Shortness of breath and dyspnea are both terms that describe the feeling of uncomfortable breathing. Shortness of breath can be normal in healthy people during exertion. At other times, it can be a potentially serious sign of an underlying illness. It is a symptom that occurs in many people each year for various reasons. Because it can be a sign of a serious disease, doctors will investigate thoroughly in search of a diagnosis, and initiate treatment based upon those findings.
Frequency
Uncomfortable breathing is a common and rather distressing symptom. Given its many causes, patients seeking or under medical care are likely to exhibit the symptom at a relatively high frequency, according to "Harrison's Principles of Internal Medicine" by Dr. Anthony S. Fauci.
Causes
Uncomfortable breathing has many potential causes. Some of the most important and potentially dangerous are heart and lung issues, according to "Harrison's Principles of Internal Medicine." The lungs exchange oxygen and carbon dioxide between the air and blood. When the lung tissues are not functioning well --- such as when a portion of lung is filled with fluid and debris of bacteria and immune cells during pneumonia --- gas exchange may be impaired, leading to shortness of breath.
The right side of the heart is responsible for pumping blood to the lungs, while the left side is responsible for pumping it to the rest of the body. If the heart is pumping ineffectively, as during or sometimes after a heart attack, shortness of breath can develop.
Mechanism
Uncomfortable breathing is a sensation interpreted by the brain from one or more inciting factors. Some of these include an increased work of breathing, restrictions in the amount of air passing into and out of the lungs and increased levels of carbon dioxide. Receptors on the nerves in the body, such as in the lungs, airways, chest wall and blood vessels, sense the local environmental conditions. For example, nerves in the blood vessels can sense high carbon dioxide in the blood. They send messages to the brain, which are ultimately perceived as shortness of breath.
Diagnosis
The diagnosis of uncomfortable breathing begins with your doctor obtaining a history. The history include characteristics of the uncomfortable breathing, such as things that make it better or worse, and any other symptoms, like pain or fevers. It also includes other medical conditions and surgeries, medications taken, habits such as smoking, work history, medical conditions in the family, and a checklist of other possible symptoms. The physical exam will be guided by the findings on the history, but will typically at least include a heart and lung exam. Laboratory and imaging studies such as blood tests and X-rays may follow.
Treatment
The treatment for shortness of breath largely depends on the cause. Much of the time, supplemental oxygen is delivered. It can be delivered by two prongs that fit in the nose called a nasal cannula, by face mask or through a breathing tube. Some lung problems will also respond to bronchodilators, drugs that dilate the airways of the lungs. Treatment of the underlying cause is also important. For example, bacterial pneumonia can be treated with antibiotics and congestive heart failure with drugs that remove fluid from the body and help the heart to contract.
References
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci; 2008
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar; 2009
