What is Breathlessness ?

Breathlessness is the uncomfortable sensation of not being able to breathe. Some people refer to it as shortness of breath or difficulty breathing. 

It is normal to feel breathless after significant exertion but if you feel breathless at rest, after minimal exertion or after an activity that recently would not leave you breathless then a medical condition may be responsible for this and an expert assessment is recommended.

What causes shortness of breath?

There are many conditions that result in breathlessness. These can be due respiratory, cardiac, neurological or other issues. 


  • Pulmonary embolism
  • Airway disease (e.g. asthma, COPD, broncheictasis, bronchiolitis)
  • Interstitial lung disease (e.g. sarcoidosis, organising pneumonia, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis)
  • Respiratory infection (e.g. pneumonia, tuberculosis)
  • Pleural effusion
  • Irregular heart rhythm (e.g. atrial fibrillation)
  • Heart failure
  • Neuromuscular weakness


  • Anxiety and panick attacks
  • Anaemia
  • Obesity
  • Deconditioning

Tests to identify causes of breathlessness

  • 1. Radiological Tests

    • Chest X-Ray: This fundamental test offers a snapshot of the lungs and heart, revealing potential issues like pneumonia, lung collapse, or heart enlargement.
    • Computed Tomography (CT) Scan of the Chest: Providing detailed images, a CT scan can detect finer abnormalities in the chest not visible on a regular X-ray.

    2. Lung Function Testing

    These tests measure lung volume, capacity, and flow rates, helping diagnose conditions like asthma, COPD, and fibrosis.

    3. Cardiopulmonary Exercise Testing

    This test evaluates the performance of the lungs and heart during exercise, providing insights into issues that might only arise during physical activity.

    4. Blood Tests

    Comprehensive blood tests can uncover conditions like anaemia or infection that might lead to breathlessness.

    5. Arterial Blood Gases

    This test measures the levels of oxygen and carbon dioxide in your blood, offering critical information about your lungs’ ability to move oxygen into the blood and remove carbon dioxide.

    6. Echocardiography

    An echocardiogram uses ultrasound to visualise heart function, detecting problems like heart failure or valve disorders that can cause breathlessness.

    7. Electrocardiogram (ECG)

    An ECG records the electrical activity of the heart, revealing heart-related issues like arrhythmias or heart attacks.

Treatment of breathlessness

Management is focused at treating the underlying condition. 

In cases where breathlessness is ongoing a multi-professional approach is useful at controlling the symptom of breathlessness.

This is a programme for people with lung disease. It involves physical exercise training and education on how to manage you condition. 

  1. Becoming aware of faulty breathing patterns
  2. Being able to relax the jaw, upper chest, shoulders and accessory muscles
  3. Re-education on abdominal or low-chest nose breathing pattern
  4. Being aware of normal breathing rates and rhythms at rest, as well as during speech and activity

Supplemental oxygen may be indicated if you have low oxygen levels. This may be needed during exercise (ambulatory oxygen) or long-term.

Medication is targeted at treating the underlying condition (e..g bronchodilators in airway dsiease, diuretics for pulmonary oedema). 

Anxiolytics may be helpful for patients with anxiety. 

Opiates may be helpful to reduce the sensation of breathlessness. 

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