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Dyspnea: Causes, Symptoms, And Treatment Options
When you have shortness of breath, you can't catch your breath or get enough air in your lungs. Your doctor might call it dyspnea. It can be a warning sign of a health problem that needs treatment right away.
If you're a healthy adult, you breathe in and out up to 20 times a minute. That's nearly 30,000 breaths a day. A hard workout or the common cold might change that pattern from time to time, but you should almost never feel short of breath.
If you have new shortness of breath, call 911. If you have another health condition that makes you more likely to get seriously ill and you have a fever or cough, call your doctor to ask whether you might have COVID-19.
If you have sudden, severe trouble catching your breath, call 911. This is especially true if you also have nausea or chest pain.
Dyspnea vs. Shortness of breath
Dyspnea and shortness of breath mean the same thing. They are two different ways to label the same medical problem.
Dyspnea pronunciation
The way to pronounce dyspnea is [dis - pe - na].
Dyspnea and shortness of breath are two ways of saying the same thing. Photo Credit: Catherine McQueen / Getty Images
When you have dyspnea, you might feel:
It can be acute (sudden dyspnea) or chronic (long-lasting dyspnea). Acute dyspnea starts within a few minutes or hours. It can happen with other symptoms like a fever, rash, or cough. Chronic dyspnea can make you feel out of breath with everyday tasks, such as walking from room to room or standing up.
Sometimes, shortness of breath gets better or worse with certain body positions. For example, lying down flat can trigger shortness of breath in people who have certain types of heart and lung disease. Keeping track of your symptoms can help your doctor figure out what's wrong and recommend the best treatment.
Many conditions can cause shortness of breath. The most common causes of shortness of breath are:
Some of the more common causes of long-term dyspnea are:
Other things, including lung cancer and tuberculosis, can make you feel out of breath. If you have dyspnea and don't know why, see your doctor to find out.
How to tell if shortness of breath is from anxiety
Anxiety-induced shortness of breath often occurs during or immediately after periods of stress, worry, panic, or anxiety attacks. If you notice that your breathing difficulties coincide with these emotional states, it may be a sign of anxiety-related shortness of breath. If you have anxiety-related shortness of breath, you may have rapid, shallow breathing or hyperventilation. This can lead to feelings of breathlessness and a sense of not being able to catch one's breath. If you find that relaxation techniques such as deep breathing exercises, meditation, or calming activities temporarily help your shortness of breath, it may suggest that anxiety is the underlying cause.
Dyspnea during pregnancy
Shortness of breath is common during pregnancy. Because your body is adapting to pregnancy, it is normal to experience some dyspnea. However, if you experience severe or persistent shortness of breath, chest pain, or any other concerning symptoms, it is crucial to seek immediate medical attention to rule out any serious medical conditions.
The doctor will examine you and listen carefully to your lungs. You might have a lung function test, called spirometry, to measure how much air you can blow in and out of your lungs and how fast you do it. This can help diagnose asthma and COPD.
Other tests you might have include:
Dyspnea scale
Doctors use a Modified Medical Research Council (mMRC) dyspnea scale to rate the severity of your shortness of breath. The scale goes from 0 to 4, with 0 being "I only get breathless during strenuous exercise" to 4 being "I am too breathless to leave the house or I am breathless when dressing."
Breathing and relaxation methods may help. But your shortness of breath treatment will depend on what's causing your dyspnea. For example, if you have asthma, you may get an inhaler to use when you have a flare. If there's fluid in your lungs, the doctor might need to drain it. If an infection or a blood clot is making you feel short of breath, you could need medication. You also might get oxygen. If you take medications, always take them as your doctor prescribes. And if possible, try to keep up a regular exercise routine. Staying at a healthy weight and being active on a normal basis are important to overall well-being.
You often can build up your lung strength with exercise. Ask your doctor what activities are right for you. If you smoke, quitting is the ideal option to help with shortness of breath and overall health. Also, try to avoid being around secondhand smoke and other pollutants. Try not to be active in extreme temperatures such as very hot or humid or overly cold climates. If you travel somewhere with an elevation change, take time to adjust before exerting yourself. Make sure to stick to your medication and care plans carefully. And check ozone warnings before going outside to see what the air quality is like.
Shortness of breath is not a symptom to ignore. Call your doctor if your symptoms change, if your problem gets worse after you use an inhaler, or if your shortness of breath comes along with:
Call 911 or have someone take you to the emergency room if:
Dyspnea or shortness of breath is when it's difficult for you to get enough air in your lungs. If you feel tightness in your chest, wheezing, coughing, or heart palpitations, on top of not being able to breathe, you may have dyspnea. Conditions from anxiety to asthma can lead to shortness of breath, and doctors use a scale to rank how severe yours is. You shouldn't ignore this symptom, and if it comes on suddenly and severely, go to the ER right away.
There are many causes of shortness of breath as listed above, from pregnancy to heart failure to asthma.
If your lips or fingertips are blue, there is chest pain with your shortness of breath, and it has come on suddenly, these are all signs of severe dyspnea and you should immediately go to the ER.
Shortness of breath can be mild to severe depending on the situation. It can range from needing no treatment to being a sign of something life threatening and so should never be ignored.
Some of the main symptoms of dyspnea are shortness of breath, tightness in your chest, being hungry for air, and not being able to breathe deeply.
Pulmonary Arterial Hypertension
Pulmonary hypertension is a life-threatening condition that gets worse over time, but treatments can help your symptoms so you can live better with the disease. It may take some planning, but plenty of people who have it find ways to do all the things they love, just as they did before they were diagnosed.
Having pulmonary arterial hypertension (PAH) means that you have high blood pressure in the arteries that go from your heart to your lungs. It's different from having regular high blood pressure.
With PAH, the tiny arteries in your lungs become narrow or blocked. It's harder for blood to flow through them, and that raises the blood pressure in your lungs. Your heart has to work harder to pump blood through those arteries, and after a while the heart muscle gets weak. Eventually, it can lead to heart failure.
Sometimes doctors can't find a reason for high blood pressure in the lungs. In that case, the condition is called idiopathic pulmonary hypertension. Genes may play a role in why some people get it.
In other cases, there is another condition that's causing the problem. Any of these illnesses can lead to high blood pressure in your lungs:
You may not notice any symptoms for a while. The main one is shortness of breath when you're active. It usually starts slowly and gets worse as time goes on. You may notice that you can't do some of the things you used to without getting winded.
Other symptoms include:
If you have shortness of breath and see your doctor, they will ask you about your medical history. They may also ask you:
Your doctor may order tests, including:
Echocardiogram: This ultrasound picture of the beating heart can check blood pressure in the pulmonary arteries.
CT scan: This can show enlarged pulmonary arteries. A CT scan can also spot other problems in the lungs that could cause shortness of breath.
Ventilation-perfusion scan (V/Q scan): This test can help find blood clots that can cause high blood pressure in the lungs.
Electrocardiogram (EKG or ECG): An EKG traces the heart's activity and can show whether the right side of the heart is under strain. That's a warning sign of pulmonary hypertension.
Chest X-ray: An X-ray can show if your arteries or heart are enlarged. Chest X-rays can help find other lung or heart conditions that may be causing the problems.
Exercise testing: Your doctor may want you to run on a treadmill or ride a stationary bike while you are hooked up to a monitor, so they can see any changes in your oxygen levels, heart function, lung pressure, or other things.
Your doctor may also do blood tests to check for HIV and conditions like rheumatoid arthritis or lupus.
If these tests show that you might have pulmonary hypertension, your doctor will need to do a right heart catheterization to be sure. Here's what happens during that test:
Right heart catheterization is safe. The doctor will give you a sedative and use local anesthesia. You can usually go home the same day, although you will need someone to drive you home.
You may want to write down a list of questions before your appointment, so you can make sure you ask your doctor everything you want to. It can also help to have a friend or family member with you to help you get the answers you want.
Some possible questions are:
Pulmonary hypertension varies from person to person, so your treatment plan will be specific to your needs. Ask your doctor what your options are and what to expect.
First, your doctor will treat the cause of your condition. For example, if emphysema is causing the problem, you'll need to treat that to improve your pulmonary hypertension.
Most people also get treatment to improve their breathing, which makes it easier to be active and do daily tasks. Oxygen therapy, when you breathe pure oxygen through prongs that fit in your nose, will help if you're short of breath and have low oxygen levels in your blood. It helps you live longer when you have pulmonary hypertension. If you are at risk for blood clots your doctor will recommend blood thinners. Other medicines improve how well your heart works and keep fluid from building up in your body.
If you have severe pulmonary hypertension, your doctor may prescribe medications called calcium channel blockers. These medicines lower blood pressure in the lungs and the rest of the body.
If calcium channel blockers aren't enough, your doctor may refer you to a specialized treatment center. You may need more targeted therapies that can open up your narrowed blood vessels. They may be pills, medicines you breathe in, or drugs that are given through an IV. Options include:
In more severe cases, or if medicines don't help, your doctor may recommend a lung transplant or a procedure called atrial septostomy. A surgeon creates an opening between the right and left sides of the heart. This surgery can have serious side effects.
One of the best things you can do for yourself is to stay active, even if you have shortness of breath. Regular exercise, like taking a walk, will help you breathe better and live better. Talk to your doctor first to find out what kind of exercise is best for you, and how much you should do. Some people may need to use oxygen when they exercise.
Get plenty of rest, too. Pulmonary hypertension makes you tired, so get a good night's sleep and take naps when you need to.
Just like anyone else, it's good for you to eat a healthy diet with lots of fruits, vegetables, and whole grains. That's important for your overall health.
A lot depends on what's causing your pulmonary hypertension. Treating an underlying condition will help you feel better. There's no cure for pulmonary hypertension, but the earlier it's diagnosed, the easier it is to live with.
If you have idiopathic pulmonary hypertension -- the kind where doctors can't find a cause -- your symptoms may get worse over time. But treatment can slow down the progress of the disease and help you live longer.
Remember that each person is different, and there are good treatments available. Work with your doctor to find what's right for you.
The Pulmonary Hypertension Association offers in-depth information on everything from medications to tips on making daily tasks easier. It also has an active online support community.
Why Do I Have Pain Under My Left Breast?
What to Do When You Have Left Breast Pain?Athima tongloom - Getty Images
Experiencing random aches and pains is just part of life. But when you have pain under your left breast, it's understandable to have questions. After all, your heart and a bunch of other vital organs are in the general vicinity…is this something you need to worry about?
Here's the thing: There's no one-size-fits-all answer. "When differentiating between causes of chest pain, there are many things to consider," says Anais Hausvater,, M.D., a cardiologist at NYU Langone Heart.
You don't necessarily want to assume the worst (a heart attack or something similar), but you also don't want to rule it out, either, says Yu-Ming Ni, M.D., a cardiologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif. "Left breast pain or just left-sided chest pain can be a wide variety of things," he says. "Some of them are pretty benign and not concerning; Others are more concerning."
With that, there's a lot to go over. Here's what could be behind the pain under your left breast, what to do about it, and when to seek medical care.
What are the main causes of pain under your left breast?There can be a bunch of different potential reasons why you're having pain in this area, but doctors say these are the biggest ones to keep in mind.
Muscle sorenessThere are a bunch of muscles in your chest, and it's entirely possible to pull or strain one, leading to pain in the area, says Harmony R. Reynolds, M.D., director of the Sarah Ross Soter Center for Women's Cardiovascular Research at NYU Grossman School of Medicine. "Chest pain can come from the muscles and bones, such as from a pulled muscle," she says. This type of pain usually feels more dull and the area may even feel tender if you touch it, Dr. Ni says.
Tight braIt seems random, but Dr. Ni says he's seen this. "I had one patient with chest pain and it turned out that the problem was her bra size was too small," he says. "She got her bra re-fitted—she actually had it measured—and the left breast pain went away." If your pain started around the time you got a new bra, or you notice that your chest size seems to have gone up lately, this is at least worth considering.
Acid refluxAcid reflux is what happens when the contents in your stomach come back up into your esophagus, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says. It can lead to a range of symptoms, including heart burn, chest pain, nausea, problems swallowing, hoarseness, and a cough. There is usually some kind of link to certain foods, like those that have high amounts of acid, says Joanna Troulakis, M.D., a cardiologist at NewYork-Presbyterian Queens. "It may be worse when lying down shortly after a meal, and it may be associated with gas in the abdomen, burning in the esophagus, a lump sensation in the throat, and/or a bad taste in the mouth," she says.
CostochondritisCostochondritis is an inflammation of the cartilage that connects a rib to the breastbone, the Mayo Clinic explains. It usually impacts the upper ribs on the left-hand side of your body and can cause a sharp, aching, or pressure-like feeling. It can also feel worse when you take a deep breath, cough, or sneeze, the Mayo Clinic says. "Like other causes of musculoskeletal pain, is superficial," Dr. Troulakis says.
Tietze syndrome"Tietze syndrome is similar to costochondritis, in that the joints between the ribs and the sternum may be inflamed," Dr. Troulakis says. It's slightly different, though: Tietze syndrome also causes the joint to swell. It also usually impacts ribs closer to your shoulders, the Cleveland Clinic says. The pain can be worse when you move or twist your upper body, and it may hurt to sit or lay down in certain positions, the organization says.
PleurisyPleurisy is an inflammation of the lining of the lungs and chest called the pleura, Penn Medicine explains. It can cause chest pain when you take a breath or cough. "It can be from any number of reasons—an infection, immune reaction, a virus, or physical activity that caused a little irritation in the area," Dr. Ni says. While it can be uncomfortable, Dr. Ni says that it's "a pretty benign condition on its own."
PericarditisPericarditis is inflammation of the pericardium, a sac-like structure with two thin layers of tissue that surround the heart to hold it in place, according to the American Heart Association (AHA). "The pain is more typical with certain positions," Dr. Ni says. Leaning forward may make your chest feel better with pericarditis, while laying flat on your back can make it feel worse, he says. "It can be quite painful," Dr. Ni adds.
Angina
Angina is chest pain that happens when an area of your heart muscle doesn't get enough oxygen-rich blood, according to the National Heart, Lung, and Blood Institute (NHLBI).The pain can happen when your heart is working hard and may go away when you rest. It can feel like pressure or squeezing in your chest, and may spread to your shoulders, arms, neck, jaw, or back, the NHLBI says. "Angina is concerning," Dr. Ni says. "It can indicate a scenario where you're at risk of heart attack in the future."
Pulmonary embolismPulmonary embolism is a blockage in a lung artery, the American Lung Association (ALA) explains. It's usually caused by a blood clot in the leg that travels to the lungs, and is a life-threatening medical emergency. Symptoms can include sudden shortness of breath, sharp chest pain that can become worse when breathing in, a cough that can contain blood, leg pain or swelling, pain in your back, excessive sweating, and blueish lips or nails. "This condition is also usually associated with a fast heart rate and low oxygen saturation, which can be life-threatening," Dr. Troulakis says. If you suspect that you have a pulmonary embolism, you need to seek medical care immediately.
Heart attackA heart attack happens when an artery that sends blood and oxygen to the heart is blocked, the Mayo Clinic says. It can cause a range of potential symptoms, including chest pain that can feel like pressure, tightness, pain, squeezing, or aching, as well as fatigue, nausea, and shortness of breath. A heart attack is a medical emergency—you should call 911 if you suspect that you or a loved one is having a heart attack, Dr. Ni says.
How to treat pain under your left breastThe right treatment for pain under your left breast ultimately depends on the cause. If you suspect that you're dealing with a muscle issue, over-the-counter medications like acetaminophen and ibuprofen may help with the pain, Dr. Ni says.
Think your chest pain could be due to acid reflux? Dr. Hausvater suggests trying an antacid. (It's also a good idea to see your doctor if you regularly struggle with acid reflux, Dr. Ni says.)
But if you suspect that your chest pain is due to something going on with your heart or lungs, Dr. Ni says it's best to see a doctor.
When to see a doctor for pain under your left breastIf you have pain and it's concerning you, Dr. Ni says it's a good idea to get it checked out. But there are some situations where pain under your left breast should be evaluated ASAP.
"Pain or discomfort in or around the chest that is unfamiliar to you and lasts more than 10 to 15 minutes should be checked out immediately in an emergency room," Dr. Reynolds says. "It's better to jump to the wrong conclusion and have a false alarm than to miss a heart attack."
Still, she says, you don't need to panic every time you have pain under your left breast. "Most chest pain is not from heart attack," Dr. Reynolds says.
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