What Causes Breathing Difficulty?

Breathing difficulty – shortness of breath – labored breathing – dyspnea – what do each of these terms have in common? Each is synonymous with the other in describing an uncomfortable, abnormal awareness of your breathing. What causes breathing difficulty?

The causes of shortness of breath are as numerous as the day is long. According to the Mayo Clinic however, most cases of breathlessness are due to illnesses related to the heart and lungs.1

Lung Problems That Cause Shortness of Breath

Because the lungs are responsible for transporting oxygen to the tissues and moving carbon dioxide out, it’s not surprising that illnesses involving the lungs result in shortness of breath. Listed below are some of the most common lung conditions that cause difficulty breathing:1

  • Chronic obstructive pulmonary disease (COPD)
  • Pulmonary hypertension
  • Asthma
  • Pulmonary embolism
  • Pneumonia
  • Pneumothorax
  • Pulmonary edema
  • Pulmonary fibrosis
  • Sarcoidosis
  • Tuberculosis
  • Interstitial lung disease
  • Pericarditis
  • Croup
  • Pleurisy
  • Lung cancer

Heart Conditions That Cause Shortness of Breath

Many people don’t realize that shortness of breath is not always indicative of lung disease. In fact, heart disease is often under-diagnosed and under-treated in patients with advanced lung disease.2 The following causes of shortness of breath are associated with the heart:1

  • Congestive heart failure (CHF)
  • Heart disease
  • Cor pulmonale
  • Cardiac taponade
  • Atrial fibrillation
  • Cardiomyopathy
  • Myocardial infarction (heart attack)
  • Cardiac arrhythmias

Shortness of Breath Due to Other Causes

Some causes of shortness of breath are attributed to conditions completely unrelated to the heart and lungs as in the following cases:

  • Anemia
  • Rib fractures
  • Obstruction of the airway
  • Epiglottis
  • Generalized anxiety disorder
  • Panic disorder
  • Guillain-Barre syndrome
  • Myasthenia gravis
  • Obesity

Whatever the reason for your breathing difficulties, working with your health care provider to obtain an accurate diagnosis is paramount to medically managing the condition that’s causing the symptom.

Treatment for Shortness of Breath

Treatment for shortness of breath is dependent upon its underlying cause. Possible treatment options for lung problems include:

Heart conditions that make breathing difficult are often treated with:

  • Smoking cessation, diet and exercise
  • Diuretics
  • Blood thinners
  • Antibiotics (if a heart infection is present)
  • Anti-hypertensives
  • Anti-arrhythmics
  • Cholesterol-lowering medications
  • Medical procedures and/or heart surgery

Treatment options for conditions unrelated to the heart and lungs include anti-anxiety medications for panic and generalized anxiety disorders, blood transfusions for severe cases of anemia and weight loss for obesity.

When to Seek Emergency Care

Shortness of breath that comes on suddenly, is unrelieved by rest and affects your ability to function is often a true medical emergency. Additionally, shortness of breath that is accompanied by chest pain, fainting, sweating, and nausea or vomiting may be signs of a heart attack or pulmonary embolism. Call 911 or go to your nearest emergency room if you’re experiencing any of these symptoms.


Author: Deborah Leader RN, BSN, PHN


1 Mayo Clinic. Shortness of breath. April 13, 2013.
2 Robert M. Reed MD, et. al. Coronary artery disease is often under-diagnosed and under-treated in advanced lung disease. The American Journal of Medicine. Volume 125, Issue 12 , Pages 1228.e13-1228.e22, December 2012.

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