Respiration Disease

Breathlessness (dyspnoea) is an unpleasant sensation of uncomfortable, rapid or difficult breathing. People say they feel puffed, short of breath or winded. Your chest may feel tight and breathing may hurt. Everyone can experience breathlessness if they run for a bus or exert themselves to an unusual extent. Breathlessness is the distressing sensation of a deficit between the body’s demand for breathing and the ability of the respiratory system to satisfy that demand. Breathlessness can be classified by its speed of onset as :

Acute breathlessness : develops over minutes, hours, or days.
Chronic breathlessness : develops over weeks or months and lasts more than one month.
Chronic refractory dyspnoea is defined as breathlessness daily for three months at rest or on minimal exertion where contributing causes have been treated maximally. Common causes include chronic obstructive pulmonary disease (COPD), heart failure, advanced cancer and interstitial lung diseases. Physiologically, we are all aware of breathlessness when we exercise beyond our normal tolerance but pathologically it can occur with little or no exertion. Afferent sources for the sensation of breathlessness arise from receptors in the upper airway, lungs and chest wall as well as autonomic centers in the brain stem and motor cortex. It is almost always associated with fear and, when chronic, can be disabling and severely diminish quality of life.

Respiratory Causes:

Conditions affecting the lungs and the respiratory tract are most commonly associated with shortness of breath. These include:


Infection of the bronchi (bronchitis) and lungs (pneumonia) are commonly associated with shortness of breath. The patient may show the presence of symptoms like cough, white or yellow colored sputum, and fever. The diagnosis may be confirmed through an x-ray of the chest.


Asthma is a recurrent condition where the smaller airways narrow in response to certain stimuli like cold air or a viral infection, resulting in difficulty with breathing. The patient feels better on sitting down than while lying. Wheezing is present when the patient breathes out. The patient gives a history of similar episodes in the past, which have reduced with anti-asthma medications.

Chronic obstructive lung disease (COPD):

COPD includes conditions like chronic bronchitis and emphysema. Chronic bronchitis usually affects smokers and is characterized by the presence of a chronic cough with sputum production. Emphysema is also seen in smokers and is diagnosed on x-ray.

Occupational lung disease:

Exposure to substances like silicon or asbestos in the workplace can damage lung tissue and result in shortness of breath. In some cases, the patient may develop cancer due to exposure to these substances. It is therefore necessary to evaluate these cases early and reduce exposure as soon as possible.

Pulmonary embolism:

Pulmonary embolism is a condition where a clot usually from the legs travels to the lungs. It results in sudden shortness of breath with pink colored frothy sputum and sometimes chest pain. The patient may have undergone recent surgery, may have been bedridden in the recent past due to some health issue, or may be on medications like estrogens. The condition is a medical emergency and warrants immediate treatment.

Foreign body:

The presence of a foreign body in the respiratory tract should be suspected in a child complaining of sudden breathlessness.

Lung cancer:

Lung cancer can result in shortness of breath. Other symptoms include cough, weight loss, and coughing up of blood. The patient often gives a history of smoking.

Pleural effusion:

Pleural effusion is a condition where the area outside the lungs gets filled with fluid. The fluid restricts the breathing of the patient, resulting in shortness of breath. The condition can be diagnosed on examination.


Air may get into the area surrounding the lungs during chest trauma; this condition is called pneumothorax. The air does not allow free expansion of the lungs and results in shortness of breath. The breathlessness is sudden and should be treated as a medical emergency.