Dyspnea - difficulty breathing: diagnosis of causes and effective treatment

The article was checked by a cardiologist, Ph.D. Zhelyakov E.G., is for general informational purposes only and does not replace specialist advice. For recommendations on diagnosis and treatment, consultation with a doctor is necessary.

Specialists at the Clinical Hospital on Yauza diagnose the causes of shortness of breath (assessment of respiratory function, X-ray, ECG) and treat the diseases that cause it at the modern level. Treatment of shortness of breath always involves treating the underlying disease and eliminating its causes (for example, achieving compensation for heart failure, etc.).

Shortness of breath is the main symptom of chronic heart failure, bronchial asthma, chronic obstructive pulmonary disease
Up to 27% of people worldwide suffer from some form of shortness of breath
Spirography is the gold standard for assessing external respiration

Shortness of breath (dyspnea) - a violation of the rhythm, frequency, depth of breathing, a subjective feeling of lack of air, difficulty breathing - this is a complaint with which the patient first of all turns to a doctor. This symptom can be a manifestation of various diseases.

Respiration is an important body function that ensures that all cells have enough oxygen to survive and that toxic carbon dioxide is removed. Any problems that arise during the breathing process and cause shortness of breath may be a sign of serious illness. Therefore, there is a need for immediate medical attention.

Sudden shortness of breath may be caused by the development of heart pathologies or an asthma attack. Long-term shortness of breath is usually associated with pulmonary pathology.

Types of shortness of breath

The sensation of shortness of breath occurs when a signal from receptors located in the epithelium of the respiratory tract enters the respiratory center located in the brain stem. Respiratory signals are processed taking into account behavioral, intellectual and situational signals.

Shortness of breath is a symptom of the disease, not the disease itself. Therefore, its etiology can be defined as arising from four main categories:

Central – diseases of the nervous system with impaired functioning of the respiratory center, with neuroses and other functional pathologies of the central nervous system.
Pulmonary – observed in diseases of the lungs (pneumonia, chronic obstructive pulmonary disease, bronchial asthma, pulmonary fibrosis) and chest.
Cardiac – a symptom of heart failure during myocardial infarction, myocarditis, cardiomyopathies, heart defects, etc.
Hematogenous - any type of anemia, the effect on the respiratory center of changes in blood acidity and toxic metabolic products in case of poisoning, liver failure, decompensated diabetes mellitus, etc.

For different diseases, shortness of breath is perceived differently, but in any case it differs from increased breathing, which occurs during physical activity in healthy people.

Note!

Differences between cardiac and pulmonary dyspnea:

With cardiac dyspnea, the heart cannot cope with the load, stagnation occurs and gas exchange is disrupted, which provokes rapid breathing.
Pulmonary shortness of breath appears due to the accumulation of sputum in the organs of the respiratory system and is accompanied by a cough.

Cardiac dyspnea, unlike pulmonary dyspnea, occurs without expiratory difficulties (short inhalation and difficult exhalation). In an upright position and at rest the condition improves. With pulmonary dyspnea, hypoxemia (low oxygen in the blood), respiratory acidosis (accumulation of large amounts of carbon dioxide in the blood) and hypercapnia (excessive amount of CO2 in the blood) are observed.

Shortness of breath is a subjective sensation. Only the patient himself can differentiate its intensity. However, in any case, if you feel short of breath, it is better to consult a doctor and determine the cause of the ailment. Shortness of breath is often a symptom of a serious pathology that can lead to disability. To avoid serious illnesses, make an appointment with a doctor and get tested without delay.

Respiratory neurosis

There are many types of neuroses, each of which is distinguished by a specific group of symptoms. One of them is respiratory neurosis, which is characterized primarily by neurogenic breathing disorder.

The concept was introduced into use in 1871 by the American scientist Da Costa. It has several related names: “respiratory neurosis”, “neurorespiratory syndrome”, “respiratory dystonia”. But the term most often used is “hyperventilation syndrome” (HVS) . It accounts for approximately 10% of cases. Among the patients there are both children and adults. It is worth noting that women suffer from this disease several times more often than men.

The causes of the syndrome are divided into mental, organic, and mixed. Of course, the majority (about 60%) is due to psychogenic factors.

5% of cases include organic etiology. These include disorders of the structure of the central nervous system: encephalopathy, hydrocephalus, inflammation of the meninges, as well as diseases such as diabetes, hypertension, chronic bronchitis. Sometimes the reason is taking certain medications.

During the course of the disease, there are 3 groups of signs:

respiratory;
psycho-emotional;
muscular.

Group I has several forms of manifestations:

Empty breathing is a feeling of lack of air, its pace quickens.
It seems that air is forced into the lungs, and there is a lump in the throat. Accessory muscles are involved in the respiratory act.
A premonition of breathing stopping appears, and the person is forced to control its process by consciously inhaling.
Yawning, moaning, sighing.

Group II symptoms include nervous tension and concern about one’s condition. The patient cannot relax. He develops phobias, in particular, a fear of open areas and places with large crowds of people.

Symptomatic group III includes muscle hypertonicity, various tactile sensations in the form of tingling, burning, and “goosebumps.”

This triad of symptoms is a typical, leading manifestation of the disease.

The disease is characterized by a chronic course, in which exacerbations occur.

An exacerbation of hyperventilation syndrome is called a hyperventilation crisis. This is a condition in which the manifestations of the disease intensify. Characterized by an increased sense of fear. The patient is suffocating, hysterical, and feels “near death.” At the same time, he is accompanied by chills, dizziness, nausea, and becomes covered in sticky cold sweat.

A crisis is caused by a negative psychological environment. A unique way to relieve an attack is to breathe into a bag. In this case, carbon dioxide is concentrated in it, which the neurotic inhales. Gas balance is restored, breathing is leveled out. This is the first aid in this situation.

As for children, they are also characterized by such a pathology as respiratory neurosis, which is also caused by stress, phobias and anxiety disorders. But it is worth noting that the main role in their occurrence is played by an unfavorable situation in the family, and this applies not only to rude and inadequate attitude towards the child, but also to the relationship between parents. Constant quarrels and conflicts in the family, aggression can provoke the development of psychogenic shortness of breath in children.

Such children are characterized by anxiety and lability (instability) of mood. They experience outbursts of anger over trifles, general nervousness, refusal to communicate with friends, and sleep disturbances.

Parents should be more vigilant and sensitive in raising their children.

Causes of shortness of breath

Shortness of breath, a feeling of lack of air can be associated with disturbances in external (oxygen supply through the lungs) or internal (tissue) respiration:

Impact on the respiratory center of toxins, metabolic products in severe infectious diseases.
Respiratory impairment due to exposure to toxic chemicals at the cellular level.
Chest injuries that violate the tightness of the pleural cavities; compression of the lungs with pneumothorax, hydrothorax.
Neurological complications in multiple sclerosis, myasthenia, functional and neurotic breathing disorders in hysteria, neurasthenia, etc.
Blockage of the airway lumen with viscous secretion (with bronchitis, bronchial asthma), tumor, foreign body (button, food, vomit).
Swelling and thickening of the bronchial wall, spasm of the bronchial muscles of an allergic or inflammatory nature in bronchial asthma, pneumonia, etc.
Heart failure, in which there is stagnation of blood in the vessels of the pulmonary circulation, effusion of fluid into the alveoli of the lungs, a decrease in the vital capacity of the lungs, and a decrease in peripheral blood flow.
Coronary heart disease, when the main symptom of insufficient blood supply to the myocardium is shortness of breath.
For anemia as a result of decreased hemoglobin levels and a decrease in the number of red blood cells due to blood loss; in case of poisoning with certain chemicals that bind hemoglobin.
Obesity and physical detraining can also cause shortness of breath with minimal physical activity.

Intense exercise, extreme temperatures, obesity, and high altitude can all cause shortness of breath in a healthy person. Outside of these examples, dyspnea is a sign of a medical problem. If you experience unexplained breathing problems, especially if they occur suddenly, you should consult a doctor immediately.

Characteristic symptoms

Shortness of breath with coronavirus: how to understand ? It is difficult for the patient to take a deep breath. He makes at least twenty respiratory movements, which is typical for the moderate severity of the disease. As for the severe degree, it is characterized by more than thirty respiratory movements per minute.

At the same time, severe inflammatory processes occur in the lungs: a person’s body temperature rises, but in some situations, shortness of breath with coronavirus without fever , a dry cough is bothersome. But in some cases there may be no symptoms. Then the cough is caused by fear and panic.

If pneumonia is present, during auscultation the doctor hears whistling and wheezing in the bronchi. This is often typical for patients with concomitant bronchial asthma, chronic bronchitis and in the presence of secondary lung damage. Subsequently, if treatment is not timely, edema of the pulmonary tissue may develop - this is a life-threatening condition.

Symptoms of shortness of breath

Dyspnea can be characterized by a variety of clinical manifestations due to the large number of possible causes. However, the most common symptoms are coughing and changes in breathing patterns. Signs may appear when a person is at rest and during intense exercise.

Symptoms that accompany shortness of breath:

fatigue, weakness;
cardiopalmus;
sudden lack of air;
difficulty breathing in and out;
signs of dizziness;
swelling of the lower extremities;
fast, irregular heartbeat;
decreased physical activity;
cough or wheezing when breathing;
hemoptysis (coughing up blood);
blueness of nails and lips due to poor circulation;
pain, tightness in the chest (if shortness of breath occurs as a result of a heart attack).

The patient feels as if after intense physical activity or hard physical work. Respiratory dysfunction prevents a person from speaking normally and pronouncing long words and phrases. Speech becomes short and abrupt.

All breathing problems, whether sudden or long-term, regardless of symptoms, should be taken seriously. Although many of the possible causes are harmless and easily treatable, you should still see a doctor for a thorough medical examination.

Shortness of breath in people of different age categories

Shortness of breath can occur in people of all ages, from infants to the elderly.

In children, shortness of breath can be both physiological and pathological. The appearance of physiological shortness of breath is caused by physical exertion or high anxiety, which is considered normal. When the respiratory system is immature, pathological shortness of breath occurs in the infant. How to determine the type of shortness of breath and its causes is decided by the pediatrician, selecting the necessary diagnostic methods.

In old age, people's tolerance to physical activity decreases and the efficiency of the respiratory system decreases. Due to age-related changes, the physical strength of the respiratory muscles decreases, as a result of which gas exchange worsens and normal breathing becomes difficult. In addition, older people tend to have diseases of the cardiovascular system and lungs, which lead to shortness of breath. Most often, they do not pay attention to this symptom for a long time, so the diseases that accompany it are diagnosed at advanced stages. As a result, treatment becomes more difficult, the quality of life and its duration are significantly reduced. So it is better to immediately seek medical help if shortness of breath occurs in older people, without waiting for the condition to worsen.

The best pulmonologists in Moscow - Doctor of Medical Sciences, Professor Alexander Vyacheslavovich Averyanov, Candidate of Medical Sciences Alexander Evgenievich Shuganov are receiving appointments at the therapy center of the Yusupov Hospital. Klina is equipped with innovative high-tech equipment for conducting the most modern diagnostic studies. Thanks to an integrated approach involving specialized specialists in various fields, our doctors identify the exact cause of shortness of breath and select an effective treatment regimen, taking into account the individual characteristics of each patient.

What to do if you have severe shortness of breath?

Noninvasive ventilation (NIV) provides relief for increased breathing needs. This procedure is less useful for patients with defects in oxygen diffusion in the alveolar arteries. The most effective component of pulmonary rehabilitation is special breathing exercises.

Recommendations to follow in case of severe shortness of breath:

If you have serious breathing problems, it is better to sleep with the head of the bed raised. This will help the lungs expand and promote drainage of secretions.
While sitting, lean forward on your elbows. This will also help your lungs expand and make breathing easier.
To reduce anxiety, you can use relaxation techniques (take slow, even, deep breaths and try to focus on pleasant things).
Take medications strictly as prescribed by your doctor.
If you experience side effects from your medications, especially if they are severe, tell your doctor or emergency team members.
Use pursed-lip breathing when you feel short of breath. Inhale through your nose and exhale very slowly through your mouth, pursing your lips slightly. The exhalation should last twice as long as the inhalation.
If you experience sudden breathing problems, you should open a window, move to another room where there are fewer people, or go outside.
Nicotine and other chemicals in cigarettes can make shortness of breath worse. Electronic cigarettes also contain nicotine.
Cold air and using fans to blow air onto the face can significantly improve shortness of breath. Supplemental oxygen has only been shown to be beneficial in hypoxic patients.

Simple but effective recommendations help improve your shortness of breath. Additional measures are aimed at reducing anxiety and providing an increased sense of control.

There are a huge number of reasons for shortness of breath. It is impossible to determine on your own whether it is a symptom of a serious illness. Only a highly qualified specialist can determine which organ disease caused the pathology and prescribe the appropriate examination. Make an appointment with your doctor to determine the cause of your discomfort.

Diagnostic stages

Consultation with a therapist. The doctor will conduct a thorough examination of the patient and ask him about accompanying symptoms. If necessary, he will refer the patient to other specialists at our hospital - a cardiologist, hematologist, and psychotherapist.

Laboratory diagnostics

general blood analysis;
blood chemistry.

Instrumental diagnostics

spirography
ECG;
ECHO-KG
Chest CT scan or radiography.

Additional examination

, the volume of which is determined individually depending on the direction of the diagnostic search.

Which doctor should I contact if I have shortness of breath?

If this clinical manifestation is regular, you should first visit your doctor. He will conduct an examination, collect anamnesis - and, based on the information received, send the patient to an appointment with a specialist in pulmonology, cariology, hematology, neurology or endocrinology.

If a patient has a traumatic injury to the chest, he should consult a traumatologist. In cases where shortness of breath is part of an emergency condition - it appears suddenly and sharply - you should immediately call an ambulance.

Treatment of shortness of breath

Treatment of shortness of breath is carried out in accordance with the cause and individually for each patient.

For bronchitis with difficulty in sputum discharge, the therapist may prescribe sputum thinners and expectorants; for bronchial obstruction, bronchodilators.

Treatment of shortness of breath in heart failure is complex and prescribed by a cardiologist.

For hematogenous dyspnea, treatment is aimed at combating anemia.

The psychogenically caused feeling of lack of air, characteristic of panic attacks and other forms of neurotic disorders, is treated in a course of psychotherapy.

In case of massive pleural effusion (accumulation of fluid in the pleural cavity and compression of the lung), puncture of the pleural cavity (removal of fluid) may be necessary, performed by a surgeon.

In acute conditions with severe life-threatening respiratory disorders, urgent hospitalization of the patient in the intensive care unit for mechanical ventilation is required.

If you are concerned about shortness of breath, you should consult a doctor. The multidisciplinary team of doctors at the Yauza Clinical Hospital will help you correctly prescribe and conduct an examination, establish the cause, and prescribe effective treatment.

Cough with suffocation

An acute lack of air provokes anxiety and even fear for one’s life. Typically, bronchospasm develops suddenly; the attack may begin with a strong cough, a feeling of pressure in the chest, anxiety and itchy skin. Attacks of suffocation can be caused by asthma, COPD, pneumothorax, laryngitis and tracheitis in advanced forms, edema and tumors of the larynx, trachea and bronchi, and lung cancer.

Complications after difficulty breathing

People suffering from shortness of breath are limited in daily and social activities. This affects independence and reduces social significance. As it progresses, anxiety and worry arise. Sleep disturbance occurs and depression develops. Chronic heart failure is especially dangerous.

Metabolism and gas exchange disorders in the body can lead to dangerous complications:

decrease in blood pressure;
pulmonary edema;
persistent breathing problems;
attacks of suffocation against the background of cardiac cardiac asthma.

As the disease progresses, the following disorders are observed:

blueness of the limbs and lips (cyanosis);
suffocating cough at night;
gurgling sensation in the heart area;
the appearance of profuse cold sweat;
development of pulmonary emphysema;
discharge of sputum with traces of blood;
decreased elasticity of lung tissue and blood vessels.

Pulmonary edema and heart failure are very serious and dangerous pathologies for human health. If shortness of breath occurs at rest, you should immediately seek medical help.

Psychogenic asthma

In general, bronchial asthma refers to a pathology of the respiratory system. Its development is associated with changes in the structure of the bronchi against the background of immune failures, that is, it is a very specific disease, the etiology of which is not related to mental factors.

People suffering from this disease may develop a condition called psychogenic asthma. This happens when attacks of suffocation, the main symptom of the disease, are provoked by nervous overstrain, both positive and negative, whereas in normal cases this occurs under the influence of cold, infections or physical exertion.

Under the influence of super-emotions, histamine is released. This is one of the main mediators of inflammation. It causes bronchospasm. The result is a dry cough, shortness of breath and an attack of suffocation.

Psychogenic asthma often develops in women during the menstrual period and in children, whose psyche is still quite unstable and very sensitive.

Prognosis and prevention

Dyspnea does not fall into the category of systemic diseases. This is a sign of the development of cardiac or pulmonary pathology. The problem can only be dealt with by treating the underlying disease. With dystrophic changes as a result of the development of cardiac pathologies, survival rate decreases to 60%. Only early diagnosis and timely treatment can guarantee a favorable outcome.

To relieve the symptoms of shortness of breath or for prevention purposes, it is recommended to adhere to the following rules:

Perform simple exercises to train the respiratory system and increase muscle tone, unless there are contraindications.
Avoid contact with allergens that may worsen the condition.
Prevent seasonal infections.
Stop smoking.
Control body weight.

The main condition for preventive measures is strict compliance with all recommendations of the attending physician.

Shortness of breath may make it difficult to eat. Here are some practical tips for saving energy and getting the most out of your food:

eat in small portions;
try to breathe calmly and evenly while eating;
Frozen convenience foods, ready-made meals, or take-out and delivery can make life easier;
it is recommended to limit the amount of products that cause gas formation;
You can keep a food diary to determine which foods worsen your overall condition.

In some cases, acupressure and/or acupuncture can help. Before deciding to prescribe procedures, you should definitely consult your doctor. Both practices focus on stimulating hot spots to optimize energy flow and release blockages.

Dyspnea at rest is a rare phenomenon that accompanies severe and advanced diseases. This phenomenon usually appears during physical activity. Pay attention to whether you have difficulty breathing when climbing stairs or walking quickly. If you notice a lack of oxygen, be sure to make an appointment with your doctor for consultation.

Why us

Doctors. We receive specialists of the highest qualification category, holders of academic degrees, with extensive experience in leading Russian clinics.
Individual approach. The doctor will develop an individual examination and treatment plan for each patient in accordance with the cause of development and clinical picture of the disease.
Complexity. The therapists at our clinic work in close collaboration with other specialists - cardiologists, hematologists, psychotherapists. This provides effective treatment for shortness of breath of various origins.
Expert equipment. All studies are carried out using modern equipment and are highly accurate.
Comfort. All consultations, studies and treatment are carried out within our hospital, which allows our patients to save energy and time.

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