What Does Difficulty Breathing Feel Like?
![If it is hard to breathe it's important to see a doctor to diagnose the cause and receive proper treatment. Some causes of breathing difficulty can be life-threatening. Difficulty breathing (dyspnea) may be characterized by shortness of breath, difficulty getting a breath in, or pain when breathing and can be a sign of a serious medical condition.](https://images.medicinenet.com/images/article/main_image/what-is-breath-sound-assessment.jpg?output-quality=75)
Difficulty breathing (dyspnea) may be characterized by shortness of breath, difficulty getting a breath in, or pain when breathing and can be a sign of a serious medical condition. Shortness of breath may be acute (sudden dyspnea) or chronic (long-term dyspnea).
If it is hard to breathe it’s important to see a doctor to diagnose the cause and receive proper treatment. Some causes of breathing difficulty can be life-threatening.
What Are Symptoms of Difficulty Breathing?
Symptoms of difficulty breathing include:
- Shortness of breath
- Pain when breathing
- Feeling unable to breathe properly/inhale deeply
- Wheezing
- Rapid, shallow breathing
- Increased effort to breathe
- “Air hunger”
- Heavy breathing
- Feeling of suffocation
Symptoms that may accompany difficulty breathing include:
- Cough
- Chest pain/tightness
- Sweating
- Blue lips or nails
- Pale skin
- Sputum production
- Stuffy nose
- Swelling of extremities
- Raynaud’s phenomenon (cool blue extremities)
- Joint swelling
- Muscle weakness
When it’s hard to breathe, see a doctor immediately or call 911 if you have difficulty breathing and:
- Symptoms have a sudden onset
- Pain or pressure in the chest
- Fever
- Swelling in your feet and ankles
- Trouble breathing when you lie flat
- Chills
- Cough
- Wheezing
- Is associated with itching, hives, or facial/lip swelling
- Feeling like your throat is swollen
- Shortness of breath becomes more severe
- Palpitations
- Lightheadedness or feeling faint
- Is accompanied by severe confusion, chest or jaw pain, or pain down your arm
What Causes Difficulty Breathing?
Emergency causes for difficulty breathing include:
- Head, eyes, ears, nose, and throat (HEENT):
- Angioedema
- Severe allergic reaction (anaphylaxis)
- Throat infections
- Deep neck infections
- Foreign body in airway (choking)
- Neck trauma
- Chest wall
- Rib fractures
- Flail chest
- Pulmonary (lung-related)
- Chronic obstructive pulmonary disease (COPD)
- Asthma exacerbation
- Blood clot in the lung (pulmonary embolism, or PE)
- Collapsed lung (pneumothorax)
- Lung infection by bacteria, virus or fungus
- COVID-19 coronavirus infection
- Acute respiratory distress syndrome (ARDS)
- Pulmonary contusion or other lung injury
- Bleeding (hemorrhage)
- Cardiac (heart-related)
- Acute coronary syndrome
- Acute decompensated heart failure
- Flash pulmonary edema
- High output failure
- Cardiomyopathy
- Arrhythmia
- Valvular dysfunction
- Cardiac tamponade
- Neurologic
- Stroke
- Neuromuscular disease
- Toxic/metabolic
- Organophosphate poisoning
- Salicylate poisoning
- Carbon monoxide (CO) poisoning
- Toxic ingestion
- Diabetic ketoacidosis
- Sepsis
- Anemia
- Acute chest syndrome
- Miscellaneous
- Hyperventilation
- Anxiety
- Pneumomediastinum
- Lung tumor
- Pleural effusion
- Ascites
- Pregnancy (not a cause of dyspnea but may worsen it)
- Massive obesity (not a cause of dyspnea but may worsen it)
The five most common causes of chronic breathing difficulty (dyspnea) include:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Interstitial lung disease
- Heart problems
- Obesity/deconditioning
How Is Difficulty Breathing Diagnosed?
It is important to diagnose the underlying cause of why it is hard to breathe in order to determine treatment. In addition to a physical examination, tests may include:
- Chest X-ray
- Ultrasound
- Electrocardiogram (ECG)
- Blood tests
- Cardiac biomarkers (e.g., troponin I)
- Brain natriuretic peptide (BNP)
- D-dimer
- Arterial and venous blood gas
- Carbon dioxide monitoring
- Chest computerized tomography scan (CT)
- Pulmonary ventilation/perfusion (V/Q) scan
- Negative inspiratory force (NIF)
- Multidetector computed tomography (MDCT) scan of the chest
- Peak flow and pulmonary function tests (PFTs)
Tests for chronic shortness of breath depend on the suspected cause and may include any of the above tests, as well as:
- Blood tests
- Complete blood count
- Glucose, blood urea nitrogen, creatinine, electrolytes
- Thyroid stimulating hormone (TSH)
- Spirometry pre and post inhaled bronchodilator
- Pulse oximetry during ambulation at a normal pace over approximately 200 meters and/or up two to three flights of stairs
What Is the Treatment for Difficulty Breathing?
Treatment for acute difficulty breathing in an emergency setting usually includes:
Oxygen
- Determining if the patient needs emergency airway management and ventilatory support
- Establishing the most likely causes of the difficulty breathing and initiating treatment
Treatment for chronic breathing problems varies widely depending on the cause. For example:
- If chronic difficulty breathing is caused by asthma, that may be treated with medications such as bronchodilators or inhaled steroids
- If chronic difficulty breathing is caused by a blood clot (pulmonary embolism), you may need blood thinners
- If chronic difficulty breathing is caused by fluid in the lungs, that fluid may need to be drained
What Are Complications of Difficulty Breathing?
Complications of difficulty breathing include:
- Low blood oxygen (hypoxia)
- Loss of consciousness
- Brain Damage
- Cognitive impairment
How Do You Prevent Difficulty Breathing?
Some causes of difficulty breathing may be prevented, and in doing so, this will prevent difficulty breathing from developing or worsening.
- Don’t smoke or quit smoking
- Lose weight and maintain a healthy weight
- Avoid allergens
- Practice stress reduction techniques
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https://www.uptodate.com/contents/evaluation-of-the-adult-with-dyspnea-in-the-emergency-department
https://www.cedars-sinai.org/blog/shortness-of-breath.html