BREATHLESSNESS
As a symptom breathlessness has many causes, some relatively minor and some serious.For Acute Breathlessness Click Here. However Breathlessness can come on more gradually and that is what is covered here on this page.
Breathlessness itself is what the patient actually feels and it may or may not be associated with externally obvious signs such as a wheeze, rapid and/or laboured breathing, poor colour and cough . It may occur at rest, be brought on by minimal exertion, stress, anxiety, lying flat in bed or exposure to allergens such as pollen, house dust mite or animal dander. It may be associated with chest pain or tightness. The patient may be otherwise fairly well or quite ill. There may be an associated fever.
BREATHLESSNESS AT REST
This may be a constant feeling of breathlessness or may be in response to events or occur apparently at random. It always warrants being checked out.
BREATHLESSNESS ON EXERTION
Given enough exertion everyone gets breathless, even a trained athlete. If one does little exercise, gets overweight or smokes then the onset of exertional breathlessness may occur sooner without there being an actual illness. However, if you make a noise on breathing, seem more breathless than you would expect given your weight, level of fitness etc. or you suffer associated symptoms like dizziness then it should be checked medically.
BREATHLESSNESS IN BED AND ON LYING FLAT
A common symptom is to experience breathlessness at night. This occurs in two conditions and for different reasons. In asthma the airways often narrow towards the end of the night reducing the rate of airflow through them. One can speculate as to why this is but the body has a daily rhythm involving its hormones, metabolism etc. and the airway narrowing is probably part of that process. Occasionally house-dust mite allergy - the mites are microscopic creatures which live in mattresses on shed human skin scales - can be a cause of a worsening of asthma at night.
The other cause of night-time breathlessness is left heart failure. The left side of the heart takes blood from the lungs and pumps it out to the body. If it fails to work efficiently (left ventricular failure - or LVF) then fluid can build up in the lungs quite quickly. This can cause anything from mild breathlessness at night to a very severe and acute medical emergency called pulmonary oedema. There is a tendency for this problem to occur at night and people with left heart failure become more breathless on lying flat and get relief on sitting up. Sometimes they cannot tolerate going to bed at all and have to sleep in a chair.
Any night-time breathlessness warrants further investigation and may be greatly helped by appropriate treatment.
BREATHLESSNESS CAUSED BY ENVIRONMENTAL FACTORS
Asthma can be made worse by exposure to such factors as pollen, animal dander and house dust mite. Sometimes the effect is on the nasal air passages and although this doesn't really cause actual breathlessness it can make breathing uncomfortable. Usually an allergic reaction follows quite quickly on the stimulus. Sometimes, particularly with house-dust mite the cause is less obvious. If there is any doubt blood tests may help especially if the fate of a much-loved pet depends on clearly establishing an allergic cause for a worsening of someones asthma.