Persistent cough and shortness of breath

Persistent cough with shortness of breath should be assessed, especially when breathing is worsening, sudden, or limiting ordinary activity. The combination can arise from airway, lung, blood, or heart problems, so symptoms alone cannot identify the cause.

Acute bronchitis or asthma can cause cough and breathlessness, while bronchiectasis and COPD may cause ongoing mucus, wheeze, or reduced exercise tolerance. Anaemia can contribute to breathlessness through reduced oxygen-carrying capacity. Angina may cause pressure or discomfort with exertion, and atrial fibrillation may bring a racing or irregular heartbeat. A severe allergic reaction can cause rapid breathing difficulty with swelling or wheeze.

Stop exertion, sit upright, and avoid smoke while arranging medical advice. Record when breathlessness occurs, whether it is sudden or gradual, and any chest discomfort, fever, wheeze, palpitations, swelling, or coloured mucus. Do not start someone else’s inhaler or antibiotics. A clinician may check oxygen levels, heart rhythm, chest sounds, and other factors before deciding on tests or treatment.

Call emergency services for severe breathing difficulty, inability to speak normally because of breathlessness, blue or grey lips, fainting, confusion, sudden facial or throat swelling, or severe chest pressure. Urgent assessment is needed for new breathlessness at rest, coughing blood, or a rapidly worsening pattern. Do not drive yourself if you feel faint or severely short of breath.

Ask whether the cough and breathlessness suggest an airway, lung, heart, or blood-related problem; what examinations are needed; and which changes require emergency help. Bring a list of medicines and describe smoking exposure, recent infection, allergies, activity limits, and the timing of symptoms.