Breathlessness

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.

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What causes shortness of breath?

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

Respiratory

  • 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
Cardiac
  • Irregular heart rhythm (e.g. atrial fibrillation)
  • Heart failure
Neurological 
  • Neuromuscular weakness

Other

  • Anxiety and panick attacks
  • Anaemia
  • Obesity
  • Deconditioning

Tests to identify causes of breathlessness

  • Radiological  – Chest x-ray and Computed Tomography (CT) scan of the chest
  • Lung function testing
  • Cardiopulmonary exercise testing
  • Blood tests
  • Arterial blood gases
  • Echocardiography
  • Electrocardiogram

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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