Feeling breathless? That could be a dangerous sign

An emotional experience that takes your breath away can be a good thing, but if day-to-day life has you huffing and puffing, it might be time to get that checked out.

Shortness of breath is not something to ignore, as it could be a sign of a serious underlying condition, said Benjamin R. Levin, MD, a hospitalist and primary care physician based at Strawberry Hill Primary Care in Hyannis.

“Shortness of breath on exertion is always something we start to get a little worried about because it could be heart disease,” he said. “If it comes on suddenly, if you are really in completely normal health and then suddenly start getting short of breath, that could be a problem. If it comes with chest pain, that’s very concerning.”

If your shortness of breath is accompanied by swelling in the leg, particularly, that can be of concern, said Dr. Levin.

If you have leg swelling, either one or both, with shortness of breath, that could imply a few different things could be going on, he said. If it’s both legs, it could be heart failure, liver failure or kidney failure. If it’s one leg, it could be a blood clot that has traveled to your lungs.

“Those are all cases where you should get checked out in the ER,” he said.

Dr. Levin discussed some other potentially serious conditions that can cause shortness of breath. See your healthcare provider if breathing difficulties happen at rest or during activities that previously did not make you breathless.

Obesity and Deconditioning

“When you’re carrying a lot of extra weight, you’re doing more work than people who are not obese,” he said. “Even just walking for a short period, you’re carrying all this extra weight and that can be hard. There’s more pressure on your lungs and more pressure on your heart. Obesity can lead toward the more dangerous causes of shortness of breath, so it’s a real problem.”

Heart Failure and Heart Attack

“Heart failure can be more of a chronic condition, where your heart just doesn’t pump that well for many different reasons, and the blood backs up. You can get swelling in your legs and you can also get it in your lungs. People who have heart failure have trouble catching their breath when they walk or sometimes when they lay flat at night.”

The condition is often treatable with medications, he said.

But a heart attack “is a totally different story,” as it is an immediate life-threatening situation, he emphasized. Anyone who suspects they may be having a heart attack should call 911 and go directly to the closest emergency center.

Anxiety Disorders

People with anxiety can feel lightheaded and have difficulty taking a deep breath, he said. They become hyper-focused on their breathing.

“Anxiety can certainly present as a benign cause of shortness of breath, but you want to make sure you don’t jump right to thinking that’s the cause and not something more dangerous,” he said.

Asthma

“Asthma feels like sucking air through a straw,” according to Dr. Levin. “You’ll see somebody taking these deep gasps, if they’re really having a bad attack, and they just cannot get the air to come in. That’s because the little muscles that surround the microscopic air sacs in your lungs have all spasmed, so you can’t open them up.”

Asthma patients usually have inhalers that open the lungs. Asthma can be benign or severe. “Depending on how bad it is, it can be pretty dangerous,” he said.

COPD (Chronic Obstructive Pulmonary Disease)

“COPD is a lung disease like asthma, but it works a little bit differently,” he said. “The structure of the lungs changes over time, usually from smoking. As that structure changes, your ability to exchange air gets worse and worse. COPD is a chronic condition.”

Treatment is usually a combination of various inhalers and steroids, if warranted, he said.

Pregnancy

Pregnancy pushes extra weight on the diaphragm, which can lead to a benign cause of shortness of breath, said Dr. Levin. But there are dangerous conditions that can happen during a pregnancy, like a pulmonary embolus, he added.

“If you have the red flag symptoms or they’re very severe, such as swelling in one or both legs or chest pain, you need to be checked out right away.”

Less-Worrisome Causes

Breathing difficulties for someone with allergies and sinus congestion, and it has happened in the past, are generally benign, according to Dr. Levin. Shortness of breath when trying to exercise after not having done it for a while is also normal. You should recover very quickly as you’re building up your strength, he said.

“If it’s fairly mild, and it’s been going on a little while, and you don’t have any of the red flag symptoms, then it would probably be worth getting breathing issues checked out by your primary care doctor. Have them listen to your lungs, do an assessment, and see if they can figure out what might be going on, what’s causing it and if there’s anything they can do to relieve it.”