Doctor’s Tip: Shortness of breath is a common complaint
A frequent complaint that brings patients to primary care doctors is shortness of breath. Often the cause is weight gain or poor aerobic conditioning. This column is about more serious causes.
Lung infections: Pneumonia usually occurs as a complication of a viral upper respiratory infection such as influenza. Classic symptoms in addition to shortness of breath are moderate to severe cough, fever, chills and sometimes chest pain with a deep breath. Symptoms may be less severe in “walking pneumonia,” but pneumonia can be serious, and people still die from it. Viral pneumonia does not respond to antibiotics, but bacterial pneumonia does. If you have any symptoms of pneumonia, the sooner you get diagnosed and receive appropriate treatment, the better.
One of the hallmarks of severe COVID-19 disease is low oxygen, which causes shortness of breath. Again, the sooner you’re diagnosed and treated, the better. Even better is prevention, through immunization and, when appropriate, social distancing and masking.
Asthma is an inflammatory condition that causes spasm of the breathing tubes in the lungs, resulting in wheezing and shortness of breath. Asthma can be fatal, so if you think you might have it, seek professional help.
Emphysema is caused by loss of alveoli (small, delicate air sacs in the lungs where oxygen enters the blood). Smoking, second hand smoke and air pollution all play a role in this chronic and progressive disease. Exertion causes oxygen levels to drop, resulting in shortness of breath. You can check your oxygen level by buying a finger oximeter at any pharmacy and wearing it while walking briskly up some stairs (normal oxygen level is greater than 90% at all times).
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Coronary artery disease (atherosclerotic plaque in your heart arteries) can cause shortness of breath. Especially in women, shortness of breath with or without exertion can be a symptom of a pending or actual heart attack.
Heart arrythmias: In atrial fibrillation and other heart irregularities, the heart beats irregularly and/or very fast. This results in inefficient delivery of oxygen to organs and tissues, causing shortness of breath with exertion and sometimes at rest.
Congestive heart failure occurs when the heart muscle becomes weakened by conditions such as atherosclerosis or tight or leaky heart valves. Blood and fluid back up into the lungs, causing shortness of breath.
Blood clots in the lung: The medical term for this is pulmonary emboli, which can cause shortness of breath at rest or exertion. Usually they are associated with chest pain, but not always, and they can be fatal.
Anemia refers to a low red blood cell count. The most common cause is iron deficiency, from loss of iron due to conditions such as heavy menstrual periods in premenopausal women; or loss from the GI tract from bleeding ulcers, colon polyps or colon cancer. Red blood cells carry oxygen to organs and tissues, and a low red count causes shortness of breath with exertion.
Mental health factors: A common symptom of anxiety is the feeling that the sufferer can’t get a deep enough breath. In severe anxiety such as panic attacks, people start to breath rapidly, which causes the level of carbon dioxide in the blood to fall, which in turn causes numbness and tingling in extremities. Although nobody dies from panic attacks, the sufferer feels like they’re going to die. Treatment is to breathe into a paper sack, which brings CO2 levels back to normal.
The take-home message is this: Many causes of shortness of breath are serious. If you have this condition, see a medical provider on an urgent basis.
Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email firstname.lastname@example.org.
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