Short Breathlessness

Short Breathlessness

Breathing is inhaling air into lungs through nose and exhaling it out through the same, this process is called respiration. It is essential for the body as it involves taking in the necessary oxygen into the body.

Breathing is inhaling air into lungs through nose and  exhaling it out through the same, this process is called respiration. It is essential for the body as it involves taking in the necessary oxygen into the body. Oxygen is needed by the cells of the body along with the food consumed to produce the necessary energy needed for working and/or living.

Breathing Pattern

Breathing though is conscious felt; it is a spontaneous function of the body under our control. We can alter the pattern according to our wish, which usually is not necessary. Body has the ability to alter the pattern, rate of respiration whenever needed as decided by our metabolism, energy requirements, and insult to the body by foreign or internal factors. The ability to adjust rate and depth of respiration in response to insult to the body is entirely involuntary and the person has to go through it.

Many of the pathological conditions resulted from infections, metabolic, hormonal, hemodynamic imbalances lead to change in the breathing pattern. Sometimes it could be physiological too but necessary. These changed patterns of breathing can be presented as symptoms to the doctor. When you ask a doctor about the same, he might try and rule out the pathological or physiological causes for the same. Hence, changed pattern of breathing is one symptom both patient and doctor should be concerned about. Any sort of change in pattern of breathing should be addressed well with a consultation to a specialist with a detailed clinical examination with or without investigations. No effort should be left missed as the changed breathing pattern could be pathological and could be life threatening in some cases. Most of them could be preventable or treatable conditions too.

There are few altered patterns in the breathing as below:

1. Change in rate of respiration. Breaths per minute

2. Change in depth of respiration, deep or shallow breathing.

3. Associated noises due to alteration in the air conducing system of lungs

4. Change in pattern needing effort, due to shortness resulted by obstruction or restriction in breathing

Most commonly presented pattern of all above is shortness of breath, as this is well perceived and physically troublesome. Increased rate and depth in respiration is felt by the patient but not as troublesome as shortness of breath. Hence, most do present to the doctor as soon as they realize they have shortness of breath. Well, the condition requiring immediate patient and doctor attention is no joke. It is presented in pathological conditions most often with background of serious illnesses.

Cause of Short Breathlessness

It is important to know the causes of shortness of breath. Below are some common causes:

1. Cardiac causes - causes secondary to heart diseases.

2. Pulmonary causes - causes secondary to lung diseases.

3. Renal causes - secondary to kidney related issues.

4. Metabolic disorders

5. Psychological causes

A few clinical features or history of past illness can point in identifying the cause of shortness of breath. A patient by himself may not be to identify or self-manage, hence it is always advisable to attend the doctor as early as possible. The underlying causes for shortness of breath most of times are serious and need immediate attention of a doctor.

1. Cardiac causes

Heart related causes for shortness of breath include heart failure either chronic right side or left side, acute heart failure as in case of uncontrolled hypertension, valve disease, pericarditis and many other. In these conditions the heart will not be able to pump the blood into the body and as a result there is pressure against the blood coming out from the lungs. This results in fluid collection in the lungs which is termed as pulmonary edema resulting in shortness of breath. Here the patient experiences breathlessness more on lying down or on exertion. Breathlessness can be momentarily reduced by removing water from the lungs using the diuretics but the mainstay treatment will be managing and treating the heart pump failure.

2. Plumonary causes

Causes in lungs include chronic obstructive pulmonary disease like asthma, bronchiectasis, emphysema, chronic bronchitis, other conditions like interstitial lung disease, infective conditions like pneumonia, tuberculosis, pleural effusion etc and many other conditions which may alter the lung structure resulting in improper expansion or recoil of lungs. This results in decreased oxygenation in the lung and decreased oxygen supply to the body leading to compensatory changes in rate, depth and pattern in breathing. Change in pattern can be expected as direct result of the insult to the lung tissue. Management depends on the conditions like inhalers in case of airway disease like asthma where the medication is directly inhaled which temporarily reverses the changes happened in the air conducting system. In infective conditions antibiotics would be definitive treatment.

3. Renal causes

Kidney is involved in clearing of the excess water from the body in the form of urine. Whenever there is problem with filtration process in the kidney, there could be water logging in the body causing swelling or edema of the limbs or even face. In extreme cases there may be water collection in the lungs too causing shortness of breath. Such conditions include kidney damage due to infection, severe dehydration as seen in cases of acute severe gastroenteritis, renal stones etc. Conditions like Diabetes, hypertension cause damage to the kidney filtration process leading to fluid accumulation and shortness of breath. Management of specific kidney condition and conditions causing secondary kidney damage is necessary here. Fluid restriction also plays an important role in management most of times in kidney related conditions.

4. Metabolic conditions

Metabolic disorder is a resultant of altered chemical reactions of metabolism in one or various processes. There might be nonformation of necessary substrate or formation of unnecessary toxic substances which can alter the fluid balance in the lungs leading to shortness of breath. Anemia, vitamin deficiencies, diabetes, amyloidosis, siderosis and many other conditions can lead to deposition bad chemicals in the lung tissue or deficiency of necessary things in the blood can cause damage to the lungs leading to decreased oxygenation. Some conditions can cause heart failure and then lead to shortness of breath.

5. Psychological causes

A minor anxiety or panic attack can result in shortness of breath; this response is most often physiological. As a response to anxiety there may be hormones like adrenaline released which increase the respiration rate causing shortness of breath in the individual. There may be a concomitant increase in heart rate too. These responses occur to cope with the mental tension created during an attack. A simple episode of fear also can cause increase in heart rate and breathing these are mechanisms to provide increased oxygen and food to the body so as it increases its energy production and expenditure to either get rid of the fear causing factor or to fight it.

Causes of shortness of breath range from physiological to pathological. Shortness of any severity or duration should always be looked up by a doctor as there may be many underlying conditions which if addressed earlier can get resolved. Shortness of breath is not only related to lungs as explained above damage or insult to any other organs or organ systems of the body can result in shortness of breath. A symptom like shortness of breath should never be ignored.

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