What should you know about wheezing shortness of breath?

Asthma, acute bronchitis, bronchiectasis and COPD can make airflow noisy and leave you breathless. An allergic emergency can narrow the airway rapidly. Breathlessness without a clear wheeze may also occur with anaemia, angina or atrial fibrillation, so the combination should not be self-diagnosed. Chest pain or pressure, a racing or irregular heartbeat, unusual tiredness, fever, cough or swollen legs can provide important clues.

Describe whether symptoms began suddenly or gradually, occur at rest or with activity, and improve when you sit upright. Mention recent infection, travel, new medicines, allergies, smoking or vaping exposure and any known heart or lung condition.

Stop activity and sit upright in a comfortable position. Move away from smoke and other irritants. If you have a prescribed inhaler or written action plan, follow it exactly. Arrange prompt medical review for new breathlessness, symptoms that limit normal activity, or episodes that are becoming more frequent. Do not assume a wheeze is asthma or take another person’s medication.

Call emergency services if breathlessness is severe or rapidly worsening, you cannot speak comfortably, your lips look blue or grey, you feel faint or confused, or you have severe chest pain or pressure. Sudden symptoms with facial, lip or throat swelling may be anaphylaxis. New breathlessness with collapse, a very fast or irregular heartbeat, or marked weakness also needs urgent assessment.

Could this be an airway, heart or blood-related problem? Which examination or tests are needed? How should I use my prescribed medicine, and what exact changes should prompt emergency care?