Stress and shortness of breath: what should you know?

During fear or tension, breathing can become faster, chest muscles may tighten and dizziness or tingling may follow. The sensation can be frightening and may increase the cycle of anxious breathing. Breathlessness also occurs with asthma, acute bronchitis, anaemia, COPD, bronchiectasis, atrial fibrillation or angina. Sudden breathing difficulty after an exposure, with swelling of the lips or tongue, may indicate anaphylaxis and needs emergency help.

Stop exertion, sit upright and loosen tight clothing. Breathe gently and slowly without forcing a deep breath; try a longer exhale while observing whether symptoms settle. Use a prescribed reliever inhaler exactly as directed. Note the onset, activity, chest symptoms, wheeze, fever, palpitations and triggers. Do not drive yourself if breathing is severe or worsening.

Call emergency services for severe or rapidly worsening breathlessness, blue or grey lips, inability to speak normally, fainting, confusion, chest pressure, or sudden breathlessness with sweating or weakness. Get urgent assessment for a first episode, breathlessness at rest, coughing blood, or symptoms after an allergic exposure. Arrange a GP review for recurring or unexplained episodes.

Could my lungs, heart, blood count or medicines explain this? Do I need breathing tests or an examination? How should I use my inhaler? Which warning signs mean I should seek emergency care?