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Shortness of Breath, by Dr. Zach Levine

BT Montreal | posted Tuesday, Oct 24th, 2017

Shortness of breath (aka dyspnea) is the feeling of not being able to get enough air.  It is very uncomfortable and quite common.  It results from the brain sensing that the tissues are not getting enough oxygen, or CO2 is too high.


Shortness of breath is one of the most common reasons people go to the ER (along with chest pain, injuries, abdominal pain, back pain, headache, and infections).  Almost everyone experiences it at some point in their life.


Dyspnea is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations[2] or light exertion.


In 85% of cases it is due to lung disease, heart disease, or psychological causes, specifically asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, chronic obstructive pulmonary disease, or psychogenic causes,[2][3] such as panic disorder and anxiety.[4] Treatment typically depends on the underlying cause.[5]


Causes range from the benign to the life-threatening:


Lung and airway causes: pneumonia




Pneumothorax (punctured lung)

Airway blockage from mass or infection


Being physically deconditioned (in bad shape) and exerting yourself


Cardiac (heart) problems:

Heart failure causing fluid backup into the lungs

Inflammation or swelling on the pericardium (the lining around the heart)

Inflammation of the heart muscle


Circulatory problems heart and lungs):

Pulmonary embolus (blood clot in the lungs)



Blood problems:

Anemia (low oxygen delivery to tissues due to low levels of hemoglobin in



Hormone problems:


Adrenal Gland insufficiency


Nerve problems:

Amyotrophic Lateral sclerosis (Lou Gherig’s Disease)

Guillane Barre Syndrome

Myasthenia Gravis


Psychiatric Problems:

Panic Attack

Generalized Anxiety Disorder


With so many causes for shortness of breath, what is one to do when one feels short of breath?  The safest thing to do is, of course, to see a doctor.  In a very brief period of time the doctor can rule out almost all of the causes and narrow it down to a handful of possibilities.


When discussing your case with you, the doctor will ask you how long the symptom has been present, what makes it better or worse, and what other symptoms you are suffering from.  In addition the doctor will find out about your medical history, medications, and recent illnesses.  The doctor will certainly ask whether you smoke, the major cause of COPD (chronic lung disease) and lung cancer, and whether you have been exposed to things that are potentially harmful to the lungs, such as asbestos.


Then the doctor will examine you.  First he or she will check your vital signs — your heart rate, blood pressure, oxygenation, and temperature.  Then they will listen to your heart and lungs and possibly examine other parts of you, if needed.


Finally, testing may be necessary.  Tests may include x-ray or CT scan of the lungs, pulmonary function tests to see how well you are able to inhale and exhale, and blood tests, and possibly more specialized testing.


Once all of this is done the doctor can give you a clear diagnosis and treatment plan.  Once you have this you no longer dealing with the fear of the unknown.


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