Signs and Symptoms of Dyspnea

Oxygen therapy
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Dyspnea, or the experience of unpleasant or uncomfortable sensations during breathing, has many causes and is a relatively common symptom described by people visiting their doctor. Some people complain of tightness in the chest while others describe feeling suffocated. Commonly referred to as shortness of breath, it is also sometimes referred to as air hunger, or the sensation of having the urge to breathe, that is caused by lack of oxygen in the bloodstream.

 

Dyspnea Signs and Symptoms

Dyspnea does not always indicate the presence of an abnormal condition. At times, it is completely normal, such as during strenuous exercise. However, it is usually a warning sign that significant disease does exist, so it is important that you seek medical attention immediately. In fact,  if you notice severe and sudden shortness of breath, and it is accompanied by chest pain, nausea, or lightheadedness, you should call 911 or have someone drive you to the closest emergency department.

Signs and symptoms of dyspnea include:

  • Clearly audible, labored breathing
  • An anxious, distressed facial expression
  • Flaring nostrils
  • Protrusion of the abdomen and/or chest
  • Gasping
  • Cyanosis

Conditions Causing Dyspnea 

The way a person describes the experience of dyspnea can be a clue to its underlying cause since people experience it differently depending on what condition is causing it. However, the list of potential causes is extensive, and can include any of the following: 

  • Disturbances of the heart, including heart attack, congestive heart failure, and arrhythmias
  • Disturbances of the lungs, including COPD, pulmonary hypertension, and pneumonia
  • Inhalation of a foreign object
  • Allergies
  • Obesity
  • Gastroesophageal reflux disease (GERD)
  • Trauma to the chest wall
  • Panic attacks

Evaluating and Treating Dyspnea

Because dyspnea is a warning signal to caregivers that serious illness may exist, your doctor is likely to conduct a thorough history and physical if you describe experiencing this symptom.

Your doctor will want to know whether you experience dyspnea mostly during activity or at rest, and whether it comes on suddenly or slowly.

Understanding your medical history is helpful because certain risk factors (such as a history of smoking) can help your doctor rule out certain conditions and give more weight to others. All of these clues will help guide further testing to help identify the cause of your dyspnea and guide treatment. These may include:

  • Blood tests
  • Chest x-ray
  • Electrocardiograph
  • Screening spirometry
  • Complete pulmonary function testing
  • Arterial blood gas measurement
  • Echocardiography
  • Standard exercise treadmill testing
  • Complete cardiopulmonary exercise testing

Treatments for dyspnea will depend on the underlying cause. For example, if asthma is making it difficult to breathe, initiating or tweaking medications such as bronchodilators and steroids can alleviate the condition. If an anxiety or panic disorder is to blame, treatment with cognitive behavioral therapy and/or medication can help. When COPD is to blame, specialized breathing techniques and oxygen supplementation can help. 

Sources:

A.D.A.M. Breathing Difficulty. http://adam.about.net/encyclopedia/Breathing-difficulty.htm

Donald A. Mahler; Denis E. O'Donnell (20 January 2014). Dyspnea: Mechanisms, Measurement, and Management, Third Edition. CRC Press. 

Wills CP, Young M, White DW (February 2010). "Pitfalls in the evaluation of shortness of breath". Emerg. Med. Clin. North Am.

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