inhaler in hand to deliver medicine to your lungs; it should help with your breathlessness. Pneumonia may also cause shortness of breath and a cough. Do see a doctor to get antibiotics. If you have COPD, it’s likely that your breathlessness means your condition got worse.

A heart problem

It’s possible you could be having a heart attack without obvious symptoms like chest pain. Some patients experience just the breathlessness — we call this a “silent” heart attack. Sudden breathlessness can also mean heart failure or a problem with your heart rate or rhythm.

A panic attack

In some cases, sudden breathlessness is caused by a panic attack. Breathing exercises can bring your breathing back to normal, but only if you are certain anxiety is the reason behind your breathlessness. Otherwise, seek a medical emergency immediately.

Patients with long term breathlessness often experience shortness of breath due to reasons like obesity, anaemia, COPD, pulmonary embolism and lung cancer. All these are equally serious conditions and should be given medical attention.

When to see a doctor

When seeing patients experiencing shortness of breath, many doctors including myself will consider the possibility of a life-threatening event. It is considered an emergency if you have:

  • Unexplained shortness of breath for the first time
  • Difficulty breathing at rest
  • Difficulty breathing accompanied by chest pain, lightheadedness or cold sweats
  • Shortness of breath that’s worse than usual if you have existing heart failure, asthma or emphysema
  • While not all scenarios are considered life threatening, why take that chance? My advice is to play it safe and always listen to your body.
  • Should you have any questions regarding cardiovascular health, feel free to reach out and I’ll do my best to reply.

References

  1. Bausewein, C., & Simon, S. T. (2013). Shortness of breath and cough in patients in palliative care. Deutsches Arzteblatt international, 110(33-34), 563–572. https://doi.org/10.3238/arztebl.2013.0563
  2. Coccia, C. B., Palkowski, G. H., Schweitzer, B., Motsohi, T., & Ntusi, N. A. (2016). Dyspnoea: Pathophysiology and a clinical approach. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 106(1), 32–36. https://doi.org/10.7196/samj.2016.v106i1.10324