What should you know about chronic shortness of breath?

Breathlessness may appear during activity, at rest, when lying flat, or with an attack of wheeze. Cough, chest tightness, palpitations, leg swelling, fatigue, fever, or a change in sputum can provide useful clues. Asthma, COPD, bronchiectasis, anaemia, angina, atrial fibrillation, and acute bronchitis can have overlapping symptoms. Anaphylaxis is a rapidly developing emergency rather than a cause to monitor at home.

Assessment may include oxygen measurement, pulse and blood pressure checks, listening to the chest, and tests chosen from your history. Tell the clinician whether the symptom is new, worsening, triggered by exertion, or linked to an allergen or infection.

Arrange a clinical appointment for breathlessness that persists, limits normal activity, or is gradually worsening. Keep a brief record of triggers, timing, exercise tolerance, cough, wheeze, and prescribed inhaler use. Take medicines as directed and use an inhaler only with the technique taught to you; ask for a technique check if it does not seem effective.

Avoid smoke and other known irritants. Do not assume reduced fitness explains new breathlessness, and do not borrow someone else's inhaler. A clinician can decide whether you need breathing tests, a chest assessment, blood tests, or heart investigations.

Call emergency services for severe or sudden breathlessness, blue or grey lips, inability to speak normally, fainting, confusion, severe chest pressure, or swelling of the tongue or throat. Seek urgent assessment for breathlessness with coughing blood, a new irregular heartbeat, one-sided leg swelling, or rapidly worsening symptoms. Sit upright and follow your personal emergency plan if you have one while help is arranged.

Ask which causes fit your symptoms, what tests are needed, and how to recognise a flare or emergency. Clarify your inhaler or medicine plan, safe activity levels, whether allergies or anaemia could contribute, and when follow-up should happen if symptoms continue.