Shortness of Breath: Causes, Tests & Diagnosis Guide

Breathing is something that most of us no longer think about. It can be alarming when breathing becomes hard or difficult. Most of us have experienced shortness of breath now and then—especially after exercise or strenuous activity. But, when you are short of breath every time you lay down, or even stand up, that could be your body’s way of telling you something isn’t right.

Why Am I Short of Breath All the Time?

In this blog we will discuss frequent shortness of breath causes, appropriate tests for shortness of breath, and what to expect during a shortness of breath diagnosis and evaluation. The question “why am I short of breath all the time” is a common question that doctors hear. Occasional shortness of breath may not be alarming, but shortness of breath every day,

Regardless of activity (or inactivity), is. Your lungs, your heart, your muscles, and your mind can all have a say on your breathing. So, while shortness of breath can reflect lung problems; it can also reflect heart health, circulation, and even stress disorders.

Common Causes of Frequent Shortness of Breath

Here are the most common causes for constant shortness of breath:

1.     Respiratory System Problems

•  Asthma: Sudden shortness of breath can be caused by narrowed airways and airway swelling.
• Chronic Obstructive Pulmonary Disease (COPD): Usually due to smoking, COPD damages the lungs and eventually leads to shortness of breath even at rest.
• Infections: Infections of the lungs (i.e. pneumonia and bronchitis), which can be caused by viruses (including COVID-19) can leave you feeling like you can't breathe.

2.     Heart-Related Causes

 

• Heart Failure: When your heart can't pump blood efficiently, extra fluid builds up in your lungs, which makes it hard to breathe.
• Arrhythmias: When heart rhythms are abnormal, they can lead to reduced oxygen delivery to the body.

3.     Circulatory Problems

• Blocked blood flow like in pulmonary embolism (blood clot in the lung) leads to sudden and severe shortness of breath.

4.     Anxiety and Stress

• In some cases, the lungs are in good condition, but your body is tricked into "over-breathing." Panic attacks and anxiety disorders or chronic stress frequently led people to feel the sensation of shortness of breath.

5.     Lifestyle Factors

• Improved fitness or obesity often leads to physiologically increased strain on your respiratory system.
• Constant exposure to pollution (or smoking), or substance use increases the risk of shortness of breath.

Medical Tests for Breathing Problems

If shortness of breath continues to disrupt your daily activities, physicians generally recommend obtaining tests for breathing problems. In doing so, they can help identify if the problem is related to your lungs, heart, or something else.

1. Pulmonary Function Tests (PFTs)- A PFT is designed to assess your lung's ability to expand and contract efficiently and the effectiveness of your oxygen use.

2. Chest X-ray or Chest CT Scan (or a combination bar/review chest and lung scan evaluation)- Imaging tests will reveal your lungs' function including the presence of infection, damage to your lungs, any tumors, or other abnormalities or infections inside the chest cavity.

3. Electrocardiogram (ECG, EKG, etc.) and Echocardiogram - An ECG is intended to evaluate your heart's rhythm and an Echocardiogram is intended to evaluate how well your heart is functioning. Given shortness of breath caused by heart diseases is a relatively common occurrence, an ECG and or Echocardiogram are typically recommended.

4. Blood Tests - Even if you did not present as anaemic, (there are more causes of shortness of breath than haemoglobin), assessing for the presence of anaemia, an infection, or for blood clotting illnesses, can expose covert contributors to your shortness of breath.

5. Oxygen Saturation Test (also known as pulse oximetry) - Was initially thought that oxygen saturation tests, while important, were not as important to your shortness of breath as other assessments, turns out they are just as important when performing an assessment of breathlessness as anything else, when you assess shortness of breath.

Managing and Treating Breathlessness

When you have given the cause for your shortness of breath, treatment options can differ greatly:

• For lung diseases: Inhalers, oxygen therapy, or a pulmonary rehabilitation program may be recommended
• For heart issues: Medication, lifestyle changes, and sometimes surgery may be warranted
• For anxiety-related causes: Therapy, breathing exercises, and stress relief exercises can often help

Whatever the origin of the breathlessness condition, lifestyle changes such as quitting smoking, exercise, and maintaining a healthy weight can make significant improvements

When to See a Doctor Immediately

Visit the emergency room if you are experiencing:

• Sudden and severe breathlessness
• Chest pain spreading to your arm, neck or jaw
• Feeling faint, dizzy or confused
• Bluish lips/tips of your fingers

These can be signs of heart attack, severe asthma attack, or pulmonary embolus and require immediate medical attention

Final Thoughts

Shortness of breath isn't a disease or illness but a symptom of an underlying condition. Knowing and understanding the possible causes of frequent shortness of breath and receiving the appropriate medical work-ups for shortness of breath are two key steps toward finding treatment and relief. Such conditions may be found in your lungs, your heart, or in an emotional based (overnight, mourning, anxiety, or panic attacks) condition. The earlier the detection and/or intervention, the easier (or more normal) life can be.

Never dismiss the signs and signals your own body is sending you. If you are constantly asking yourself, "Why am I short of breath all the time?" it may be time to do something about it, and get the correct medical tests for breathing disorders, along with advice from your doctor or medical professional.

Frequently Asked Questions:

Q: Why am I short of breath all the time?

A: If you are feeling breathless all the time it can come from an extensive range of causes! These causes may stem from lung diseases, pulmonary diseases, cardiovascular disease, anxiety disorders, panic attacks, and anaemia, to name just a few. Since causes of constantly feeling short of breath can be complex in nature, I encourage you to see a doctor, have the appropriate medical tests performed, and receive a formal diagnosis.

Q: What type of medical tests could a doctor suggest for breathing problems?

A: Usually a doctor will suggest, or order pulmonary function testing, a chest x-ray, an electrocardiogram (ECG), or blood tests. These tests are the most reliable means of ruling out causes regarding the problem.

Q: How long will the process of diagnosing shortness of breath take?

A: This will vary based on medical history and the complexity of symptoms in each patient. Sometimes, a single test is sufficient. At other times it takes several tests, follow-up visits and about a month.

Q: Are the causes of frequent shortness of breath treatable?

A: Yes. Whether asthma, heart disease or anaemia, addressing the cause will generally mitigate the symptoms of shortness of breath. Changing lifestyle can have a significant impact on these symptoms as well.

Q: Should I be worried if my shortness of breath only happens after exercise?

A: It is normal to have mild shortness of breath following intense activity. however, if you are experiencing shortness of breath following light exercise or at rest you should make an appointment with your health care professional for a thorough assessment.