What Do I Do When It's Hard to Breathe?

Reviewed on 12/2/2020

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.
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.

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:

The five most common causes of chronic breathing difficulty (dyspnea) include:

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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 
  • 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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Reviewed on 12/2/2020
References
https://www.uptodate.com/contents/approach-to-the-patient-with-dyspnea

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