Shortness of breath during exercise. How to distinguish physiological shortness of breath from breathing disorders in serious illnesses

1.What is shortness of breath?

Shortness of breath (dyspnea)

is a subjective state characterized by dissatisfaction with breathing against the background of its intensification. Various breathing problems can occur with many diseases. However, the term “shortness of breath” refers specifically to the feeling that even rapid breathing does not compensate for the lack of air.

The subjective psychological perception of this phenomenon is always negatively colored; the vital fear it evokes is associated with the inability to control this process and available ways to alleviate one’s condition. Sometimes a feeling of shortness of breath can occur against the background of objectively completely normal breathing parameters (its rhythm, depth and frequency).

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Types of shortness of breath

• expiratory,
• inspiratory,
• mixed.

Medicine knows 3 main types of shortness of breath:

• Inspiratory dyspnea causes difficulty breathing.
• Expiratory shortness of breath is, on the contrary, problems with exhalation.
• The mixed type is characterized by respiratory failure during inhalation and exhalation.

Based on the reasons for development, there are:

• cardiac;
• central;
• pulmonary;
• hematogenous dyspnea.

Types of shortness of breath are determined according to how deep and often the breath is taken:

• rapid (tachypnea);
• rare (bradypnea);
• rare and superficial (oligopnea);
• rapid and deep (hyperpnea and polypnea).

2.When is shortness of breath normal?

Although shortness of breath is always an unpleasant condition, it should only be a concern in cases where it indicates a disorder in the body. If a person has been exposed to physical exertion, experienced stress, or found himself in an extreme situation, shortness of breath is a physiological norm

and is in the nature of a compensatory mechanism. Rapidly climbing stairs, intense swimming, and lifting heavy objects cause rapid breathing even in the healthiest person. However, normally, after transitioning to a calm state, breathing should quickly recover, without causing a feeling of lack of air.

If shortness of breath occurs disproportionately to the impact received (during normal walking, when rushing, from a sharp sound, after bending over, lifting a heavy object once), this may indicate somatic diseases, infections, psycho-emotional or endocrine disorders.

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Shortness of breath in a child

Most often, shortness of breath in children has the same causes and develops in the same way as in adults. Specific cases occur in newborns whose mothers suffer from heart disease and diabetes. The child may develop pulmonary edema - the so-called respiratory distress syndrome . Also, shortness of breath becomes one of the obvious manifestations of heart disease . Certain respiratory diseases in children cause difficulty breathing: laryngitis, false croup .

3. Possible causes of shortness of breath

Sometimes the cause of shortness of breath during light exertion is excess weight.
Detraining of the body
with normal weight, but long periods of muscle inactivity (for example, after a protracted illness with bed rest) also causes shortness of breath even under loads that would not normally be considered excessive.
Shortness of breath can appear in an exhausted, extremely weakened person without significant exertion.
Possible causes of shortness of breath may be disturbances in the functioning of the heart, respiratory organs, nervous system, as well as blood diseases or vegetative-vascular dystonia. Shortness of breath against the background of these diseases always indicates an exacerbation of the condition and requires diagnosis and medical measures.

Shortness of breath during exercise is not a sign of any disease. Increased muscle work requires active blood supply, as a result of which the pulse and breathing become more frequent. Even if it subjectively seems that at some point there is not enough air, normally, reducing the load should immediately alleviate the condition.

The nature of rapid breathing movements is very important

, as well as which phase of breathing is difficult.
With physiologically caused shortness of breath, it is impossible to say what exactly is disrupted in breathing. The feeling of fatigue, lack of air, and fullness in the chest is always common. If only some phase of breathing movements is difficult, this is a serious symptom. So, for example, with shortness of breath caused by heart failure, inhalation is difficult
, but exhalation is easy.
Difficulty breathing
is a symptom of pulmonary disorders.

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Why do you have shortness of breath during exercise and how to get rid of it?

The cause of shortness of breath may be circulatory or respiratory failure. In lung diseases, shortness of breath is caused by impaired airway patency (swelling, mucus, spasm) and insufficient gas exchange in the alveoli. Often, chronic bronchitis, smoker's bronchitis, and even tuberculosis occur in a latent form, with no pronounced symptoms, and make themselves felt during unusual physical activity, when the need for oxygen sharply increases. Shortness of breath in a child can be caused by a malformation of the respiratory tract (usually the lungs or bronchi), or a congenital heart defect.

Shortness of breath is one of the key symptoms of heart failure, a decrease in the contractile function of the heart. This may be a temporary condition caused by medication, an infectious disease, too much exercise, or shortness of breath indicates a syndrome that has developed over a long period of time and is caused by irreversible damage to the heart. The development of heart failure is a natural consequence of myocardial infarction, when part of the active heart fibers dies.

Poor circulation causes swelling and fluid accumulation in the lungs, leading to wheezing, shortness of breath and coughing. The degree of heart failure, the functional class, is determined based on the load under which noticeable shortness of breath and weakness appear: from climbing the stairs to the third floor to shortness of breath at rest.

If you feel unwell during physical activity, then you need to be examined by a cardiologist to rule out heart failure, or begin adequate treatment in a timely manner.

Treatment of heart failure will reduce the severity of the accompanying symptoms: fatigue, shortness of breath, drowsiness, tachycardia or arrhythmia, dizziness, hypotension, swelling of the legs, cough while lying down. Protocols for the treatment of heart failure include regular use of ACE inhibitors, beta-blockers, if necessary, antiarrhythmic drugs and nitrates (for heart pain), antithrombotic and decongestant drugs. The drugs are selected individually, the prescription is adjusted for each patient depending on the specific medical history. Eltacin® helps improve myocardial contractile function : it is prescribed in combination with the drugs described above, as well as a long course after discharge from the hospital.

4.Prevention of shortness of breath

Shortness of breath is often a harmless phenomenon and passes without special measures. However, you need to be attentive to this symptom if it repeats too often, and especially during those loads that previously passed without difficulty breathing. The occurrence of shortness of breath during movement in some cases can be a sign of serious disorders in the body. If you are sure that you are healthy, but your breathing is still impaired with increasing physical activity, there may be a number of reasons for this that you should try to eliminate on your own:

• reduce weight;
• lead a more active lifestyle;
• engage in feasible regular training (swimming, dancing, physical therapy, running);
• increase stress resistance, refuse excess information;
• take measures to increase immunity;
• quit smoking.

Diagnostics

A general urine test will help identify renal pathology.
To make a correct diagnosis, a complete history and examination of the cause of shortness of breath are fundamentally important. This will help to establish the factor that provokes this condition without resorting to additional research and analysis. Depending on the initial cause, examinations are carried out:

• X-ray;
• Ultrasound;
• general urine and blood tests to identify pathologies in the kidneys and determine hemoglobin levels.

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Treatment of cardiac dyspnea (lack of air) at the CBCP clinic

If there is a suspicion of cardiac pathology causing symptoms of shortness of breath, contact the International Center for Pathology of the Circulatory Organs. We offer high-quality diagnostics using expert-class equipment. You will be able to obtain objective and detailed information about the condition of your body.

At CBCP, you have at your disposal experienced high-level cardiologists and cardiac surgeons (including pediatric ones), certified specialists in functional and ultrasound diagnostics. You will be offered non-surgical treatment of cardiovascular diseases using modern methods used in Europe, Israel and the USA.

Causes and treatments

To determine the cause of shortness of breath, it is important to know how quickly it appeared. It can occur acutely - within minutes, hours, several days, or gradually - over several weeks, months or years. Let's look at the main reasons.

• Poor physical shape

In principle, in this case, shortness of breath is more likely a normal phenomenon than a cause for serious concern.
Physiological shortness of breath appears after you climb the stairs or catch up with the bus. The muscles involved in the work remove oxygen from the blood. The brain tries to cover the resulting oxygen deficiency, that is, it forces us to breathe more often. Such shortness of breath in itself is not dangerous, but if you find yourself out of breath even after climbing a couple of floors, it’s time to think about your physical fitness. In physically active and trained people, shortness of breath occurs less frequently.

What to do to get rid of such shortness of breath? Regular aerobic exercise is needed, which leads to an increase in respiratory rate and heartbeat. If you don't have time to go to the gym, brisk walks will do. Go up and down the stairs within 3-4 floors.

• Panic attack

As you know, strong excitement, anxiety, anger and fear stimulate the production of adrenaline. Once in the blood, adrenaline forces the body to pass a lot of air through the lungs, causing hyperventilation. Therefore, during serious experiences, the heart rate increases and shortness of breath appears. What to do? Shortness of breath caused by such strong emotions is, in principle, safe for health. However, for serious panic attacks (and not just shortness of breath from anxiety), it is better to consult a doctor. Severe shortness of breath during panic may indicate a disease - for example, vegetative-vascular dystonia (VSD).

• Anemia or anemia

The most common is iron deficiency anemia. Iron ions saturate the blood with oxygen and play an important role in hematopoiesis. When they are deficient, hypoxia develops and an emergency protective mechanism—shortness of breath—is activated. This condition is more typical for women, although men also often experience a lack of iron in the body. The presence of anemia is diagnosed based on clinical blood test data. What to do to get rid of anemia and shortness of breath? If the hemoglobin level decreases significantly, the doctor prescribes treatment with iron-containing drugs. They must be taken for at least two months and monitor proper nutrition. Iron is well absorbed from liver and red meat, but from plant foods, such as buckwheat or pomegranates, which are considered a panacea for anemia, it is quite poorly absorbed. To ensure that the iron contained in the drug or food is better absorbed, vitamin C is also prescribed.

• Obesity

This is no longer just a lack of training, but a serious illness that requires a lot of effort from a person to improve his health. In this case, it is not the external fat on the hips or buttocks that poses the danger, but the internal one, since obesity is not just a cosmetic defect. A layer of fat envelops the lungs and heart, preventing a person from breathing normally. In addition, in obese people, the heart endures increased stress, since it needs to pump blood into a large fat pad. Therefore, less oxygen reaches important organs. There is only one solution to the problem - get rid of fat under the supervision of a doctor. You cannot start with intense training in the gym - there is a high risk of losing consciousness.

• Pulmonary diseases

Shortness of breath that occurs with diseases of the respiratory organs is of two types. Inspiratory - when there is difficulty in inhaling as a result of clogging of the bronchi with mucus or with lung tumors, and expiratory - when there is difficulty in exhaling as a result of spasms that occur with bronchial asthma. To determine the causes of pulmonary shortness of breath, you will have to undergo examination and treatment under the supervision of a specialist.

• Cardiac ischemia

In this case, shortness of breath is manifested by a feeling of lack of air. In general, shortness of breath is as typical a sign of coronary heart disease as squeezing pain in the left side of the chest. What to do? If you experience shortness of breath and severe chest pain for the first time, call an ambulance immediately. In men, especially young men, coronary heart disease sometimes manifests itself for the first time as a myocardial infarction. When providing first aid, the scope of research is usually limited to a cardiogram, and after that the decision regarding examination and treatment is made by a cardiologist.

• Congestive heart failure

It is quite difficult to catch the early signs of this disease - this is usually done with the help of special examinations. In congestive heart failure, shortness of breath is always accompanied by a forced position of the patient. It occurs in a person lying on a low pillow and goes away when the patient assumes a sitting position. For example, US President Roosevelt slept in a sitting position in a chair for precisely this reason. This shortness of breath occurs due to increased blood flow to the heart in a supine position and overflow of the heart chambers. Treating shortness of breath in heart failure is not an easy task, but experienced cardiologists and modern medications sometimes work wonders.

• Cardiac asthma or paroxysmal dyspnea

Such sudden shortness of breath, which develops into suffocation, often appears at night. Shortness of breath does not go away either in a sitting or standing position. The person becomes pale, moist wheezing appears in the chest, and the lungs begin to swell. This condition threatens the patient’s life, so you should immediately call an ambulance. Typically, prompt treatment is effective and eliminates an attack of cardiac asthma. In this case, the patient will need to regularly visit a cardiologist, since only competent treatment of cardiovascular diseases will maintain normal health.

• Pulmonary embolism

Almost the most common cause of shortness of breath is deep vein thrombophlebitis.
At the same time, a person does not always develop varicose veins on the surface of the skin, which would give a call to see a doctor. The insidiousness of deep vein thrombophlebitis is that the first episode is quite easy - the leg swells slightly, pain and cramps appear in the calf muscle - the sensations are just like a sprain, and there is no prompting to be examined by a doctor. The problem is that after this, blood clots appear in the veins of the problem limb, which can move to the pulmonary artery and block the lumen in it. And this, in turn, leads to the death of a section of the lung - infarction-pneumonia. Signs of pulmonary embolism are severe shortness of breath that suddenly appears against the background of normal health, stabbing pain in the chest, and a painful cough. In especially severe cases, a person’s face turns blue. Modern medical methods effectively treat this serious disease, however, it is better not to lead to thromboembolism, but to promptly seek help from a doctor if there is any suspicion of pathology of the veins of the lower extremities. Signals may include swelling, heaviness in the legs and cramps in the calf muscles. As you can see, shortness of breath appears for many reasons, ranging from those requiring only some lifestyle changes to those that require serious treatment. Fortunately, many conditions can be prevented or significantly alleviated by timely treatment of pulmonary and cardiovascular diseases. There are contraindications. Read the instructions or consult a cardiologist at the EMC clinic.

Treatment Options

In the event of shortness of breath and lack of air due to heart failure, treatment involves taking medications to improve the functioning of the heart muscle. After studying the research results, the doctor will tell you what to take in case of heart failure to eliminate the feeling of lack of air. Treatment at home is possible only for the chronic form of the disease: the acute form requires hospitalization under round-the-clock medical supervision.

When shortness of breath appears during physical activity, the first thing you need to do is to minimize the load on the body and give it a rest. In case of acute dyspnea, walking in the fresh air will help ensure normal ventilation of the lungs. If the cause of oxygen deficiency is inflammation of the respiratory system, then it is necessary to eliminate the source of infection.

If the lack of air is associated with chronic diseases or conditions that do not require hospitalization, an effective method to cope with the lack of air is the use of oxygen cartridges. They contain a concentrated mixture consisting of 80% oxygen and 20% nitrogen. It quickly saturates the blood and relieves symptoms of oxygen deficiency. Spray cans have virtually no contraindications. They are also suitable for making oxygen cocktails, another effective way to increase oxygen levels in the blood.

The PRANA company produces KISLOROD oxygen cylinders with a volume of 8 to 16 liters and offers to purchase them in bulk at competitive prices. Find out what delivery conditions we can offer by contacting the manager.

What to do if you have shortness of breath?

Various types and types of shortness of breath (including shortness of breath after eating) are indicators of the presence of certain diseases. At the same time, lack of air in itself is not a disease and cannot be treated separately. We are talking about complex treatment of the cause of shortness of breath. To identify it, you need to contact a qualified specialist and undergo an examination using modern equipment. Only after this can we pinpoint exactly what is causing the breathing difficulty and create an individual treatment program for the patient.

Do not delay in seeing a doctor. In certain diseases, shortness of breath can develop into suffocation, which has a sharply negative effect on brain function. Every time you put off going to the clinic after an attack of shortness of breath, your condition only gets worse.

Edema and heart failure

Edema is not always a sign of heart failure. Their most common cause is peripheral venous insufficiency. Due to the expansion of the veins and the incompetence of the venous valves, the blood does not overcome gravity well (it is difficult to climb up the veins of the legs), stagnates in the legs and part of the plasma goes into the tissues. Such swelling is treated with compression hosiery, venotonic drugs, and in severe cases - with surgical methods.

There are still many causes of edema, so if you do not have obvious heart disease, but edema appears, first be examined by a competent therapist.

The main causes of edema:

• Peripheral venous insufficiency
• Lymphostasis
• Taking calcium antagonists, oral contraceptives, non-steroidal anti-inflammatory drugs
• Heart failure
• Liver diseases (liver cirrhosis)
• Kidney disease (severe renal failure)
• Compression of large vessels by the tumor
• Idiopathic edema

I’ll write separately about swelling on the face, which is very frightening for women and which for some reason is popularly considered “renal.” In fact, this is most often a purely cosmetic problem rather than a disease. There is fatty tissue around the eyes that reacts to changes in the amount of fluid around and accumulates water very well. With excessive consumption of salt and liquid, there is a slight increase in the volume of this periocular tissue. In this case, you just don’t need to eat salty foods or drink a lot at night.

How to diagnose heart failure

But let's return to the diagnosis of heart failure: in fact, it is not as simple as it seems. In addition to symptoms, we focus on two studies: echocardiography and a special blood test for brain natriuretic peptide levels.

In echocardiography, the main indicator that indicates a decrease in cardiac contractility is ejection fraction . Ejection fraction is the percentage of blood volume that is pushed out of the heart's left ventricle during each heartbeat. If there were 100 ml of blood in the ventricle, and after the heart contracted, 55 ml entered the aorta, then we can say that the ejection fraction was 55%. By the way, this indicator is the limit of the norm. If the ejection fraction on echocardiography is <55%, then they speak of systolic heart failure.

In recent years, it has become possible to diagnose heart failure even through a blood test. This test is called brain natriuretic peptide . This protein serves as a regulator of water-salt metabolism and blood pressure in the body. An increase in its level is an additional sign of heart failure.

What can be seen on an ECG in a patient with heart failure? Yes, almost anything. Each of the identified changes gives a hint to the doctor regarding treatment tactics.