Be careful if you are suffering from shortness of breath!

Last updated date: 16-Jul-2021

Acibadem Kozyatagi Hospital

5 mins read

If you feel inability to breathe sufficiently in the day time, the underlying causes should be investigated.

Potential causes of shortness of breath

If you feel somewhat like difficulty breathing or air hunger, the underlying cause should necessarily be investigated. Shortness of breath is caused by allergy and obesity along with diseases of lung, heart, digestive system and kidneys. Shortness of breath implies a feeling of inability to breathe sufficiently or air hunger. Therefore, the underlying causes cover a very wide range. The shortness of breath may arise out of lung pathology, but air hunger can be felt, although the person breathes sufficiently. Therefore, causes of shortness of breath are addressed in two categories; pulmonary causes and non-pulmonary causes.

Pulmonary causes

Breathing capacity or the ability to expand enough to allow sufficient air influx may decrease in lungs. There are many diseases that lead to this condition. The most common one is asthma. Asthma is characterized by stricture of airways. Patients feel shortness of breath or dyspnea, as sufficient air cannot pass through the narrow airways in a certain time. Similarly, structure of lung impairs and sufficient air inflow is hindered in Chronic Obstructive Pulmonary Disease (COPD) that is also called disease of smokers. In emphysema, the oxygen contained in inhaled air cannot be properly transported to lungs, even if air inflow is intact. Therefore, shortness of breath is felt due to poor oxygen supply to lungs. Recently, increase in smoking is the most common cause of rising incidence of COPD. As is the case with developed countries, rate of smoking can be decreased through anti-smoking campaigns in Turkey, but COPD is a very serious disease, as it develops and progresses over many years. Considering people who started smoking two decades ago, the rate of smoking was 50 percent in Turkey 20 years ago. Now, it is very likely to see these smokers present with COPD, as they are smokers for 20 years.

Industrialization, environmental pollution, working in factories and exposure to particles that impair health of lungs are other reasons. COPD is basically covering two diseases: Chronic bronchitis and emphysema. It is an irreversible disease due to chronic bronchitis. Complaints relieve, when one quits smoking. Although certain functions cannot be restored, it becomes easier to continue living without any problem. On the other hand, emphysema is manifested by severe air entrapment in lungs due to structural defects; this condition can be partially treated with novel methods.

Lung cancer is also among the most significant causes of shortness of breath. The condition may even severe enough to provoke feeling of suffocation.

Other diseases that cause shortness of breath are listed below:

  • Pneumonia is a condition characterized by accumulation of fluid in lungs and resultant poor oxygen transfer in lungs and it may lead to shortness of breath.
  • Heart failure is another disease that affects lungs… It may cause accumulation of fluid in pleura. Thus, the person feels shortness of breath due to incomplete expansion of lungs.
  • Anemia may also induce shortness of breath. Because anemia implies low hemoglobin that is a component of red blood cells, which carry oxygen in blood. Irrespective of inhaled air, oxygen level decreases and oxygen supply to tissues ceases (hypoxia) and therefore, the person feels air hunger.
  • Among diseases of thyroid gland, hypothyroidism may cause shortness of breath. Thyroid hormones do not function as expected or the metabolism may slow down.
  • Reflux may also result in shortness of breath. Gastric acid flows into trachea and leads to injury of lung.
  • Clinical picture of shortness of breath can be detected in kidney diseases, especially if urea is high or kidneys do not function properly.
  • This condition is felt in cases of obstructed upper respiratory tract or in other words, poor nasal breathing.
  • Obesity and pregnancy are also regarded among causes of shortness of breath. Shortness of breath may emerge in conditions that increase the intra-abdominal pressure.
  • Chest deformities, such as scoliosis, leads to shortness of breath, as lung capacity reduces.
  • In case of psychogenic dyspnea, the person has no physical disease. These patients need to inhale more air due to anxiety, but they fail. This clinical picture is secondary to excitement, exam stress, feeling of failure, sadness and similar conditions.

Non-pulmonary causes

Shortness of breath with cardiac origin is more common. In terms of a broad categorization, group of elderly patients mostly visit a doctor with complaints of heart failure. The heart may expand in these patients. Heart valve diseases are either congenital or acquired; the latter is secondary to rheumatoid diseases or calcium deposits in heart valves secondary to aging. Moreover, shortness of breath is associated with chest pain especially in elderly patients, when the problem originates from coronary arteries. In other words, shortness of breath points to occlusion of coronary arteries. Other patients may suffer from palpitation. The shortness of breath emerges secondary to palpitation especially in rhythm disorders. Sudden-onset hypertension, accumulation of fluid in lungs and occlusion of pulmonary blood vessels by a large clot may cause sudden-onset shortness of breath.

May patient differentiate heart diseases from lung diseases?

A patient cannot differentiate heart diseases from lung diseases. Even physicians may face challenges in this differentiation. Especially shortness of breath induced by COPD is confused with dyspnea that begins in patients with heart failure; or both conditions may co-exist. Advanced stages of COPD may induce a heart failure. Severe accumulation of fluid in lungs may compress the airways. Imaging studies, such as computerized tomography, chest X-ray, and cardiac tests, such as echocardiography, can be used for differential diagnosis.


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