Shortness of breath - causes and therapy

Shortness of breath - causes and therapy

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If you suffer from shortness of breath, your breath will stop. It does not supply the body with sufficient oxygen, which is why those affected can do less and less physically. They also feel like they're suffocating, and that often triggers fear.

Affected people should definitely see a doctor, because shortness of breath almost always accompanies serious illnesses. Diseases of the lungs, bronchi and heart are usually the cause, sometimes rheumatic complaints or nerve damage. Obesity is also often associated with shortness of breath, and the more obese a person is, the more they suffer from it.


Shortness of breath often begins unnoticed and increases depending on how far the basic disease progresses. Those affected initially notice that they "get out of breath faster". This can also be due to a lack of training, an unhealthy diet and excessive consumption of alcohol and narcotics.

Many sufferers get used to a lifestyle in which they avoid stress and hardly notice the symptoms. In addition, the breathing problem only shows up with intensive exertion at the beginning, and the work of many people today does not physically challenge them.

Once the disease has progressed, the problems can no longer be suppressed. When climbing the stairs, the victims suffer from shortness of breath and after long walks they struggle for oxygen. Breathing now causes pain.

Short breathing can easily be mistaken for shortness of breath. Shortness of breath is perfectly normal in certain circumstances. If a trained athlete runs 5000 meters at the highest possible speed, his muscles need a lot more oxygen than when at rest. The body produces a large amount of carbon dioxide and has to excrete it through increased breathing. An untrained person with poor physical condition will already be short of breath if he only runs 500 meters instead of 5000.

Shortness of breath

First of all, shortness of breath is not a medical diagnosis, but a sensation. The body breathes more intensely because those affected do not get enough oxygen. Such shortness of breath differs from chronic shortness of breath in that those affected take a deep breath at first, only with increased breathing frequencies do the breaths become shallower - people breathe shorter because they breathe faster.

Inhalation transports the air to the lungs, where the oxygen gets into the blood and in the alveoli.

The oxygenated blood pumps the heart into the circulation. The respiratory system, heart, vessels and blood work together.

Each of these “building blocks” is impaired if it receives too little oxygen. Receptors in the body detect the undersupply, notify the brain and this sends the information breathlessness and the order to increase the respiratory rate.

Shortness of breath also arises from stress. Our body switches to an alarm state. This increases the pulse and breathing rate. We also pay less attention to our breath and do not take a deep breath. The breathing system is in no way disturbed, nor in pregnant women whose body needs more oxygen than in normal mode.


The list of diseases associated with short breathing is long. These include disorders of the metabolism as well as anemia, deformities of the chest, but also bone diseases. Injuries, for example badly healed rib fractures, can also cause an increased respiratory rate, poisoning or numerous complaints in the chest area.

Late pregnancies also lead to shortness of breath, diphtheria such as hives, vocal cord disorders such as lung cancer, pneumonia, chronic bronchitis, tuberculosis or pleurisy. There are also funnel breasts, diseases of the diaphragm or disorders of the nerves, muscles and skeleton.

Cause: funnel breast

The inward growing sternum pushes the heart to the left. The chest is large enough that the heart can pump largely undisturbed, but heart rhythm problems can be accompanied by a funnel chest.

A pronounced funnel chest squeezes the right side of the heart, exactly where the blood flows into it. This limits the right main chamber, which transports the blood to the lungs. Patients with severe deformity therefore breathe quickly, which means that they increase their heart rate to compensate for the reduced cardiac output.

The lungs are now constricted by the heart, but the person affected generally does not notice any of this, although adults with an extreme funnel breast have bronchitis more often than people without this condition.

The deformed chest wall itself is not associated with pain, but the resulting incorrect posture of the body leads to the following complaints: those affected hang their shoulders forward, the thoracic spine forms a “hump”, and the abdominal wall steps forward like a limp balloon.

The psychological consequences put the physical complaints in the shade: those affected do not dare to go into the swimming pool and shy away from physical contact, they feel like "freaks" and lose their zest for life.

In adolescents, physical and psychological problems increase, and vice versa. They suffer from shortness of breath, tightness in the body and their performance in sports is restricted. In addition, they avoid sports because they are embarrassed that their classmates see their thorax. Some of those affected isolate themselves socially, they become lonely and the risk of suicide increases.

Shortness of breath in lung cancer

Lung cancer is also a "killer cancer" because there are hardly any early warning signals. For example, while a person affected by skin cancer recognizes early on that skin discoloration expands, becomes dark or hurts, the person affected by lung cancer usually goes to the doctor when it is already too late.

The patient's performance falls rapidly, shortness of breath sets in when climbing stairs or running continuously. He suffers from fever, irritable cough, sweat breaks out at night, and throws bloody secretions when he coughs. With these symptoms, however, the tumor has proliferated long ago and already forms metastases. In addition, the person affected often does not take these symptoms seriously, because they are not a monopoly of lung cancer: bronchitis and other respiratory diseases are similar.

Irritable cough that persists for more than 3 weeks should therefore be clarified in more detail.

In advanced lung cancer, however, there is chest pain, acute shortness of breath and a massive drop in physical performance. The affected person also loses weight and feels weak overall.

Even at this stage, however, the tumor can often not be identified on the x-ray. A so-called "round lung lung", which can be seen in the picture, could also speak for tuberculosis. However, it can also be a metastasis of a primary tumor located elsewhere. But benign round stoves can also be considered.


Difficulty breathing is often due to asthma. With bronchial asthma, the airways narrow, exhalation is impeded, the lungs become bloated as a result, the respiratory muscles cramp, the lungs produce mucus that clogs the airways, and the bronchial mucosa reacts hypersensitively to external stimuli.

Those affected can tell from the seizures that they have asthma. While shortness of breath as a result of exertion, for example in the case of obesity, is not accompanied by other key symptoms, asthma sufferers suffer from severe coughing and shortness of breath.

Not only physical exertion, but inflammation, pollen or animal hair can trigger an attack. In the case of allergic asthma, the doctor uses a skin test to identify which allergy is present. If the skin reacts to cat hair, for example, this suggests a cat hair allergy.

Room sprays, cleaning agents or medication can also trigger asthma.

Heart failure

Heart problems are also a cause of breathing problems. In the case of heart failure, the heart muscle is responsible for the lack of oxygen. He lacks the strength to pump oxygenated blood into the body.

Even worse: the blood builds up back into the lungs, where fluid can accumulate, which forms a lung congestion or even pulmonary edema, and the oxygen inhaled through the air hardly ever gets into the blood. Shortness of breath is the result because the brain receives the information that there is insufficient oxygen.

Shortness of breath can even warn of impending cardiac death. According to a study by the Cedars-Sinai Center in Los Angeles on 18,000 volunteers, patients with shortness of breath without further evidence of heart disease were four times more likely to die than those without these symptoms. Moreover, the risk was twice as great as that of patients complaining of chest pain.

It is possible that doctors send patients with chest pain more often for diagnosis, thereby preventing impending heart failure through stents or bypasses.

Wrong breathing

Shortness of breath can also be due to incorrect breathing. Those affected then do not breathe in the abdomen, but only in the lower chest. You pull your chest up with your neck muscles. This way, the lungs get very little air, which means that those affected increase their breathing frequency in order to get the necessary oxygen.

Imaginary shortness of breath

Shortness of breath and shortness of breath are also typical symptoms of people suffering from hypochondria. An affected person writes that he constantly has to breathe deeply and still feels like he is not filling the lungs. He also feels pain in the heart and sternum and spine.

A lung function test and an EKG showed that everything was OK. Still, he was afraid of lung cancer. He does not dare to have an X-ray taken, for fear that this will show the tumor. Before that, he was afraid of a brain tumor.

A fellow sufferer on the internet forum for hypochondriacs, on which the person concerned revealed himself, replied: “I was in a similar mood to you last night and tonight. A feeling on the chest as if it would crush my heart ... and shortness of breath. Now, as a hobby asthmatic, I know how to deal with something like this. In the event of a seizure, my reason turns on and takes over the action. It didn't work yesterday ... reason was forbidden to mouth. "

In such cases, it is not shortness of breath that has physical causes, but a hypochondriacal anxiety disorder. Those affected scan their body for symptoms of illness. This can cause actual shortness of breath: If the ill person is afraid, this leads to stress, and if we suffer from stress, the body switches to shortness of breath.

No specialist in respiratory diseases is required here, but a psychotherapist.

Anxiety disorders

Fear is an existential feeling of our evolutionary development. There is no caution without fear, and those who are completely without fear do not pay attention to dangers. We do not feel fear of a concrete threat, but of something indefinite. It is our ideas about what could happen that scare us.

If this fear paralyzes those affected in everyday life, we speak of an anxiety disorder. This can be general or refer to certain situations, objects or living things: social fear, fear of exams, fear of spiders etc.

Fear is a feeling, that is, psychological, but it shows itself physically: we sweat, we tremble, the muscles tense, we feel pain in the stomach and heart, suffer from diarrhea and shortness of breath. All of these symptoms can also indicate physical illnesses. Anxiety sufferers are constantly in this state of emergency.

Therefore, someone suffering from chronic shortness of breath should also check for an anxiety disorder.

Affected people can ask themselves the following questions:

1) Does shortness of breath occur in situations, in people, animals or thoughts that are fraught with fear for me?

2) Did body examinations only show that everything is OK?

3) Have family, friends, acquaintances approached me because of exaggerated fears?

4) Do I breathe normally when I'm not afraid?

5) What thoughts and feelings do I have when I am short of breath?

If you are short of breath as a result of an anxiety disorder, only psychotherapy can help.


Post-traumatic stress syndrome is associated with shortness of breath. Those affected repeat their traumatic experience in the bursts of "flash-back". This experience was an exceptional psychological situation and the body switched to "survival mode".

In such extreme conditions, the organism tries to supply the body with as much oxygen as possible in order to increase performance. To do this, he increases the respiratory rate.

People suffering from PTSD are familiar with situations when they are sitting in the bar at the counter and absolutely need to be in the fresh air because they feel that they are not getting oxygen. This is often accompanied by dizziness, a buzzing in the ears and fragments of horrible associations. Some even hyperventilate.

Breathing techniques

Breathing training helps against almost all forms of shortness of breath, even if it is a symptom of serious physical illnesses. Those affected can attend yoga classes or take breathing therapy.

However, simple exercises such as those recommended by pulmonary doctors already help with everyday life. Dr. Konrad Schulz, Medical Director of the Bad Reichenhall Clinic of the Deutsche Rentenversicherung Bayern Süd writes: “If you are short of breath, e.g. under physical exertion or after a hard cough, the breathing technique of the dosed lip brake (...) can often be very helpful and effectively supplement the drug therapy. "

The dosed lip brake slightly brakes the air when you exhale with your lips and builds up resistance that creates a little back pressure, which continues from the upper to the lower airways. The exhaled air can flow out of the lungs better and therefore those affected can breathe in more fresh air.

For the lip brake, those affected place their lips lightly on one another as they exhale until they hear a slight “wind noise”. You shouldn't press your lips together and exhale as slowly as possible.

Affected people should use the lip brake not only in an emergency when breathlessness becomes acute, but in all situations that can trigger short breathing. Schulz explains: "Many sufferers can use this to keep their airways open and exhale better, despite chronic narrowing."

He continues: “Be sure to use the lip brake whenever you do something that can make you breathless, such as B. climbing stairs or shopping bags. It is crucial to use the lip brake preventively at the beginning of the exercise - not only when shortness of breath has already occurred. Practice this technique consistently and regularly so that you can use it safely and automatically with any form of stress. "

Firstly, this training has a preventive effect against shortness of breath, secondly, it allows you to breathe properly in an emergency. Schulz explains: “If you practice the dosed lip brake regularly, you can also ensure that you have mastered this breathing technique in an emergency. Anyone who has ever suffered from shortness of breath knows the accompanying, oppressive feeling of fear of suffocating. In such situations, however, panic must be avoided in order not to worsen shortness of breath. Rather, it is an essential aid to self-help that the lip brake can also be used in emergency situations in order to effectively alleviate acute shortness of breath. "

What can you do?

Acute shortness of breath should be taken seriously. If you experience sudden shortness of breath, you should call a doctor immediately.

Take a posture that allows more air into the body. Stay calm. If you suffer from shortness of breath, you should definitely limit smoking. If you are overweight, it helps to reduce weight. Light sports stimulate the respiratory flow, this also applies to obese people or patients with lung diseases.

Exercise strengthens the cardiovascular system, the blood receives more red blood cells and transports more oxygen. The blood flows better and takes up more oxygen. The cells have more mitochondria that convert energy sources into energy. This also makes the body use oxygen more effectively, because the capillaries around the alveoli become denser, the more oxygen comes from the lungs into the blood. Exercise strengthens the muscles, and those include the respiratory muscles. Do respiratory therapy. For example, yoga exercises help control the breath. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch


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ICD codes for this disease: R06ICD codes are internationally valid encryption codes for medical diagnoses. You can find yourself e.g. in doctor's letters or on disability certificates.

Video: Treating Difficulty Breathing Not Related to the Lungs Video. Matthew Clary, MD, ENT. UCHealth (December 2022).