Shortness of breath  

Introduction 

Questions to think about while you are waiting for the doctor

  • Did the breathlessness come on suddenly or gradually?
  • Did anything trigger it, such as exercise?
  • How bad is it – does it only happen when you have been active, or when you are not doing anything?
  • Is there any pain when you breathe?
  • Do you have a cough?
  • Do certain positions make it worse – for example, are you unable to lie down?

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Sudden shortness of breath, or breathing difficulty, is the most common reason for visiting a hospital accident and emergency department.

It's also one of the most common reasons people call 999 for an ambulance.

It is normal to get out of breath when you have over-exerted yourself, but when breathlessness comes on suddenly and unexpectedly, it is usually a warning sign of a medical condition. The medical name for it is dyspnoea.

What you should do

You should call your GP immediately if you have sudden shortness of breath, as there may be a problem with your airways or heart. Your GP will assess you over the phone and may either visit you at home or admit you to hospital. 

If your shortness of breath is due to anxiety, you may be asked to come to the surgery rather than a home visit.

Feeling that you cannot get enough air can be terrifying, but doctors are well trained in managing this. You will be given oxygen to breathe through a mask to help your symptoms while they investigate and treat the health condition causing your breathing problems.

If you have struggled with your breathing for a while, don't ignore it: see your GP as it is likely that you have a long-term condition, such as obesityasthma or chronic obstructive pulmonary disease, which will need managing properly.

The information below outlines the most common reasons for:

  • shortness of breath that has come on suddenly
  • shortness of breath that has lasted for a while

This guide should not be used to self-diagnose your condition, but should give you an idea of what is causing your breathlessness.

Causes of sudden shortness of breath

Sudden and unexpected breathlessness is most likely to be caused by one of the following health conditions. Click on the links below for more information about these conditions.

A problem with your lungs or airways

Sudden breathlessness could be an asthma attack. This means your airways have narrowed and you will produce more phlegm (sticky mucus), which will cause you to wheeze and cough. You will feel breathless because it will be difficult to move air in and out of your airways.

Your GP may advise you to use a spacer device with your asthma inhaler. This will deliver more medicine to your lungs, helping to relieve your breathlessness.

Pneumonia (lung inflammation) may also cause shortness of breath and a cough. It is usually caused by an infection, so you will need to take antibiotics.

If you have chronic obstructive pulmonary disease (COPD), it is likely your breathlessness is a sign this condition has suddenly got worse.

A heart problem 

It is possible to have a "silent" heart attack without experiencing all the obvious symptoms, such as chest pain and overwhelming anxiety. In this case, shortness of breath may be the only warning sign you are having a heart attack. If you or your GP think this is the case, they will give you aspirin and admit you to hospital straight away.

Heart failure can also cause breathing difficulties. This life-threatening condition means your heart is having trouble pumping enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly. It leads to a build-up of water inside the lungs, which makes breathing more difficult.

A combination of lifestyle changes and medicines or surgery will help the heart pump better and relieve your breathlessness.

Breathlessness could also relate to a problem with your heart rate or rhythm, such as atrial fibrillation (an irregular and fast heart rate) or supraventricular tachycardia (regular and fast heart rate).

Panic attack or anxiety

panic attack or anxiety can cause you to take rapid or deep breaths, known as hyperventilating. Concentrating on slow breathing or breathing through a paper bag should bring your breathing back to normal.

More unusual causes

These include:

  • partial collapse of your lung caused by a small tear in the lung surface, which allows air to become trapped in the space around your lungs (this is known as pneumothorax)
  • a blockage in one of the blood vessels in the lung (known as a pulmonary embolism)
  • idiopathic pulmonary fibrosis, a rare and poorly understood lung condition that causes scarring of the lungs
  • a collection of fluid next to the lung (called pleural effusion)
  • a complication of diabetes known as diabetic ketoacidosis, where acids build up in your blood and urine

Causes of breathlessness that has lasted a while

Long-term breathlessness is usually caused by:

  • obesity or being unfit
  • asthma that is not controlled properly
  • chronic obstructive pulmonary disease (COPD), which is permanent damage to the lungs usually caused by years of smoking
  • anaemia, which is a low level of oxygen in the blood due to a lack of red blood cells or lack of haemoglobin (the part of red blood cells that carries oxygen)
  • heart failure, which means your heart is having trouble pumping enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly
  • a problem with your heart rate or rhythm, such as atrial fibrillation (an irregular and fast heart rate) or supraventricular tachycardia (regular and fast heart rate).

Click on the links above for more information on these conditions.

More unusual causes of long-term breathlessness are:

  • a lung condition called bronchiectasis, where the airways are abnormally widened and you have a persistent phlegmy cough
  • a recurrent blockage in one of the blood vessels in the lung (known as a pulmonary embolism)
  • partial collapse of your lung caused by lung cancer
  • a collection of fluid next to the lung (pleural effusion)
  • narrowing of the main heart valve, restricting blood flow to the rest of the body
  • frequent panic attacks, which can cause you to hyperventilate (take rapid or deep breaths) 

Page last reviewed: 19/02/2013

Next review due: 19/02/2015

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Comments

The 12 comments posted are personal views. Any information they give has not been checked and may not be accurate.

katie_dh said on 11 August 2014

Hi,
I've been experiencing shortness of breath for 2 months now. The, doctors think it's an anxiety disorder however, I.don't feel anxious and I am not.stressed or worried about anything. I'm.convinced it's not an anxiety issue. The shortness of breath does not come on for any particular reason and seems random. I have to constantly keep.taking deep.breaths but feel.like I still haven't got enough oxygen. I yawn a lot - I guess this is to try and open my airways. The shortness of breath makes me feel panicky and I recently went to a&e due to a panic attack - they took an X-Ray of my lungs, a urine sample and a blood test and found nothing. My doctors gave me an inhaler to try but this doesn't help.

Is it possible to be anxious without knowing you are? What can I do to stop this? I'm.relatively healthy, I exercise and I'm in my early 20s.

Any help would be really appreciated.

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ketch said on 05 May 2014

Hi, I've just registered and would like to comment on earlier posts. I'm 81 and was diagnosed with copd a year ago. I was classified as severe, which implies I went through mild and moderate without too much bother, any breathlessness I experienced I put down to heart failure (I had a moderate heart attack when I was 66). I'm currently on a rehab course where the emphasis is on exercise, I walk to the shops regularly and carry my shopping and suffer moderate breathlessness for parts of the journeys but quickly recover. Exercising with the group is sociable, but alone at home it can be a boring chore. I play bowls (indoors) 2 or 3 times a week and which involves walking up and down for a couple of hours, lifting and projecting a weight (the bowl) and squatting numerous times (all prescribed exercises) without any discomfort whatsoever. For anyone seeking an alternative to gym torture, bowls could be your answer. Both the clubs I have belonged to open all year round and offer coaching for beginners, try it, its much more enjoyable and most clubs have a bar as well!

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thirtyyearsago said on 29 March 2014

I have had similar experiences to Tommo33 and Jamac1, but it began over 30 years ago! It started with a stress-inducing employer-forced job relocation; two days into the new place I had terrible chest pains at my desk, thought I was a goner. Went to the docs/hospital/ECG, - Pericarditis was the diagnosis. Treatment was "rest"! Symptoms were as Tommo's and Jamac's. No cure. I was one of the few who, for an unknown reason, did not recover from the diagnosis. After a couple of years of getting no-where, I self-diagnosed myself with Chronic Fatigue Syndrome or Myalgic Encephalomyelitis. I had all Tommo's tests and more last year, after I had "hurried" downhill to catch a bus, and had serious palpitations when I reached the bus-stop, again I thought I was a goner, but the tests showed I was "normal"! The medics/researchers have no idea what causes the problem, and in fact the NHS has been told to not waste any more time or money on CFS/ME as there's no cure, - just "give patients some counselling and tell them not to over-exert". One problem is that the condition varies so much with each individual; mine is fairly mild, as at the moment I've just painted a wall without fully realising the effort required, and now I can't do a thing for a couple of weeks, it really is annoying. I'm going to try the Djokovic diet when the weather improves, - I've tried all sorts over the years to no avail, - sorry guys! Check out CFS/ME on google, there's loads of info. All I can suggest as a starter is serious rest, and just gentle walking, and see if that helps.

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Tommo33 said on 12 February 2014

Well, heart tests came back normal. So, according to 5 hospitals, 4 consultants and 4 Gp's, I'm perfectly healthy with a normal metabolism! Except of coures I'm piling on inexplicable weight, have real difficulty breathing with the slightest excertion, serious foot pain and chills and fever at night. So much so I have been unable to work for over half a year!!
I feel a major issue here is that I keep telling consultants the pain is emanating from my upper left quadrant area, just around the diaphragm. That was poo pooed, "diaphragm's moving fine!" "Well it has to be my large intestine or stomach area, right?" "No. let's keep at the lungs and heart, even though you say there's no discomfort there we're certain the issue is there." " What, even after 4 CT and 3 MRI scans? 3 chest x-rays, Treadmill, bicycle stamina tests and enough blood tested to open your own vampire store? You STILL believe it's lungs or heart- even though tests show nothing but a miniscule cavity?" Strange thing is that last week they handed me over to a respiratory therapist who, after 3 minutes chatting and probing, told me the problem has to do with my rib cage. I then went through some excrutiating physical excercises with him to "fix" things. He said it would take a few months, but he believes that at least one rib has contacted my diaphragm, has ceased to work and is now restricting my breathing. He's a nice lad and he's working hard but I just have so little confidence left now that I'm not sure what to think. Doctors are letting him get on with it but they're still calling for more CT scans next week and Colonoscopy the week after. I'm certainly getting the attention...just not getting the results! Anyone any thoughts? Semms to be endless!

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jamac1 said on 11 February 2014

I have had exactly the same condition and experience as the Tommo33 [below] but without the small cavity in the lung...l have put on weight & l am dizzy, had shooting pains into the neck, palpitations fluttering in chest, pulsating & throbbing I am suffering daily 24/7 with this breathing problem, had [cardiac echo. CT pulmonary chest, x rays, bloods] & sats are fine..l have never suffered anxiety or panic attacks, and its not an attack, I have this all day & when lm laying down at night its worse!! & its not Asthma as have tried a strong inhaler ,have just finished course of steroids, to no avail, didn't touch my breathing nothing works!! cant be left like this, its not imaginary, I try to carry on as normal and ignore it as much as possible but my breathing becomes so laboured at times. lm desperate for help...any suggestions would be much appreciated...

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Tommo33 said on 27 January 2014

For the past year or so I have been having difficulty breathing, in fact it has forced me off work for the past 6 months. I have had numerous tests of lung, chest and heart, but still no answers. I've had x-rays, CT and MRI scans and still they can find nothing. They did howevever find a small cavity in the lung, but so small they couldn't take a biopsy from it, but hacve said they are concerned and may need to remove part of this lung at a later stage - something I am averse to doing since they tell me it has nothing to do with my present breathing issue. Who would want to lose half a lung under such conditions. Any attempt at exercise and I'm out of breath; pulling a seat belt across me can do it, and I'm piling on weight inexplicably! They've checked the thyroid, nothing! Still doing heart tests at the moment. I have trouble sleeping, I'm fatigued all the time, sometimes a little dizzy and, of coursed, depressed by it all. Anyone have ANY idea what's going on? I would greatly appreciate any thoughts on this matter!
Good health to all.

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LucyG29 said on 23 January 2014

Vishal6683 I'd get your heart checked out again as pains in jaw neck and back can be linked to heart attack?

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vishal6683 said on 07 December 2013

I went to the doctors because I was having trouble breathing when exercising they did ecg n other tests. It hasent helped one bit, now ever walk up the road or up the stairs I feel breathless. It like I try to breath in but something is stopping it. There is a type of shivering in t body n at times pain in t left shoulder n back..i also had mri scan of cervical spine n ncv of upper limbs vut its normal..there is lots of tiredness n weakness that has suddenly come in my body. I also now and then get pain in my chest and jaw especially when doing something e.g. Anything. Any help !

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Ria Brittan said on 17 June 2013

I went to the doctors because I was having trouble breathing when exercising they did no tests and put me straight on an inhaler. It hasent helped one bit, now ever walk up the road or up the stairs I feel breathless. It like I try to breath in but something is stopping it. Its hard to sleep and when getting up I go light headed and the vision nearly completely goes but then comes back and im fine then. I also now and then get pain in my chest and jaw especially when doing something e.g. Anything. Any help !

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taymarie83 said on 15 May 2013

what if breathing difficulties wake you up from your sleep? E.G a child wakes who can not breath properly and making heavy breathing sounds from throat and the process of recovery is 20 mins...is this asthma or heart etc..docs said this is not asthma because child I not wheezing, this has happened 3 times between 2009 and 2013 and ear throat nose specialists also say nothing wrong...Then why does this happen and I would like this to be looked at further...child is only 7 years old.

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whnau said on 28 April 2013

I have had the "silent" heart attack.
Once all my test were done, they put a "stent" in.
How ever this did not fix my problem of short breathiness .I have had asthma for many years now over 30 years.
Since my heart attack I have had more difficulty in breathing. I have had several test done on my asthma breathing and found that I have a problem breathing out!!???
Can you explain this to me and what can be done to over come this? As nothing here does!

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vivi74uk said on 18 July 2012

I had a viral infection possible chest infection and was short of breath for a few days. After my GP told me to go to hospital I was very puzzled by the amount of staff that kept asking me about suffering from asthma, which I don't and never have. This article now explains why.

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