Reasons for Shortness of Breath, Difficulty Breathing

Chronic Causes of Dyspnea

Shortness of breath that is lasting for weeks or months, sometimes for years, is usually due to a chronic cause. Specialist medical care is required to diagnose and manage the underlying condition causing the dyspnea. Despite this difficulty with breathing lasting for long periods of time, it can suddenly become a medical emergency and therefore requires careful monitoring. Chronic causes of dyspnea does not mean that a person will have difficulty breathing all the time.  In these cases, dyspnea may occur in episodes and develop over long periods of time since the underlying cause is chronic in nature.

If this shortness of breath has only been present for a few hours or days, then it is possibly due to a more acute cause. Refer to the article on What Causes Shortness of Breath? for a list of acute causes of dyspnea.


Any deficiency of red blood cells will reduce the amount of oxygen and carbon dioxide carried through the bloodstream. The body caters for this by increasing the breathing and heart rate and dyspnea especially upon exertion. Dyspnea upon rest indicates severe anemia and requires medical attention. Iron deficiency anemia (low blood iron) is one of the more common types of anemia, particularly in young girls and women who are menstruating.

Other features may include :

  • Low blood pressure.
  • Increased heart rate.
  • Rapid shallow breathing.
  • Fatigue.
  • Paleness (pallor) of the hands and feet.
  • Bluish tinge of the fingers and toes when exposed to cold.

Chronic Obstructive Pulmonary Diseae (COPD)

COPD refers to a group of lung diseases, with chronic bronchitis and emphysema being the most common. In these conditions, the lungs lose their natural elasticity to push our air and inflammation of the air passages hampers air flow. While these chronic conditions may not result in significant symptoms in the early stages, an acute exacerbation can cause severe dyspnea.

Other features include :

  • Tight chest sensation or chest pain.
  • Wheeze, especially on exertion.
  • Productive, persistent cough particularly in chronic bronchitis (smoker’s cough).
  • Easily fatigued upon exertion.

Heart Failure

Heart failure develops over long periods of time and the shortness of breath will gradually progress. However, sudden severe shortness of breath with dizziness and/or fainting, mental confusion and signs of shock is a medical emergency and immediate treatment is required.

Other features include :

  • History of chronic conditions like diabetes, kidney failure, hypertension and other lung or heart diseases.
  • Swollen legs, hands, abdomen or swelling throughout the body – edema.
  • Fatigue.
  • Chronic cough.
  • Bubbling or crackling sounds when breathing due to fluid in the lungs.

Interstitial Lung Disease

In this condition, the tissue between the tiny air sacs in the lungs become inflamed. There are a number of types of interstitial lung disease and with time, scarring and thickening of the lung tissue affects the lung volume and functioning.

Other features may include :

  • History of exposure to toxins (occupational/environmental), repeated lung infections, long term use of drugs, radiation therapy to the chest and certain types of autoimmune diseases.
  • Dry cough.
  • Clubbing of the fingers.
  • Chest pain.
  • Wheezing.

Obesity and Lack of Physical Activity

A sedentary lifestyle often result in shortness of breath upon exertion. In obesity, the dyspnea may occur even at rest as a result of being physically unfit, coronary artery disease or heart failure. Early intervention by exercising regularly and losing weight will reverse most cases of dyspnea in obesity if there are no other underlying chronic diseases.


Iron-deficiency anemia is common in pregnant women and this can lead to dyspnea as mentioned above. The growing fetus occupies space and this can also limit the depth of breathing leading to the feeling of shortness of breath. Fatigue and shortness of breath are also common features of pregnancy due to the increasing demands of the growing fetus.


TB of the lungs is caused by the Mycobacterium tuberculosis bacteria and is a slow progressing infection. It is often missed until the infection has reached a serious stage. Due to the incidence of HIV/AIDS, this lung infection has been on the increase globally.

Other features include :

  • Persistent coughing, with blood streaked mucus or coughing up of blood.
  • Swollen lymph nodes.
  • Fever and chills.
  • Night sweats.
  • Loss of weight.
  • Lack of appetite.
  • Chest pain when breathing and coughing.


Any tumor that develops along the air passages or in the lungs will contribute to dyspnea. This includes benign and malignant tumors (cancer).

Other features include :

  • Loss of weight.
  • Lack of appetite.
  • Pain in the chest or throat.
  • Coughing blood streaked¬† mucus or blood.
  • Changes in breathing sounds or voice.
  • Swollen lymph nodes.
  • Night sweats.

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