Dyspnea on exertion: Definition, causes, treatment, and more - Medical News Today

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Dyspnea on exertion: Definition, causes, treatment, and more - Medical News Today Posted: 08 Jan 2019 12:00 AM PST Dyspnea, or shortness of breath, that occurs during exertion has several possible causes. It is not typically a cause for concern, but a person should seek medical help in certain cases. Depending on the cause, dyspnea can occur alongside other symptoms, such as a tight chest and anxiety. Read on to learn more about dyspnea on exertion, including the possible causes and when to see a doctor. Dyspnea on exertion means that a person feels short of breath during exercise. It can cause someone to feel as though they are running out of air and cannot breathe fast or deep enough while exercising or exerting physical effort. Dyspnea on exertion can also cause: uncomfortable or difficult breathing chest tightness a sensation of suffocating or gasping or gulping for air anxiety and fear Millions of people experience dyspnea of varying intensities and durations. When dyspnea occurs during exertion, it typically improves upon rest. As dyspnea is a sensation, each person may experience it differently. While some people only experience dyspnea during intense exercise or exertion, others may develop it from simple activities, such as: walking going up steps sitting still jogging Dyspnea on exertion is a common, often harmless condition that usually gets better when a person rests. However, if a person experiences dyspnea that comes on suddenly for no apparent reason or is very intense, they may require medical care. Dyspnea can also be a sign of underlying conditions, some of which require intensive medical treatment. According to a 2020 article, the sensation of dyspnea upon exertion occurs due to signal interactions between the: central nervous system (CNS) peripheral chemoreceptors mechanoreceptors in the chest wall and respiratory tract The medulla, a structure in the brain stem at the top of the spinal cord, primarily controls breathing. It senses changes in blood acidity using chemoreceptors that detect carbon dioxide (CO2) levels. High CO2 levels make the blood more acidic. This lower pH causes the medulla to trigger hyperventilation, which is a rapid increase in breathing where the body exhales more air than it inhales. This action helps the body regain balance by reducing excess CO2. On the other hand, when CO2 levels are too low, the medulla reduces respiration rates to help increase them. Three nerve groups in the medulla control different aspects of breathing. Mechanoreceptors in a person's airways, trachea, lungs, lung vessels, and chest wall detect how much these structures expand and contract with breathing. They communicate with the medulla, telling it how much space is available to fill with air. The brain coordinates breathing rate and volume by sending signals to the respiratory muscles of the diaphragm and chest, as well as the muscles surrounding the lungs. It tells them how much and how quickly to expand and contract. Some people may experience breathlessness or shortness of breath during exercise because they are not accustomed to that much exercise. Alternatively, they may be exercising in conditions that can affect breathlessness, such as higher altitudes or warmer climates. However, a wide range of respiratory, cardiac, and systemic conditions can also cause or trigger dyspnea on exertion. These can interfere with the rate, volume, or general regulation of breathing. The following conditions may cause dyspnea on exertion. Respiratory conditions Respiratory conditions are a common cause of dyspnea on exertion. Common respiratory causes include: Healthcare professionals will treat each case of dyspnea on exertion differently depending on its cause. Common treatment options for respiratory causes include: inhalers, such as antimuscarinics, corticosteroids, and short- or long-acting bronchodilator inhalers supplemental oxygen therapy chemotherapy or radiation therapy surgery to remove cancerous lung sections, tumors, or abnormal growths surgery to repair a collapsed lung, a hiatal hernia, pleurisy, pneumothorax, or a pulmonary embolism antibiotics rest and fluid therapy emergency procedures to remove inhaled objects thoracentesis, a procedure to remove excess fluid from the lungs Cardiovascular conditions As the cardiovascular system plays a role in respiration, several cardiac conditions are associated with dyspnea on exertion. These include: Common treatment options for cardiovascular causes of dyspnea on exertion include: Systemic conditions Researchers have also linked several systemic conditions, which are those that affect the whole body, to dyspnea on exertion. Common examples include: Treatments that target systemic causes of dyspnea on exertion include: antihistamines dialysis intravenous antibiotics medications and treatment to control vitamin, mineral, and fluid levels epinephrine auto-injectors, such as EpiPen diuretics medications to lower blood pressure radioactive iodine, beta-blockers, or carbimazole surgery to remove part of the thyroid A doctor may also recommend making changes to everyday habits, such as: taking iron, vitamin B12, folic acid, and vitamin C supplements reaching or maintaining a moderate body weight avoiding or limiting alcohol intake managing diabetes or metabolic syndrome properly, for those with these conditions eating a healthful, balanced diet, including dietary sources of iron, such as dark leafy greens, beans and pulses, dried fruits, and fortified products Chemical and environmental irritants Chemical and environmental irritants can also cause dyspnea if a person has exposure to them or inhales them during exercise or exertion. Examples of these irritants include: air pollution chemical fumes dust smoke tobacco smoke pollen mold spores The treatment for dyspnea on exertion that occurs due to chemical or environmental irritants depends on the specific cause, but common options include: stopping smoking or avoiding exposure to tobacco smoke wearing protective covering and breathing devices when exposed to chemical fumes avoiding going outside or to places where pollution, dust, pollen, or smoke levels are high spending as little time outside as possible when mold spores are in the air at high levels, which is often in summer or fall in the United States People should speak with a doctor if they experience frequent dyspnea that does not seem to be due to being unused to exercise, exercising too intensely, or exercising under challenging environmental conditions. They should also talk with a doctor if dyspnea during exercise is severe or disabling or develops suddenly without a clear cause. People who may be experiencing an asthma attack or an attack of another respiratory or cardiac condition, such as COPD, should seek emergency care. A person should also seek emergency care if the following symptoms accompany dyspnea upon exertion: nausea loss of consciousness or unexplained sleepiness chest pressure or chest pain high fever or chills irregular heartbeat severe or worsening cough with or without mucus bluish or discolored skin, starting at the lips and fingertips increased urinary frequency at night swelling in the abdomen, legs, ankles, or feet unexplained exhaustion coughing up blood swelling of the tongue, lips, mouth, or throat swelling with a rash bruising more easily than usual pale or yellowish skin dizziness cold hands and feet confusion unexplained weakness chronic lack of appetite unexplained weight loss unexplained itchy skin reduced urination irregular menstruation severe sore throat and trouble swallowing abnormal, high pitched breathing sounds Many people experience the sensation of breathlessness or restricted breathing while they are exercising. It is often harmless and goes away with rest. However, for some people, dyspnea during exertion is a sign of an underlying respiratory, cardiac, or systemic condition, many of which require medical attention or emergency care. It is important to consult a doctor when dyspnea during exertion is unexplained, sudden, severe, or disabling, or if one of the more serious symptoms listed above accompanies it.

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