Usually, when something takes your breath away, it’s a good thing. But what if even basic tasks like walking a block or climbing a flight of stairs leaves you huffing and puffing?
If you’re finding yourself feeling short of breath all the time, your body might be giving you a warning sign that something needs a physician’s attention.
Dr. Jason Fritz, pulmonologist at Penn Medicine, often sees patients who are living with shortness of breath. If you have concerns about shortness of breath and aren’t quite sure where to start, Dr. Fritz shares several insights to help you breathe a little easier.
Shortness of breath Q&A
Q: What condition are patients in when they first come to you?
Dr. Fritz: It spans a wide spectrum, depending on the severity of the shortness of breath. If it’s significant, it can impact day-to-day functioning and quality of life. It’s not uncommon for people to say that even climbing one flight of stairs or simply walking one block causes difficulty breathing.
Q: What causes shortness of breath?
Dr. Fritz: Shortness of breath is a symptom of an underlying problem or problems, not a disease of its own. There is a whole spectrum of things that can cause people to be short of breath, but it frequently stems from a problem that’s pulmonary (related to the lungs) or cardiovascular (related to the heart).
Sudden onset of shortness of breath may indicate something quite serious requiring immediate medical attention, such as a heart attack, a blood clot in the lungs or a problem with the aorta.
Q: For shortness of breath that doesn’t come on suddenly, what are some of the underlying problems that cause it?
Dr. Fritz: From a pulmonary standpoint, it can be caused by disorders that affect the air passages, like asthma or chronic obstructive pulmonary disease (COPD). Less common pulmonary causes of shortness of breath include various types of pulmonary fibrosis or pulmonary hypertension.
Being overweight can contribute to a sense of difficult breathing, as can certain neuromuscular conditions or having a low blood count (anemia).
From a cardiovascular standpoint, it’s common to see people short of breath if they’re experiencing heart failure. It commonly exists in conjunction with diabetes, high blood pressure, or atrial fibrillation. Leaky or stenotic (too narrow) heart valves can similarly cause shortness of breath.
It is also possible that someone could have more than one diagnosis accounting for breathing trouble.
Q: Which gender and age group come in for evaluation most often?
Dr. Fritz: It’s a pretty even split between genders; however, we are seeing more and more elderly folks coming in with breathing complaints. It can be more challenging to diagnose what’s causing shortness of breath in older people because they can have multiple medical problems that could contribute to breathing difficulty.
In the elderly population, a form of heart failure called diastolic dysfunction (a problem with relaxation of the heart muscle) is an increasingly recognized cause of shortness of breath.
Q: What’s the worst-case scenario in someone with shortness of breath?
Dr. Fritz: Again, it comes back to the underlying cause. When it comes to shortness of breath, we really need to figure out what condition is causing it. There isn’t a “shortness of breath pill,” so the treatment is really directed at the underlying cause, making accurate diagnosis crucial.
The worst-case scenario would be not finding the cause and missing the opportunity to intervene on a treatable condition. In severe cases, not treating the underlying cause can be fatal. However, with our current diagnostic tools, we have a very reasonable chance of diagnosing and treating the problem.
Q: If people are experiencing shortness of breath, when should they see a physician?
Dr. Fritz: There are symptoms that patients need to pay attention to:
- Chest pain or discomfort
- Becoming dizzy or fainting with activity
- Having breathing problems at night
- Significant or worsening fluid retention (edema)
- Coughing up blood
These are all indicators that something serious may be going on and that you should come in to see a physician. The abrupt onset of the above symptoms warrants immediate evaluation. The earlier you find something, the greater chance you have to do something before there is progressive or irreversible damage.
When to See Your Doctor
"If patients can think back and say, 'I used to be able to do X, Y and Z — and now I can't because of shortness of breath,' that's a good time to come in."
Jason Fritz, MD
- Assistant Professor of Clinical Medicine Division of Pulmonary and Critical Care Penn Medicine
Q: Do they need to see a specialist right away?
Dr. Fritz: If symptoms are not severe, primary care providers (PCPs) are usually equipped to do an initial evaluation, which may include some basic tests aimed at detecting heart or lung problems. They will be able to do a workup in the most efficient way possible and send patients to the correct specialist, if necessary.
Consultation with a pulmonologist or cardiologist and additional studies may be required based on the results of these initial tests, or if uncertainty remains regarding the diagnosis.
If you have been having problems with shortness of breath over a period of time, it might be time to see a provider.