“My chest feels tight.” “My breathing isn’t normal.” “I feel like I’m suffocating.”
These are just some of the ways a person may describe experiencing shortness of breath, also known as dyspnoea. It’s a common symptom that brings many patients to primary care clinics and emergency departments.
Why does it happen? While conditions involving the heart, lungs, musculature, mental health, or certain chronic diseases can make a person become breathless, environmental factors such as air pollution, high altitudes, or exposure to noxious gases can also be culprits.
Some causes of breathlessness are life-threatening, such as a heart attack or severe lung dysfunction, making it critical for anyone experiencing these symptoms to seek prompt medical attention.
The onset of breathlessness varies depending on the underlying cause. It might develop quickly, over minutes to hours, or it could slowly evolve over a longer period. The acuteness of the symptom, its progression, and other associated signs will help the physician determine the most likely diagnosis.
Risk factors associated with breathlessness include obesity, nicotine use, increasing age, chronic medical conditions, and the presence of other risk factors for cardiovascular diseases.
The brain acts as a central processing unit, collecting data from mechanical and chemical sensors in our body to regulate breathing rate and volume. This regulation is influenced by factors such as oxygen levels, blood pH, and lung volume. Any disturbance to this mechanism can result in abnormal breathing patterns.
It’s important to remember that breathlessness is merely a symptom; further in-depth questions, a thorough physical examination, and relevant clinical investigations are required to find the underlying cause. This typically occurs at a primary care clinic or emergency department, where patients are then referred to the appropriate medical specialty for further management if necessary.
Ultimately, treating the condition behind breathlessness will significantly improve the symptom. Blood or urine tests, and an ECG or chest X-ray, if indicated, are usually a good place to begin. A lung function test known as spirometry may be useful for screening those at risk of asthma, with a history of smoking, or who present with respiratory symptoms.
The decision to order other investigations would depend on the findings of the treating doctor.
If you see someone suffering from breathlessness, remain calm and try to reassure them. Encourage them to sit in a comfortable position and loosen any tight clothing to help them breathe more easily.
Call 999 immediately to seek professional medical help or get them medical assistance if available nearby. While waiting for help to arrive, stay with the person and monitor their condition closely.
Evidence-based medicine emphasises delivering the right care at the right time to the right patient, which is particularly crucial for those with shortness of breath. A treatment plan will largely depend on the underlying cause of the breathlessness.
Pharmacological management is usually coupled with lifestyle-modification activities such as breathing exercises, relaxation therapy, routine exercise regimes, stress management, as well as achieving a healthy weight and eating well.
This article was written by Dr Durga Vettivel, senior lecturer in family medicine at the School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University.