Cough, shortness of breath and fatigue: what to know

Acute bronchitis can make breathing feel tight while a cough is active. Asthma may cause variable breathlessness, wheeze and cough, often with triggers or at night. COPD can cause ongoing breathing limitation and reduced stamina, particularly in people with a smoking or exposure history. Bronchiectasis may produce a long-term mucus cough and repeated chest infections. Anaemia can reduce oxygen delivery and leave someone tired or breathless with activity without causing a primary lung problem. Angina may cause chest pressure and breathlessness with exertion. Atrial fibrillation can bring an irregular heartbeat, tiredness and breathlessness. Anaphylaxis is a rapidly developing emergency when breathing trouble accompanies swelling, hives or throat tightness.

Stop strenuous activity, sit upright and note whether breathlessness occurs at rest or only with movement. Avoid smoke and take prescribed inhalers exactly as directed. Arrange medical review promptly if this is new, worsening or limiting ordinary activity; assessment may include listening to the chest, checking oxygen level and reviewing blood or heart symptoms. Do not drive yourself if you feel faint or severely breathless.

Call emergency services for severe or rapidly worsening breathlessness, blue or grey lips, fainting, confusion, severe chest pressure, coughing blood, or swelling of the face, tongue or throat. Urgent assessment is needed when breathlessness appears at rest, follows a possible allergen, or comes with a very fast or irregular heartbeat. A new combination that persists should be checked even if the cough seems mild.

What is the likely source of my breathlessness: airway, blood, heart or another cause? Should I have lung function, blood or heart testing? How should I use my inhaler during worsening symptoms? Which changes mean I should seek emergency help?