dyspnoia

Dyspnea, also spelled dyspnoea or dyspnea, is the subjective sensation of breathing difficulty. It is a symptom, not a disease, and can result from many conditions ranging from mild exertional breathlessness to acute emergencies.

Common causes include cardiopulmonary diseases such as asthma, chronic obstructive pulmonary disease (COPD), pneumonia, pulmonary edema, pulmonary embolism, and interstitial lung disease; heart conditions like heart failure and ischemia; and noncardiorespiratory factors such as anemia, obesity, deconditioning, fever, and anxiety.

Patients describe onset as acute or chronic and may report chest tightness, cough, or waking at night. Exam may show rapid breathing, use of accessory muscles, wheeze, crackles, tachycardia, or cyanosis. Oxygen saturation is often monitored to assess severity.

Evaluation includes a detailed history, physical examination, vital signs, chest imaging, and selective laboratory tests. Spirometry helps diagnose asthma or COPD; CT or ultrasound may be used for suspected pulmonary embolism or edema. Arterial blood gas testing can assess gas exchange in more acute cases.

Management targets the underlying cause and the degree of breathlessness. Hypoxemia usually requires supplemental oxygen. Acute bronchospasm is treated with inhaled bronchodilators and steroids; heart failure with diuretics; infections with antibiotics; and suspected embolism with anticoagulation. Nonpharmacologic measures include rest and, when appropriate, rehabilitation and breathing techniques.

Prognosis and prevention vary with the underlying disease; maintaining disease control, vaccination, smoking cessation, physical conditioning, and adherence to therapy can reduce symptoms and improve quality of life.

Seek urgent care for sudden, severe breathlessness with chest pain, confusion, fainting, blue lips or fingers, or collapse, as these may signal life-threatening conditions such as heart attack, pulmonary embolism, or severe pneumonia.