Dyspnea, generally known as shortness of breath, is a feeling of labored breathing that involves mixed sensations of variable severity. It can happen during physical activities like walking or climbing stairs or even while resting. Dyspnea can also be a sign of various conditions, such as respiratory, cardiac, neuromuscular, psychogenic, or systemic illness or a combination of these.
The onset of dyspnea can be acute or chronic, distinguished between hours to days in acute and over more than 4 to 8 weeks in chronic. Around 10% of the adult population deals with dyspnea each year in the U.S. alone. Moreover, many people tend to ignore this issue, which results in distress and anxiety at later stages. Read on to find out what dyspnea is, its symptoms, shortness, major causes, and treatment options.
What is Dyspnea?
Dyspnea is the medical term for shortness of breath. It can manifest as an intense feeling of needing more air or struggling to breathe. The sensation can be frightening and range from mild discomfort to overwhelming breathlessness.
Dyspnea is not a condition on its own but a symptom of other underlying health problems, including respiratory, cardiac, and psychological issues. For some, dyspnea is noticeable only during physical activity, known as dyspnea on exertion. Others may experience it even at rest.
8 Major Types of Dyspnea
Different conditions manifest with shortness of breath for varying duration and reasons. This forms the basis for classifying dyspnea into different types, which are discussed as follows:
- Acute Dyspnea
Acute dyspnea is a sudden onset of shortness of breath that lasts from a few hours to a day. It can be caused by physical activity, stress, allergic reactions, colds, or respiratory infections. In some cases, acute dyspnea may indicate serious conditions like heart problems or lung infections that require immediate medical attention.
This condition can also have an emotional impact on patients. Feelings of anxiety or fear can arise due to the difficulty in breathing, which may worsen their symptoms. Therefore, doctors should address both the physical and emotional aspects of acute dyspnea for effective treatment and recovery.
- Chronic Dyspnea
Chronic dyspnea lasts more than 2-3 weeks. It’s often caused by long-term health conditions like asthma, chronic obstructive pulmonary disease (COPD), heart failure, or pulmonary hypertension. This type of dyspnea requires proper diagnosis and continuous management.
- Paroxysmal Nocturnal Dyspnea (PND)
Paroxysmal nocturnal dyspnea refers to sudden breathing difficulties during sleep, causing you to wake up gasping for air. This is often linked to heart failure, as lying flat can cause fluid to accumulate in the lungs and make breathing difficult.
- Orthopnea
Orthopnea is shortness of breath that occurs when lying flat and improves upon sitting or standing. It is commonly related to heart conditions, such as congestive heart failure, where fluid buildup makes breathing harder when lying down.
- Platypnea
Platypnea is the opposite of orthopnea. It causes breathing problems when one is upright and feels better when lying down. This rare condition is often linked to heart or lung issues, such as liver cirrhosis or a heart defect.
- Trepopnea
Trepopnea happens when lying on one side causes breathing difficulties but improves when lying on the other side. It is often associated with certain heart or lung conditions that compress or shift structures in your chest when lying in a specific position.
- Psychogenic Dyspnea
Psychogenic dyspnea refers to breathing issues related to anxiety or psychological stress. It does not occur due to physical health problems but can still cause real symptoms like hyperventilation, chest tightness, dizziness or lightheadedness, numbness or tingling, rapid heartbeat, sweating, feeling faint, difficulty concentrating, fatigue, sleep disturbances, feelings of detachment, or the feeling of not getting enough air.
- Exertional Dyspnea
Exertional dyspnea occurs during physical activities like climbing stairs, walking, or exercising. It’s usually a symptom of heart or lung conditions, such as COPD, asthma, or heart disease, that make it harder for the body to get enough oxygen during exertion.
Read More: Hyperventilation: Causes, Treatments, and Prevention
What Are the Causes of Dyspnea?
Dyspnea can result from a wide range of conditions. These are mainly divided into four categories: respiratory, cardiovascular, neuromuscular, and psychogenic.
- Respiratory Causes
Problems in the respiratory system are among the leading causes of shortness of breath. Conditions like asthma, pneumonia, chronic bronchitis, cystic fibrosis, and chronic obstructive pulmonary disorder (COPD) often lead to dyspnea. Lung infections or irritants causing inflammation can also make breathing difficult, leading to discomfort. Additionally, pulmonary embolism and pneumothorax are critical issues requiring urgent attention.
- Cardiovascular Causes
Heart conditions such as congestive heart failure (CHF), pulmonary edema, and acute coronary syndrome can cause shortness of breath. These issues restrict the heart’s ability to pump blood efficiently, causing fluid buildup in the lungs. Other concerns include cardiac arrhythmias, pulmonary hypertension, and valvular heart defects.
- Neuromuscular Causes
Disorders affecting the muscles or nerves controlling breathing can also lead to dyspnea on exertion. Conditions like spinal cord injuries, muscular dystrophy, or phrenic nerve paralysis impair the body’s ability to maintain adequate airflow.
- Psychogenic Causes
In some cases, dyspnea may stem from psychological issues. Stress, anxiety, and hyperventilation syndrome can make individuals feel like they’re not getting enough air, even when their oxygen levels are normal. This category includes conditions such as panic attacks and vocal cord dysfunction syndrome, which can be worsened by anxiety.
Symptoms and Pathophysiology of Dyspnea
Dyspnea symptoms vary widely but typically include chest tightness, shallow breathing, and a sensation of suffocation. Thus, accurate medical evaluation is necessary. This may involve questions such as how long the condition has persisted, how often symptoms occur, and whether they occur when resting or during exercise. Some of the key symptoms of dyspnea directing to some other major conditions are as follows:
- Chest Tightness
Chest tightness can arise from various causes related to dyspnea, including asthma, chronic obstructive pulmonary disease (COPD), pneumonia, bronchitis, heart conditions like angina and myocardial infarction, anxiety disorders, panic attacks, pulmonary embolism, interstitial lung disease, gastroesophageal reflux disease (GERD), rib injuries, costochondritis, and even certain medications.
Other potential causes may include obesity, hyperventilation, and allergic reactions that affect the airways, all of which contribute to feelings of pressure or discomfort in the chest.
- Rapid Breathing
Rapid breathing, or hyperventilation, is when you breathe faster than usual without physical exertion. It can be triggered by stress, panic attacks, lung infections, caffeine, or medical conditions like asthma or heart problems, leading to dizziness or light-headedness.
- Inability to Take Deep Breaths
This symptom involves feeling like you can’t fully inhale or expand your lungs, making each breath feel shallow or incomplete. It’s often linked to lung conditions like asthma, anxiety, or fluid buildup in the lungs, affecting breathing efficiency.
- Wheezing
Wheezing is a high-pitched whistling sound that usually occurs during exhalation. It’s commonly associated with asthma, allergies, or infections that cause airway narrowing. Wheezing indicates restricted airflow and often accompanies shortness of breath.
Read More: How to Manage a Respiratory Arrest?
How is Dyspnea Diagnosed?
Diagnosing dyspnea involves a systematic approach, including medical history, physical examination, and diagnostic tests. These tests help identify the shortness of breath causes and differentiate between acute and chronic conditions.
Medical History and Physical Examination
Healthcare providers gather information on the onset and severity of dyspnea, a history of cardiovascular or respiratory issues, and the presence of any other symptoms, such as fever, cough, or chest pain. Physical exams focus on breathing patterns, oxygen saturation, and the use of accessory muscles during breathing.
Diagnostic Tests for Dyspnea
After a thorough physical exam, doctors often rely on diagnostic tests to pinpoint the root cause. The following are the main diagnostic methods used by healthcare professionals:
- Vital Sign Assessment
Checking vital signs involves measuring heart rate, breathing rate, oxygen levels, and body temperature. This gives doctors important clues about a patient’s health and helps identify issues like infections, heart problems, or low oxygen levels.
- Chest X-ray
A chest X-ray is typically the first test conducted to assess lung or heart issues. It can reveal infections, fluid buildup, or abnormalities in the lungs or heart that may be causing breathing problems.
- Echocardiogram and ECG
An echocardiogram uses sound waves to create images of the heart, while an ECG records electrical signals. Together, they help detect heart conditions like valve problems, weak heart muscles, or irregular rhythms.
- Spirometry
Spirometry measures lung function by checking how much air you can inhale and exhale. It’s used to diagnose conditions like asthma, COPD, or other lung diseases by assessing airflow restrictions or reduced lung capacity.
- Arterial Blood Gas Test
This test measures the levels of oxygen and carbon dioxide in your blood. It helps doctors understand how well your lungs are functioning and if there are issues like low oxygen levels or high carbon dioxide.
- V/Q Scan
A V/Q scan examines blood and airflow in the lungs. It’s used to detect a pulmonary embolism, which is a blocked blood vessel in the lungs, especially if oxygen levels are unusually low.
- CT Scan
A CT scan takes detailed images of the chest to look for blockages, tumors, or other abnormalities in the lungs and surrounding tissues. It helps provide a clearer view than a standard X-ray.
- Blood Tests
Blood tests, like a complete blood count, measure different components of your blood. These tests help identify issues like anemia, infections, or inflammation that might be causing shortness of breath.
- Cardiac Catheterization
This test involves inserting a thin tube into the heart’s blood vessels to measure pressure and assess heart function. It helps find issues like high blood pressure in the lungs or heart-related problems.
- Exercise Pulmonary Function Tests
These tests evaluate how well your lungs and heart function during exercise. They can help identify whether breathing problems are due to physical deconditioning, anxiety, or other causes, such as heart disease.
Long-Term Treatment Plans to Breathe Easier
Dyspnea treatment depends on the underlying causes. The best way to find relief from the symptoms is by addressing the root cause so that complications can be further averted. The following are the main treatments for dyspnea:
- Acute Dyspnea Treatment
Providing supplemental oxygen is often the first step in sudden and severe breathing difficulties. In cases of respiratory failure, doctors may insert a breathing tube to ensure the airway remains open. Stabilizing the patient and conducting tests to identify the root cause is crucial.
- Chronic Dyspnea Management
Long-term treatments for ongoing dyspnea depend on the underlying condition. For example, asthma patients may require inhalers, while those with heart failure might need diuretics or other medications to reduce fluid buildup. Pulmonary rehabilitation can also help individuals with chronic lung diseases improve their breathing efficiency.
- Medications and Therapies
Medications are prescribed based on the cause of dyspnea. Bronchodilators and steroids are common choices for respiratory-related dyspnea. Diuretics and vasodilators may be recommended for cardiovascular causes. Additionally, anxiolytics are given to patients experiencing psychogenic dyspnea.
- Breathing Exercise
Breathing exercises will help you concentrate on your breathing and lung action. Two such exercises that will be helpful for you include:
- Abdominal Breathing
This exercise uses your diaphragm, the muscle under your lungs. As you inhale, focus on filling your lungs fully and letting your stomach expand outward. As you exhale, let your stomach slowly fall, and your lungs empty.
- Pursed-Lip Breathing
Inhale deeply through your nose, then gently purses your lips like you are going to whistle. Slowly exhale through your mouth, controlling the breath. Moreover, counting during each inhale and exhale can help you stay focused and relaxed.
Key Takeaway on Managing Dyspnea
Shortness of breath, or dyspnea, is an unpleasant sensation that can indicate a possible health problem ranging from respiratory illness to heart disease. Thus, patients should be aware of key causes and types to get the appropriate treatment on time. In addition, regular follow-up evaluations and prompt interventions improve the quality of life for those suffering from dyspnea.
Moreover, you should take courses on basic life support to have the confidence and knowledge to help those experiencing breathing difficulties.
