Shortness of breath

Getting out of breath is normal when you've pushed yourself too hard. But shortness of breath that comes on suddenly and without warning is usually a sign of a medical condition.

• you have severe difficulty breathing, for example you struggle to speak without pausing, or you are gasping or choking
• you have severe chest pain in the middle of your chest that isn't going away, and it may feel like pressure, tightness or squeezing
• you have pain that spreads to your arms, back, neck and jaw
• you feel more drowsy than usual or find it more difficult to wake up
• your lips or skin are turning very pale, blue or grey (on brown or black skin this is easier to see on the palms of your hands)

Information on breathing problems in children

Contact a doctor urgently if you:

• have difficulty breathing (you may be more short of breath than usual)
• have pain when breathing in or coughing
• are feeling confused, dizzy, or lightheaded
• feel sick or are being sick, for example you can't keep food or fluids down
• are coughing up blood (haemoptysis)
• have pain or swelling in 1 of your legs
• have heart palpitations, which may feel like your heart is racing, going too slowly or skipping a beat, or like a fluttering feeling in your chest

If you can't reach a doctor, phone a doctor or the 16263 health line.

Speak to your doctor if you:

• have symptoms that are not improving
• have had a cough for more than 3 weeks

Your doctor may ask you some questions, such as:

• did the breathlessness come on suddenly or slowly?
• did anything trigger it, such as exercise?
• how bad is it?
• does it only happen when you've been active, or when you're not doing anything?
• is there any pain when you breathe?
• do you have a cough?
• do certain positions make it worse, for example, can you lie down?

Feeling like you can't get enough air can be scary, so make sure you get help from a health professional. They may give you extra oxygen to breathe if you need it.

Several different health conditions can cause breathlessness that comes on suddenly and without warning.

Sudden breathlessness could be an asthma attack. You feel breathless because it's hard to move air in and out of your airways. Your doctor may advise you to use a spacer device with your inhaler to ease the breathlessness.

Pneumonia (lung inflammation) can also cause shortness of breath and a cough. It's usually caused by an infection, so you'll need to take antibiotics.

If you have COPD, your breathlessness is likely a sign that the condition has suddenly got worse.

You can have a heart attack without the obvious symptoms, such as chest pain and anxiety. When that happens, shortness of breath may be the only warning sign. If you or your doctor think this is the case, you'll be given aspirin and admitted to hospital straight away.

Heart failure can also make breathing difficult. It means your heart cannot pump enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly. Fluid then builds up inside the lungs, and that makes breathing harder. Lifestyle changes and medicines or surgery will help the heart pump better and relieve your breathlessness.

Breathlessness could also be linked to a problem with your heart rate or rhythm. Atrial fibrillation (an irregular and fast heart rate) and supraventricular tachycardia (a regular and fast heart rate) are two examples.

During a panic attack or a spell of anxiety, you may start breathing fast or very deeply. This is called hyperventilating. Breathing slowly and keeping your mind on it can bring your breathing back to normal, and so can breathing through a paper bag. Do this only when you are sure anxiety is the cause of your breathlessness.

Some less common causes of shortness of breath are:

• a severe allergic reaction (anaphylaxis)
• pneumothorax, which is a partial collapse of your lung caused by a small tear in the lung surface, letting air become trapped in the space around your lungs
• pulmonary embolism, which is a blockage in one of the blood vessels in the lung
• idiopathic pulmonary fibrosis, a condition that causes scarring of the lungs
• pleural effusion, which is excess fluid next to the lung
• diabetic ketoacidosis, a complication of diabetes where acids build up in your blood and urine

Long-term breathlessness is usually caused by:

• obesity
• being unfit
• poorly controlled asthma
• chronic obstructive pulmonary disease (COPD)
• anaemia
• heart failure
• a problem with your heart rate or rhythm

Less common causes of long-term breathlessness are:

• bronchiectasis
• a blockage in a blood vessel in the lung (pulmonary embolism)
• partial collapse of your lung caused by lung cancer
• excess fluid next to the lung (pleural effusion)
• narrowing of the main heart valve, restricting blood flow to the rest of the body
• having panic attacks often