What causes shortness of breath?


Shortness of breath describes the subjective feeling of not getting enough air. This can be due to difficult or insufficient breathing. Signs of this are usually an increased breathing rate.

In addition, affected people often use their auxiliary breathing muscles. This can be seen, for example, by placing your hands on your thighs. Another objective finding is the so-called cyanosiswhich is noticeable through blue lips and mucous membranes.

What are the causes of shortness of breath?

  • Cardiac causes (starting from the heart)

    • Heart failure (heart failure)

    • Cardiac arrhythmias

    • Heart attack

    • Coronary heart disease

  • Pulmonary causes (starting from the lungs)

    • Pulmonary embolism (blood clot in the lungs)

    • asthma

    • lung infection

    • water in the lungs

    • Inhaling a foreign body

    • COPD (chronic obstructive pulmonary disease)

    • Bronchitis (inflammation of the airways)

  • Other causes

    • Stress / Mental

    • poisoning

Stress as a cause of shortness of breath

The feeling of breathlessness can be triggered by stress. In stressful situations, the body activates the so-called sympathetic system. This is a part of our nervous system that is responsible for the "fight and flight reaction" (fight and flight).

Our body adjusts itself to having to be active in stressful situations. As a result, the body expects an increased need for oxygen, which is why the breathing rate is increased. This reaction stems from the beginnings of human development, but is still noticeable today.

Because even though escaping on a stressful workday is not the solution, the body prepares itself precisely for it. Because of this, many people are familiar with the feeling of breathlessness when they are stressed. If this breathlessness occurs more frequently, it can even lead to anxiety. In the worst case, these express themselves in panic attacks and hyperventilation.

Read more on the topic: Mentally induced shortness of breath

Heart problems as a cause of shortness of breath

The heart is the motor of our circulatory system, which is why it also plays an important role in connection with oxygen uptake and breathing.

Oxygen is added to the blood in the lungs. It then reaches the left half of the heart, from where it is pumped throughout the body. There it is supposed to supply the individual tissues with oxygen and other nutrients. This system causes problems when the heart stops pumping sufficiently. This is the case, for example, with heart failure (heart failure), but it can also occur after a heart attack or as a result of coronary heart disease (calcification of the coronary arteries).

Often with these problems, the shortness of breath does not occur at rest, but it is particularly noticeable during exercise. In these cases, the heart is not able to adequately compensate for the increased oxygen demand during physical exertion.

Another reason for breathlessness can be heart defects, in which the oxygen-rich blood from the left half of the heart mixes with the oxygen-poor blood from the right half of the heart. With such heart defects there is usually a hole in the heart septum that is supposed to separate the two halves of the heart. In these clinical pictures, "mixed saturated blood" (mixture of oxygen-poor and oxygen-rich blood) is pumped from the heart into the circulation so that all tissues and organs are supplied with less oxygen-rich blood.

Read more on the topic: Difficulty breathing due to a weak heart

Difficulty breathing due to high blood pressure

An important and often unrecognized symptom of high blood pressure can be shortness of breath (or rather shortness of breath). Even with a low load, the body is no longer able to transport enough oxygen; you gasp for air. The problem lies in the heart or in the blood vessels.

Due to the high blood pressure, the oxygen can often not be transported quickly enough into the tissues (especially muscles), which leads to a feeling of shortness of breath.

An extremely rare type of high blood pressure is what is known as "pulmonary hypertension" (high blood pressure in the lungs). This clinical picture also results in shortness of breath due to high blood pressure, which is not increased in the entire body, but only in the lungs.

You can read about how dangerous this pulmonary hypertension can be in our article: Pulmonary hypertension - That's how dangerous it is

Causes of shortness of breath in children

Children are particularly prone to breathlessness because they often choke on small things.

All kinds of small toys (Lego bricks, marbles, etc.) but also food (nuts, chunks of food that are not sufficiently chewed, etc.) are particularly popular.

Instead of landing in the esophagus, the object ends up in the windpipe, blocking the airway. In children, this usually manifests itself as sudden breathlessness or a noticeable cough. In this case, it can help to lay the child on your lap so that the head is a little lower than the stomach. The object in the windpipe can be loosened by tapping on the back (the strength should be adapted to the age of the child).

Furthermore, children are very susceptible to colds and other infections. This can cause the nose to become blocked, which can make breathing difficult. If the infection worsens and turns into bronchitis (inflammation of the small branches in the airways) or pneumonia, the children may not be able to get enough oxygen into the blood. This also leads to shortness of breath. Children with pneumonia should be hospitalized as an inpatient.

Furthermore, many children suffer from (mostly allergic) asthma. The resulting narrowing of the airways can also cause shortness of breath.

Read more on the topic: Difficulty breathing in children

Causes of shortness of breath in infants

As in children, shortness of breath in infants often results from swallowing small parts.

Infants explore their environment within the first year of life. Many objects are put into the mouth and thus examined more closely by the child. The object can accidentally get into the windpipe and block it. In this case, the infant will try to cough suddenly to get the object out of the trachea.

If this does not succeed, the infant can be placed on the lap, as with older children, so that its head is slightly below the rest of the body. Tapping gently on the back may loosen the object.

It is also popular with infants to stick objects into their noses, which also hinders breathing. The item may have to be removed by an ENT (ear, nose and throat) doctor.

Infants are also susceptible to infections such as colds, and in worse cases bronchitis or pneumonia. These diseases can manifest themselves as shortness of breath and may need hospital treatment.

Bronchitis as a cause of shortness of breath

Bronchitis is an inflammation of the bronchi. The bronchi are the small airways that branch out in the lungs. A distinction is made between acute bronchitis, which describes a newly developed inflammation, and chronic bronchitis, which is characterized by a long-lasting process.

Symptoms of acute bronchitis are mucus production, cough, and fever. Mucus production and coughing are also typical signs of chronic bronchitis. The airways are blocked by the mucus and the symptom of shortness of breath arises.

You might also be interested in: Symptoms of bronchitis

Asthma as a cause of shortness of breath

Asthma is a disease of the airways that is characterized by hyperreactivity (overreaction). The excessive reaction leads to a sudden obstruction (narrowing) of the airways.

Allergic asthma is particularly well known. The body reacts sensitively to allergenic substances such as pollen, house dust, mites or animal hair. In an acute emergency, an asthma spray usually helps. This contains substances that widen the airways again and thus make breathing easier. In severe cases, the emergency doctor can also administer medication that acts systemically (throughout the body).

Read more on the topic: Symptoms of bronchial asthma

Difficulty breathing with pneumonia

Pneumonia (also pneumonia called) refers to the inflammation of the lung tissue by viruses, bacteria, fungi or parasites. Inflammation as a result of the body's reaction to inadvertently inhaled gastric juices or toxins is also a possible cause.

Pneumonia manifests itself in the form of a cough and fever, and the breathing rate also increases, since otherwise the body will have difficulty absorbing enough oxygen.

Depending on the cause of the pneumonia, it can be treated with antibiotics (in the case of a bacterial infection) or antivirals (viral). Furthermore, bed rest, possibly antipyretic agents, oxygen administration if necessary and expectorants are recommended.

You might also be interested in: Symptoms of pneumonia

Difficulty breathing due to an overactive or enlarged thyroid gland

An overactive thyroid (also Hyperthyroidism called), leads to an increased metabolism. This hyperfunction can be accompanied by a racing heart, high blood pressure, sweating, insomnia and a few other symptoms that express a kind of "inner restlessness". Due to the increased metabolism, the body has an increased need for oxygen, which can be expressed by an increased breathing frequency and / or the feeling of shortness of breath.

Enlargement of the thyroid gland (both benign and malignant) can also cause shortness of breath if the thyroid tissue is so enlarged that it narrows the windpipe.

Difficulty breathing after eating

Difficulty breathing after eating can have various causes.

At first it is possible to choke on chunks of food. Instead of entering the esophagus, these enter the air duct and can block it. Children in particular are prone to this happening.

The shortness of breath after eating can also be caused by an overproduction of stomach acid. The symptoms that arise are called heartburn. They can appear as a slight burning sensation in the chest area, but they can also appear as chest pain so severe that it causes shortness of breath. With heartburn, the very corrosive acid gets from the stomach into the esophagus and attacks the mucous membrane there.

Difficulty breathing due to problems with the windpipe

Shortness of breath, which is caused by problems in the windpipe, initially suggests a clogging of the airway.

This can happen through all kinds of small parts accidentally inhaled (food, toys for children). Depending on the size of the swallowed object, individual branches of the branched airway system or in severe cases (almost) the entire windpipe are blocked.

Tumors located inside the windpipe can also block it. Such a tumor is probably not noticeable at first, only when it has grown large enough that it causes breathing difficulties, it will be possible to search for it specifically. But not only tumors that are located directly in the windpipe can cause shortness of breath.

It is also possible that a tumor in a neighboring structure (lymph node or thyroid gland, for example) becomes so large that it presses on the windpipe and thereby narrows it.

What can also be noticeable in infants in the first few hours of life is a faulty formation of the trachea. Since the esophagus and the windpipe run next to each other, such a malformation can create a connection between the airways and esophagus, which can also cause shortness of breath.

Read more on the topic: Narrowing of the trachea

Shortness of breath in COPD

COPD is an acronym that stands for Chronic Obstructive Pulmonary Disease (chronic obstructive pulmonary disease). So it is a disease of the lungs in which the airways are narrowed.

Initially, this causes few problems when inhaling, the exhalation phase is more problematic. Due to the constriction, not all of the air can be exhaled from the lungs. Therefore, a lot of air remains in the lungs, which only contains little oxygen, and accordingly only a little oxygen-rich air fits into the lungs with the next breath.

This results in a lack of oxygen in the air, which leads to shortness of breath.

Read more on the topic: Symptoms of COPD

Difficulty breathing in pulmonary embolism

Pulmonary embolism is a condition in the lungs in which blood clots block one or more vessels in the lungs.

The lungs are used to absorb oxygen. For this purpose, the blood is transported into many very small and branched vessels. These lie close to the surface of the lungs and can thus absorb oxygen from the air they breathe through the tissue. With a pulmonary embolism, large vessels can already be blocked, which means that the small vessels behind them are not supplied with blood. All of these vessels are no longer used to absorb oxygen, which can lead to shortness of breath.

Depending on the size of the clot and the size of the blocked portion of the blood vessels, a pulmonary embolism can be harmless or acutely life-threatening.

You might also be interested in: Pulmonary Embolism Symptoms

Pulmonary fibrosis as a cause of shortness of breath

Pulmonary fibrosis results in tissue changes in the lungs. On the one hand, this leads to the volume in the lungs becoming smaller. As a result, not so much air can be inhaled, which is why the body can absorb less oxygen. In addition, the body has to transport the oxygen from the air we breathe through the lung tissue into the blood vessels.

Pulmonary fibrosis makes the tissue thicker and more impermeable to oxygen, which is why significantly less oxygen can be absorbed from the air we breathe.

Water in the lungs causes shortness of breath

Water in the lungs is in most cases the result of heart failure (heart failure). In affected people, the heart is unable to pump the necessary amount of blood into the circulation. This is why the blood backs up in the pulmonary vessels, among other things.

Gradually, the water from the vessels passes over into the lung tissue. This condition is also called pulmonary edema.

Other causes can include gas poisoning, viral infection, or inhalation of water. Areas of the lungs that are filled with water can no longer be supplied with air. This means that the blood can no longer be enriched with oxygen at these points. There is difficulty breathing.

Pulmonary emphysema as a cause of shortness of breath

With emphysema, more air remains in the lungs due to the destruction of parts of the lungs. This is often caused by obstructions (blockages) in the airways. Reasons for this can be infections or bronchitis.

But COPD can also lead to emphysema over the long term. Because of the obstruction, inhaled air cannot be exhaled from the lungs. In the next breath, however, additional air is added. This causes the alveoli (alveoli where oxygen enters the blood) to burst and be destroyed. For this reason, symptoms such as shortness of breath occur. A distended chest is also a sign of emphysema.

Atelectasis as a cause of shortness of breath

The term atelectasis denotes a lack of ventilation in the lungs. In addition to congenital causes, this can also arise from external influences. For example, pressure on the chest leads to atelectasis. Likewise, a blockage of the airways can lead to insufficient ventilation.

In people who suffer from atelectasis, the deoxygenated blood cannot be enriched with oxygen in all places. Accordingly, it flows out of the lungs as blood that is still depleted of oxygen and combines with the blood that is rich in oxygen. If the proportion of the non-enriched blood is large enough, there is an oxygen deficiency in the entire body, which in turn leads to shortness of breath.

Read more on the topic: Atelectasis

Heart muscle inflammation as a cause of shortness of breath

Myocarditis (Myocarditis) is mostly caused by a virus infection in our latitudes. Other triggers are toxins or autoimmune processes in which the body starts a defense reaction against itself.

At first glance, the symptoms of myocarditis may look like normal flu: fever, cough, tiredness, and possibly even diarrhea. Heart-specific complaints such as chest pain and cardiac arrhythmias also appear.

If the heart is affected so badly that it can no longer pump properly, water retention can also develop in the legs and lungs. The water in your lungs can make you feel short of breath.

You might also be interested in: Symptoms of myocarditis

Pleural effusion as a cause of myocarditis

The pleura consists of two mutually displaceable pleural leaves that rest on the outside of the lungs and almost completely surround them. One leaf lies directly on the inside of the chest, the other sits on the lungs. The so-called pleural space is located between the pleural leaves and contains a small amount of fluid. If the chest expands when you inhale, the lungs are also pulled apart with the help of the pleura. It enlarges and air can flow into the lungs.

A pleural effusion can consist of different fluids: Depending on the origin, it can be blood, pus, lymph fluid or individual blood components. This accumulation of fluid hinders the breathing mechanism and leads to shortness of breath.