Shortness of breath - the causes of

[UPDATED NOVEMBER 2022]

Introduction

Most lung problems of any consequence present with difficulty in breathing. However other problems may also present with shortness of breath and should always be considered in any differential diagnosis.

Shortness of breath is a symptom which arises as a result of lack of oxygen. The causes of this are:

1. Lung disease - see Chronic obstructive airways disease - the sufferer is nearly always short of breath
2. Circulation problem ie - pump (heart) failure. See Heart disease - what are the symptoms
3. Circulation problems in the lungs such as recurrent pulmonary emboli. See Pulmonary embolus - blood clot to the lung - causes
4. Hyperventilation (causes an "apparent" lack of oxygen). Please see Hyperventilation - makes you feel as if you can't get your breath
5. Anaemia. See Anaemia - not enough blood - symptoms and diagnosis of

Chronic lung disease

Because conventional medicine tends to use the same drugs to treat lung problems, doctors have become intellectually lazy and no longer differentiate between the various types of lung disease. There are three major pathologies going on in lung disease, namely:

1. Narrowing of the breathing tubes (broncho spasm treated with blue inhalers: broncho-dilators).
2. Chronic inflammation of the lungs treated with brown inhalers (steroids). In the early stages inflammation causes mucous production and a general clogging up of the lungs. Eventually it causes increased stiffness of the lungs so breathing becomes laboured. See Chronic obstructive airways disease - the sufferer is nearly always short of breath (COAD).
3. Emphysema: loss of the surface area of the lungs. In advanced stage, oxygen is very helpful. Damage to airways may be caused by free radical stress and it is always worth looking at Antioxidants.

Narrowing of the airways

This is what happens in pure asthma. The narrowing is variable and causes a variable peak flow - see Peak flow meter for adults.

Indeed the definition of asthma is a peak flow which varies by more than 15% in 24 hours. Pure asthma is always totally reversible and has a cause. The commonest causes are viral infection, allergy (to foods, bacteria, inhalants, chemicals), hyperventilation and magnesium deficiency and increasingly air pollution. Dr Dick van Steenis maintained, with good evidence, that air pollution is now more important than smoking as the major cause of asthma and COAD.

See

• House of Commons Environmental Audit Committee Air quality: A follow up report Ninth Report of Session 2010–12 - 2 Dr Dick van Steenis Ev w 3
• The Times Newspaper - Obit - 16 April 2013 - Dr Dick van Steenis
• Guardian Newspaper - Improving air quality requires a little less conversation, a lot more action which comments that

...the late Dr Dick van Steenis proposed that “every county conduct a survey of primary schools to ascertain the proportion of children taking inhalers to school, and that any area with high proportions be investigated locally. This would be quick, cheap and effective.” (Airborne pollutants and acute health effects, The Lancet, 8 April 1995)

Chronic lung inflammation resulting in chronic obstructive airways disease (COAD)

Patients with pure inflammatory conditions of the lung (which is unusual, there is often other disease) theoretically would have a normal peak flow, but there is a general clogging up of lung tissue with mucous and inflammatory swelling so oxygen cannot pass freely into the blood and it is this which causes shortness of breath. Causes of lung inflammation in order of importance include:

• Dusts such as smoking, pneumoconiosis, silicosis.
• Pollution: small particulate matter, heavy metals, gaseous irritants such as nitrous oxide, ozone and sulphur dioxide.
• Chronic allergy: consider inhalants (house dust mite, animal furs), foods and chemicals. See Allergy to Foods, Inhalants & Chemicals - signs and symptoms of and Inhalant Allergy
• Infections such as bronchiectasis, chronic bronchitis and TB.

Related Articles

• Chronic obstructive airways disease - the sufferer is nearly always short of breath
• Heart disease - what are the symptoms
• Hyperventilation - makes you feel as if you can't get your breath
• Antioxidants
• Inhalant Allergy
• Allergy to Foods, Inhalants & Chemicals - signs and symptoms of
• Pulmonary embolus - blood clot to the lung - causes
• Anaemia - not enough blood - symptoms and diagnosis of

External Links

• Peak flow meter for adults
• House of Commons Environmental Audit Committee Air quality: A follow up report Ninth Report of Session 2010–12 - 2 Dr Dick van Steenis Ev w 3
• Guardian Newspaper - Improving air quality requires a little less conversation, a lot more action
• The Times Newspaper - Obit - 16 April 2013 - Dr Dick van Steenis

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