Patient Education - Lung Cancer Program at UCLA
yourself about lung cancer:
Breathing difficulties involve a sensation of difficult or uncomfortable breathing
or a feeling of not getting enough air. See also difficulty breathing - first aid.
Shortness of breath; Breathlessness; Difficulty breathing; Dyspnea
No standard definition exists for difficulty breathing. For some individuals,
a sense of breathlessness may occur with only mild exercise (for example, climbing
stairs) without an indication of the presence of a specific disorder. Others may
have advanced lung disease and difficulty exchanging air but may never feel a sensation
of shortness of breath.
In some circumstances, a small degree of breathing difficulty may be normal. Severe
nasal congestion is one example. Strenuous exercise, especially when a person does
not exercise regularly, is another. In many situations, however, difficulty breathing
represents the presence of significant disease and should be evaluated by a health
care provider immediately.
Wheezing is one form of breathing difficulty. See also rapid breathing, apnea,
and other lung diseases.
Shortness of breath has many different causes. Obstruction of the air passages of
the nose, mouth, or throat may lead to difficulty breathing. Heart disease can cause
breathlessness if the heart is unable to pump enough blood to supply oxygen to the
body. If the brain, muscles, or other body organs do not receive enough oxygen, a
sense of breathlessness may occur. Sometimes emotional distress, such as anxiety,
can lead to difficulty breathing. Specific causes include the following:
- Lung disease
- Coronary artery disease
- Heart attack (myocardial infarction)
- Interstitial lung disease
- Pulmonary hypertension
- Rapid ascent to high altitudes, with less oxygen in the air
- Airway obstruction
- Inhalation of a foreign object
- Dust-laden environment
- Allergies (such as to mold, dander, or pollen)
- Congestive heart failure (CHF)
- Heart arrhythmias
- Deconditioning (lack of exercise)
- Compression of the chest wall
- Panic attacks
- Hiatial hernia
- Gastroesophageal reflux disease (GERD)
Breathing difficulty, whether sudden or long term, should always be taken seriously.
Though many causes are harmless and are easily corrected, any difficulty breathing
requires a thorough medical evaluation.
Follow prescribed therapy to treat the underlying cause.
When to Contact a Medical Professional
Go to the emergency room or call the local emergency number (such as 911) if difficulty
breathing comes on suddenly or seriously interferes with breathing, or if someone
completely stops breathing.
Call your provider if any of the following accompany breathing difficulties:
- Chest discomfort
- Shortness of breath after only slight exertion or while at rest
- Shortness of breath that wakes you up at night or requires you to sleep propped
up to aid breathing
- Wheezing (may be an indication of asthma or early emphysema)
- Having inhaled or choked on an object (foreign object aspiration or ingestion)
- Tightness in the throat or a barking, croupy cough
- Development of a fever or a significant cough
What to Expect at Your Office Visit
Your health care provider will take a detailed medical history and perform a physical
Medical history questions documenting breathing difficulty may include the following:
- Do you notice shortness of breath?
- Do you make grunting sounds while breathing?
- Do you seem to be having to work hard to breathe?
- How long has the difficulty been present?
- 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 occurrences (episodes)? How long does each last,
and does each episode have a similar pattern?
- Has the breathing difficulty worsened recently?
- Does breathing difficulty cause you to awaken at night (paroxysmal nocturnal
- Does the amount of breathing difficulty change (variable over hours)?
- Does breathing difficulty occur at rest?
- How long does each episode last?
- Is it worse when lying flat (orthopnea)?
- Is it worse with a change in 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 wheezing?
- Is the breathing pattern irregular?
- Do you draw back the chest muscles with breathing (intercostal retractions)?
- What other symptoms are also present?
The physical examination will include a thorough examination of the lungs, heart,
and upper airway passages.
Diagnostic tests that may be performed include the following:
- Blood tests including arterial blood gases
- Measurement of blood oxygen saturation (pulse oximetry)
- X-ray of the chest
- Pulmonary function tests
- Exercise testing
- CT scan of the chest
In severe cases of difficulty breathing, hospitalization may be required. Many
different medications, aimed at treating the cause of breathing difficulty, may be
used in treatment.
In situations where the blood oxygen level is significantly low, supplemental
oxygen is helpful. High doses of supplemental oxygen may be hazardous for some patients,
however, and is not necessary in all cases of shortness of breath.
Review Date: 4/12/2007
Reviewed By: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A.
Stacy. Previously reviewed by David A. Kaufman, M.D., Assistant Professor, Division
of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine,
New York, NY. Review provided by VeriMed Healthcare Network (8/7/2006).
Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission
(www.urac.org). URAC's accreditation program is an independent audit to verify that
A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among
the first to achieve this important distinction for online health information and
services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy
policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles
of the Health on the Net Foundation (www.hon.ch).
The information provided herein should not be used during any medical emergency or for
the diagnosis or treatment of any medical condition. A licensed medical professional should
be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for
all medical emergencies. Links to other sites are provided for information only -- they do
not constitute endorsements of those other sites. © 1997- 2007 A.D.A.M., Inc. Any duplication
or distribution of the information contained herein is strictly prohibited.