Shortness of Breath: What's Normal?

Ever feel as though you can’t catch your breath? That heavy, can’t-quite-get-enough-air feeling that leaves you wondering if you overdid it or if something is wrong? Pulmonologist Sandeep Gupta, MD, UnityPoint Health, clarifies what’s normal and what’s not for shortness of breath, including when it’s time to see a doctor.

What Does Shortness of Breath Feel Like?

Shortness of breath, or dyspnea, is difficulty breathing when resting or performing every day, age-appropriate tasks. Shortness of breath is commonly associated with symptoms of fatigue and anxiety, as well as a possible cough and/or chest pain.

“Shortness of breath can be sudden, or it can present slowly over time,” Dr. Gupta says. “Sudden shortness of breath may be caused by a secondary infection in the already compromised lung from lung disease. Slow, onset shortness of breath usually occurs if someone is a long-standing smoker, which also leads to lung disease.”

Shallow breathing is not the same as shortness of breath. Shallow breathing isn’t considered dyspnea if the person is comfortable performing daily tasks.

“Technically, shallow breathing means shorter inhaling and exhaling than normal breathing but with an equal cadence. While in shortness of breath, inhalation is usually much shorter than exhalation,” Dr. Gupta says.

Shallow breathing can become shortness of breath when normal tasks are no longer possible, or if feelings of anxiousness start to occur.

What Causes Shortness of Breath

Many conditions can be associated with shortness of breath. Dr. Gupta lists the most common.

• Asthma. Reversible inflammation and constriction in the airway (bronchi) that makes both inhaling and exhaling difficult.
• Chronic obstructive pulmonary disorder (COPD). Irreversible condition marked by slow changes in the breathing tubes (bronchi and alveoli) that makes exhalation difficult.
• Heart attack. Causes either decreased blood flow to the lungs or congestion of the lungs with fluid.
• Interstitial lung disease. Damage in the lung tissue from various long-term causes, like smoking, job environment, etc.

“Typically, people start to feel short of breath in their 50s, as changes take time to progress. When we’re young, we can make up for reduced lung function with our physical state,” Dr. Gupta says.

If someone experiences shortness of breath at a young age, Dr. Gupta says it’s most commonly from asthma or acute bronchitis. In certain cases, like emphysema or early onset cardiac diseases, genetics may play a role.

How to Tell if Shortness of Breath is from Anxiety

Shortness of breath is a common symptom of anxiety. This is a normal reaction by the body.

“If people notice shortness of breath while feeling anxious, they should try to find the cause of the anxiety, get out of the situation and calm themselves down. Symptoms can progress to a panic attack. So, if things don’t improve, it’s best to seek urgent medical attention,” Dr. Gupta says.

Shortness of Breath from COVID-19

Shortness of breath is also one of the symptoms experienced by those who contract the COVID-19 virus. Dr. Gupta says your experience with this symptom could vary depending on the severity of the viral infection.

“Shortness of breath can be mild to very severe. The symptoms could start with a mild cough and shortness of breath with exertion and exercise, and then it progresses to be shortness of breath while at rest,” Dr. Gupta says.

Shortness of breath with COVID-19 begins because of the viral inflammation in the body, which damages the lungs. That can cause pneumonitis and pneumonia. Dr. Gupta says, unfortunately, the virus can worsen quickly causing hospitalization.

If you’re experiencing shortness of breath from COVID-19, contact your care team to determine the best approach for your care.

Shortness of Breath with Exercise

If you’re just finishing a hard workout, feeling short of breath isn’t unusual. But, if you feel like you have regular shortness of breath with exercise, Dr. Gupta suggests keeping this in mind.

“An important factor when working out is the overall conditioning shape of the body. Slowly building in intensity during your workouts should help with feeling less winded,” Dr. Gupta says.

However, there are some shortness of breath symptoms that aren’t normally associated with exercise and shouldn’t be ignored. See a doctor if you experience any of the following:

• High heart rate with chest heaviness
• Chest pain, pressure or palpitations
• Paleness
• Dizziness or sinking sensation
• Fatigue
• Fainting

Shortness of Breath Treatment

If shortness of breath is an isolated event, Dr. Gupta says you can try these methods to feel better at home:

• If associated with a cough or congestion, try using steam or over-the-counter decongestants to relieve feeling short of breath.
• If wheezing, use an inhaler with your provider’s approval.

“If shortness of breath continues for a couple of hours, doesn’t get better or comes back, it’s always safest to seek medical attention,” Dr. Gupta says.

Every person is different, and treatment options differ with disease causes. Having an accurate diagnosis by a pulmonary specialist is key to fully managing shortness of breath.

“Consult your doctor as soon as possible to get a diagnosis and treatment plan. The sooner the diagnosis, the simpler the treatment can be. Waiting too long can make the disease progress and get more complex,” Dr. Gupta says.

Shortness of breath can also warrant a visit to the emergency room. Know where to get emergency care when you need it.