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DYSPNEA

(BREATHLESSNESS ON EXERTION)
Dyspnea

WHAT YOU NEED TO KNOW:

What is dyspnea? Dyspnea is breathing discomfort. It is often described as shortness of breath and can occur during rest or activity.

What signs and symptoms can occur with dyspnea?

  • Chest tightness or pain

  • Cough or a coarse or high-pitched noise when you breathe

  • Pale and sweaty, cool skin

  • Confusion and tiredness

  • Bluish-gray lips or nails

What increases my risk for dyspnea?

  • Swelling in the throat from an infection or allergic reaction

  • Lung conditions such as asthma, COPD, cancer, infection, or a blood clot

  • Heart conditions such as abnormal heartbeats, heart failure, or coronary artery disease

  • Smoking, exposure to chemicals such as carbon monoxide, or too much aspirin

  • A condition that affects your central nervous system, such as a spinal cord injury or nerve damage

  • Enlarged abdomen because you are overweight, pregnant, or have ascites (fluid in the abdomen) from liver disease

  • Anemia (low red blood cell count), anxiety, panic, or going to a high altitude

How do healthcare providers find the cause of dyspnea? Your healthcare provider may ask when your dyspnea began and what you were doing. Tell him how often you have dyspnea and what makes it worse or better. Tell your healthcare provider about medicines you take. Tell him if you have any other symptoms, such as pain or a fever. Your healthcare provider will listen to you breathe and watch for irregular breathing. You may also need the following:

  • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood.

  • Blood tests: These can show your healthcare provider if you are at risk for blood clots or heart failure. Blood tests can also show if you have anemia or an infection.

  • Chest x-ray: This is a picture of your lungs and heart. Healthcare providers use it to look for signs of infection, or for fluid around the heart and lungs.

  • Exercise tests: These help your healthcare provider learn if you have symptoms, along with dyspnea, that limit activity. Symptoms include leg pain, fatigue, and weakness. Exercise tests can also show if your dyspnea is caused by heart problems.

  • CT scan: This is also called a CAT scan. An x-ray machine uses a computer to take pictures of your lungs. The pictures may show blood clots or an area of disease in your lungs. You may be given dye before the pictures are taken to help healthcare providers see the pictures better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye.

How is dyspnea treated? You will work with your healthcare provider to treat the condition causing your dyspnea. You may need the following to improve your symptoms:

  • Oxygen therapy: This may be used to help you breathe easier. You may need oxygen if your blood oxygen level is lower than it should be.

  • Medicines: Ask about these and other medicines you may need:
    • Steroids: These reduce swelling in your airway.

    • Diuretics: These decrease excess fluid from around your heart or lungs. They are often called water pills. You may urinate more often when you take this medicine.

    • Anxiolytics and antidepressants: These decrease anxiety and may help you feel calm and relaxed.

  • Pulmonary rehabilitation: Your healthcare provider may suggest pulmonary rehabilitation to reduce your symptoms while keeping you active. You may learn breathing techniques, muscle strengthening, and how to pace yourself when active.

How can I manage long-term dyspnea?

  • Breathing strategies:
    • Reposition yourself: Lean forward on your elbows when you sit. This helps your muscles expand and may make it easier to breathe.

    • Pursed-lip breathing: This can be used any time you feel short of breath. Breathe in through your nose and then slowly breathe out through your mouth with your lips slightly puckered. It should take you twice as long to breathe out as it did to breathe in.

  • Follow your treatment plan: This includes taking medicines to help manage medical conditions such as lung or heart disease. Follow your exercise and weight loss plan from healthcare providers.

  • Do not smoke: If you smoke, it is never too late to quit. Smoking increases your risk for dyspnea as well as lung and heart damage. Ask your healthcare provider for information if you need help quitting.

When should I contact my healthcare provider?

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

  • Your signs and symptoms are the same or worse within 24 hours of treatment.

  • You have shaking chills or a fever over 102°F.

  • You have new pain, pressure, or tightness in your chest.

  • You have a new or worse cough or wheezing, or you cough up blood.

  • You feel like you cannot get enough air.

  • The skin over your ribs or on your neck sinks in when you breathe.

  • You have a severe headache with vomiting and abdominal pain.

  • You feel confused or dizzy.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.