People who have shortness of breath describe it in different ways. Some people say that they feel like they can’t take a deep breath in or get enough air. Other people might feel like their chest is tight or they have to work harder than usual to breathe. Shortness of breath can start suddenly, over minutes to hours. It can also happen over a longer period of time, from weeks to months. Feeling short of breath can be an uncomfortable or frightening experience, especially if it has never happened to you before. It can be caused by problems with the lungs or with the heart, or by a low blood count, but its specific cause can sometimes take a while to be identified. Luckily, most causes of shortness of breath can be treated quickly once the cause is identified. Many cases of shortness of breath are caused by simple, short lived problems, such as respiratory tract infections or allergies. The medical term for shortness of breath is dyspnea. Acute shortness of breath, which comes on suddenly, over the course of minutes or hours, usually has different causes than chronic shortness of breath, which develops over weeks or months. The most common causes of shortness of breath that start suddenly are; lung problems, such as asthma, infections, or blood clots but these conditions might cause other symptoms, too. For example, a lung infection usually causes a fever and cough. Heart problems, such as a heart attack or heart failure can cause sudden shortness of breath. A severe allergic reaction, called “anaphylaxis” can cause sudden shortness of breath and this is usually associated with other symptoms such as itching, swelling, or a rash. It is usually normal for a pregnant woman to feel slightly short of breath just after they lie down or are active. The most common cause of shortness of breath that happens over weeks to months is; lung problems such as asthma or chronic obstructive pulmonary disease (COPD), both of which can make it hard to breathe. COPD is usually caused by longstanding history of smoking. Heart problems, such as heart failure or a change in the size and shape of the heart (called cardiomyopathy) and being overweight, or out of shape, can cause shortness of breath for a long time Pinpointing the exact cause of one’s shortness of breath isn’t usually easy; hence, once one experiences shortness of breath, they should seek medical care early to rule out serious causes which can be fatal if there is no early intervention. The physician will usually diagnose the cause of shortness of breath basing on the history of the patient, physical examination findings and medical investigations done. Depending on what the doctor suspects from the history and physical examination findings, he or she might order one or more of the tests such as; blood tests, chest X-ray, examination of the heart (called an ECG) to measure the electrical activity in the heart, or a breathing test. The treatment for your shortness of breath will depend a lot on what is causing it. Once your doctor or nurse figures out the cause of your symptoms, he or she will talk with you about different possible treatments. Shortness of breath caused by asthma, for example, will need one type of treatment, whereas shortness of breath caused by heart failure will need quite another Dr. Ian Shyaka Resident in Surgery, Rwanda Military Hospital, iangashugi@gmail.com
