What should you know about persistent shortness of breath?

Breathlessness can happen when the lungs cannot move air easily, oxygen exchange is impaired, the heart cannot circulate blood efficiently, or the body is carrying less oxygen. Asthma may cause wheeze and variable episodes; COPD and Bronchiectasis can bring cough and mucus. Anaemia may cause tiredness, dizziness and a fast heartbeat. Angina or Atrial Fibrillation can produce chest discomfort, palpitations or reduced exercise tolerance. Sudden breathlessness with swelling, rash or throat tightness raises concern for Anaphylaxis.

Arrange a clinical assessment if breathlessness is new, worsening, or limiting ordinary activity. Note when it occurs, whether lying down changes it, and whether cough, wheeze, chest pain, palpitations, fever, ankle swelling or fatigue accompany it. A clinician may check oxygen level, heart and lungs, and may arrange blood tests or other investigations. Use prescribed inhalers exactly as directed; do not borrow another person’s inhaler or assume persistent symptoms are simply poor fitness.

Call emergency services for severe or rapidly worsening breathlessness, blue or grey lips, inability to speak in full sentences, fainting, new confusion, severe chest pain, or throat swelling. Urgent assessment is also needed when breathlessness follows a new medicine or food, or comes with a sudden rash. Sit upright, avoid exertion and follow an existing emergency plan while help is coming.

Ask which features point towards an airway, lung, heart or blood cause, whether you need oxygen or breathing tests, and how to use any prescribed inhaler. Discuss activity limits, night-time symptoms, smoking or workplace exposures, and the warning signs that should prompt emergency care.