Dyspnea - Difficulty Breathing, Uncomfortable breathing, breathlessness, Common causes

Dyspnea is subjective experience of uncomfortable breathing. It is described differently as: intense tightening in the chest, air hunger, difficulty breathing, breathlessness or a feeling of suffocation.
Such differences in description is because, there is no objective criteria you can describe dyspnea, it is subjective experience. And simplest and broadest definition of dyspnea Is uncomfortable breathing.
Almost 85 % of cases are: Chronic obstructive pulmonary disease, cardiac failure, asthma, ischemic heart disease, interstitial lung disease and psychological conditions
Almost half of dyspnea cases are caused by Chronic obstructive pulmonary disease or Asthma.
Symptoms of Chronic obstructive pulmonary diseases(COPD) include:
Frequent coughing or wheezing. Excess phlegm or sputum. Shortness of breath. Trouble taking a deep breath. COPD is associated with long term smoking.
COPD is diagnosed using a simple breathing test called spirometry.
COPD has exacerbations which can be treated with antibiotics.
Quite smoking, exercise and healthy diet is important for management of COPD.

Asthma: affecting both children and adults, and is the most common chronic disease among children.
Asthma characterized by asthma attacks, symptoms which can be any combination of cough, wheeze, shortness of breath and chest tightness. Asthma characterized diurnal variation of symptoms. Coughing at night is common characteristic of asthma.
Inhaled bronchodilator medication can control asthma symptoms and allow people with asthma to lead a normal, active life. Avoiding asthma triggers can also help to reduce asthma symptoms.
If cough and fever are accompanied with dyspnea, pulmonary disease, infection is the primary concern. Such as pneumonia or acute bronchitis.
Acute bronchitis also can be associated with dyspnea + wheezing.
Chest radiography is fairly sensitive and specific to assess heart failure caused dyspnea.
Interstitial lung disease is an umbrella term used for a large group of diseases that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs which makes it difficult to breathe and get oxygen to the bloodstream. Lung damage from ILDs is often irreversible and gets worse over time.
shortness of breath is accompanied with a dry cough, chest discomfort, fatigue and occasionally weight loss. Interstitial lung disease is rare disease and more common in older ages.
To diagnose an interstitial lung disease a chest X-ray or CT scan is informative lung study.
Rapid onset of very severe dyspnea without any other symptoms, can indicate pulmonary embolism or pneumothorax. Such cases are rare.
Pulmonary embolism shoud be always suspected if person has new onset of dyspnea plus + Deep vein thrombosis risk factors such as: prolonged immobilization, surgery, estrogen therapy,. Or obesity, lower extremity trauma and cancer.
New onset of dyspnea can defined as 4 weeks or earlier.


Pulmonary lymphogenic carcinomatosis can be considered when patient has malignancy especially breast, lungs and gastric cancer.
If Patient reports prominent dyspnea without any other features it can be extrapulmonary causes, including: anemia, panic disorder, neuromuscular disorders.
COVID 19 also can cause dyspnea, after 10-14 days muscle weakness and dyspnea can be prominent.
If Dyspnea is worse while sitting and standing and, it is better in recumbent position, it can be caused intracardiac shunt or pulmonary vascular shunt.