About this symptom
Shortness of breath, or breathlessness, is an uncomfortable feeling of not getting enough air. Only the person feeling it can say how bad it is. A little is normal after hard exercise you do not usually do, or with a very blocked nose.
Otherwise the cause is most often in the lungs or the heart, such as asthma, a chest infection, heart failure or a blood clot in the lung. It can also come from anaemia, being overweight, smoking, a blocked airway or a panic attack. The cause cannot be worked out at home, so new or worsening breathlessness should be checked.
Possible causes
This is not a diagnosis. These are the causes doctors think about, with the ones that are most urgent to rule out first.
- Heart attackBreathlessness with a tight or heavy chest, or pain spreading to the arm, back, neck or jaw. This needs an ambulance at once.Read about it
- Pulmonary embolismA blood clot in the lung. Breathlessness comes on suddenly, often with chest or upper back pain, a racing heartbeat, or coughing up blood.Read about it
- Heart failureBreathlessness that is worse lying down or on everyday effort, with swollen ankles, a night-time cough and tiredness.Read about it
- PneumoniaBreathlessness with a cough, a high temperature and tiredness, and chest pain that is worse when you breathe in or cough.Read about it
- AsthmaBreathlessness with wheezing, a cough and chest tightness that come and go, and are often worse at night or in the early morning.Read about it
- COPDBreathlessness that begins with effort and slowly worsens, with a long-lasting chesty cough, mostly in people who smoke or used to smoke.Read about it
- Iron deficiency anaemiaBreathlessness on effort with tiredness, paler skin than usual and a noticeable, pounding heartbeat.Read about it
- AnxietyFast breathing with a racing heart, sweating and trembling during a panic attack. A first episode still needs checking.Read about it
When to get help
Also get emergency care for:
- Breathlessness with sudden chest or upper back pain, a racing heartbeat or fainting, which can be a blood clot in the lung
- Someone who has collapsed or is not breathing normally: call for help and start CPR if you know how
See a doctor soon if you have:
- Breathlessness that is getting worse with everyday activity
- Breathlessness when lying down, or that wakes you at night
- Breathlessness with swollen ankles
- Breathlessness with a cough, fever, or yellow or green phlegm
- Breathlessness with tiredness, pale skin or a pounding heartbeat
- A cough that has lasted more than two to three weeks, or wheezing
A little breathlessness after hard exercise you do not usually do, or with a very blocked nose, that settles quickly, can wait. Anything new or worsening should still be checked.
What you can do at home
With any emergency sign, do not stay at home: call for an ambulance first and follow any advice the operator gives.
Do
- Stop what you are doing, sit upright and try to stay calm
- Have someone stay with you
- Keep your medicines and with you, and take them to hospital
- If you have a long-term lung or heart condition, follow your doctor's instructions
Do not
- Do not wait to see if it passes when there is an emergency sign
- Do not drive yourself to hospital
- Do not try to work out the cause yourself
Stopping smoking and keeping to a healthy weight help over time.
What the doctor will do
The doctor will ask when the breathlessness began, whether it came on suddenly or slowly, what brings it on or makes it worse, and whether you hear wheezing. They will ask about chest pain, cough, fever, smoking and any heart or lung disease, and examine you.
They may check the oxygen in your blood with a clip on your finger, and order tests such as:
- A chest X-ray, and sometimes a
- An , and sometimes an (an scan of the heart)
- Blood tests
- Breathing tests (lung function tests, )
- An exercise test
Treatment depends on the cause. Severe breathlessness may need care in hospital, and if the oxygen level is very low, oxygen is given.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Getting out of breath is just age, weight or being unfit.”What is true?
Fact
A little breathlessness after hard exercise you do not usually do is normal. But new breathlessness, or breathlessness that is getting worse, can come from the heart or lungs, and should be checked at any age.
Myth“It is only a panic attack or nerves.”What is true?
Fact
A panic attack can cause breathlessness, but so can a blood clot in the lung, a heart problem or an infection. Do not decide on your own that it is anxiety, especially if it starts suddenly, comes with chest pain or has never happened before.
Myth“With no chest pain, it cannot be the heart.”What is true?
Fact
Heart problems such as heart failure, angina and a heart attack can cause breathlessness. Heart failure, for example, brings breathlessness, tiredness and swollen ankles, not necessarily pain. Go by all the signs, not pain alone.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
How do I know if my breathlessness is serious?
It is more worrying if it starts suddenly, is severe, comes with a tight chest, chest pain, blue or grey lips or confusion, or if you cannot get words out. Breathlessness that is getting worse, happens lying down or wakes you at night also needs a doctor soon. Call for an ambulance for any emergency sign.
Can anxiety cause shortness of breath?
Yes. A panic attack can cause breathlessness along with a racing heartbeat, sweating and trembling. But a heart or lung problem can feel similar, so have a first episode checked, and call for an ambulance if any emergency sign is present.
Why do I get breathless when I lie down?
Breathlessness that is worse lying down, or that wakes you at night, can be a sign of a heart or lung problem. If you also have swollen ankles, see a doctor soon.
What should I do while waiting for the ambulance?
Stop what you are doing, sit upright, try to stay calm and have someone stay with you. Follow any advice the operator gives, and keep your inhaler and medicines with you. If the person collapses and is not breathing normally, start CPR if you know how.