Shortness of Breath

What can cause shortness of breath?

Breathlessness can occur during exercise, at rest, when lying down or during sleep. It has many possible causes, involving the lungs, heart and other systems.

Breathlessness is described by when it happens. It can come on with exercise, at rest, when you lie flat, or during sleep. That pattern helps narrow the possible causes.

Lung causes include asthma, COPD (chronic obstructive pulmonary disease), pneumonia, scarring of the lung tissue and a clot in the lung. A cough or a wheeze points towards the airways. A separate guide to wheezing sounds and their causes explains what those sounds mean.

The heart and the blood can also be involved. Anaemia, an irregular heart rhythm or a problem with the heart muscle can all cause breathlessness. Poor fitness, extra weight, anxiety and a thyroid problem are other possible contributors.

More than one cause can be present at once. A normal result on one test does not rule out the others, so the whole picture is reviewed together.

How is breathlessness evaluated?

A specialist evaluation considers when symptoms occur, any associated cough or wheeze, your medical history, oxygen levels and relevant tests.

The assessment starts with your story. When did the breathlessness begin? What brings it on? Does it wake you at night?

It also helps to know about a cough, a wheeze or mucus, and whether you feel tired during the day.

Dr. Katranji examines your chest and listens to your breathing. A small device on your finger measures your oxygen level.

That reading can be normal at rest even when something is wrong, so it is only one part of the assessment.

A cough that will not settle is assessed in the same way. A separate page on chronic cough assessment sets out the pattern to look for.

Which tests might I need?

Depending on the presentation, investigations may include spirometry, pulmonary function testing, imaging or other specialist assessments.

Spirometry is usually the first test. You breathe into a machine that measures how much air you can move and how fast. The result is compared with values expected for your age, height and sex.

You may repeat the test after breathing in a reliever medicine. A rise of 12% and 200 mL suggests the airways were narrowed and can open again. That pattern points towards asthma, but the result alone does not prove it.

Other tests are chosen for your situation. They may include a chest X-ray, a CT scan, blood tests or an overnight sleep study. A camera examination of the airways (bronchoscopy) is used in selected cases.

When is breathlessness urgent?

Some breathing changes need emergency help. Call 998 if breathlessness comes on suddenly or is severe. The same applies if it comes with chest pain, blue lips, confusion, fainting or difficulty speaking in full sentences.

Do not wait for an appointment if you are struggling to breathe. For symptoms that are not urgent, an assessment can be arranged in the usual way.

When should I see a specialist?

Consider an assessment if breathlessness is new, is getting worse, or limits what you can do. The same applies if it wakes you at night, comes with a cough or wheeze that will not settle, or if a known lung condition needs review.

A pulmonologist in Dubai can see you in person or by video consultation. You can ask for an appointment without a diagnosis.

What can be done about breathlessness?

Treatment follows the cause. Asthma and COPD are managed with inhalers and a written action plan. Sleep-related breathing problems may need a sleep study and treatment with a positive airway pressure machine. Other causes are managed by the right specialist.

Breathlessness often improves once the cause is found and treated, but the course depends on what is driving it. Follow-up reviews check whether the plan is working.