What is Dyspnea on Exertion or Shortness of Breath on Exertion?

Dyspnea means shortness of breath or breathlessness. Dyspnea on Exertion (DOE) is a condition where a person finds it difficult to breathe or becomes breathless upon any type of exertion. By exertion, it does not only mean exercise, but also simple physical activities of daily living such as going to the mailbox or walking up the stairs.

Dyspnea on exertion (DOE) is also known as: Exertional dyspnea, shortness of breath on exertion (SOBOE), breathlessness on exertion, dyspnea on effort, short of breath with activity and exertional breathlessness.

Dyspnea on exertion or shortness of breath on exertion is described as a feeling where a person feels abnormal or excessive shortness of breath where breathing in air requires more effort than normal upon any type of exertion. There are many causes for dyspnea on exertion or shortness of breath on exertion. Congestive heart failure is one of the commonest causes of dyspnea on exertion.

It is normal to feel dyspnea upon mild exertion, especially if someone is not accustomed to exercise. However, sudden onset of dyspnea on mild exertion, such as when performing day-to-day activities is a cause of concern and requires immediate medical attention. Dyspnea on exertion or shortness of breath on exertion is an indication that the lungs are not getting sufficient oxygen in or not able to expel sufficient carbon dioxide out. Each individual experiences dyspnea on exertion in different degrees. Normal breathing of a person is slow and imperceptible. In dyspnea, a person's breathing becomes fast and shallow. Patient suffering from dyspnea on exertion or shortness of breath on exertion may start to breathe from the mouth instead of nose in an effort to get more air.

Dyspnea on Exertion or Shortness of Breath on Exertion

Treatment for dyspnea on exertion or shortness of breath on exertion depends on the underlying problem which is causing this condition.

Causes of Dyspnea on Exertion or Shortness of Breath on Exertion

There are many causes for dyspnea on exertion or shortness of breath on exertion. Low body oxygenation is an important causative factor and this is always seen in patients who present with dyspnea on exertion. Breathing through mouth and chest breathing are other causes of dyspnea on exertion or shortness of breath on exertion, as they reduce oxygenation to the brain and body leading to a feeling of breathlessness or shortage of air. Dyspnea can also occur as a result of the interaction between various physical and psychological factors. A person experiencing a panic attack feels extremely breathless, which is triggered by the brain.

Some of the causes of dyspnea on exertion or shortness of breath on exertion include:

  • Congestive heart failure (CHF) where the patient has dyspnea on exertion or shortness of breath on exertion initially, then also feels dyspnea on rest. Other accompanying symptoms include chest pain and palpitations.
  • Chronic obstructive pulmonary disease (COPD) is also a common cause of dyspnea on exertion or shortness of breath on exertion.
  • Asthma.
  • Diabetes.
  • Lung diseases where the patient has dyspnea on exertion or shortness of breath on exertion along with other symptoms, such as cough, wheeze and sputum.
  • Pneumonia.
  • Anemia where the patient also has pale skin or pallor.
  • Poor physical conditioning.
  • Hyperthyroidism.
  • Late-stage pregnancy.
  • Pulmonary embolism.
  • Tumor/Cancer.
  • Obesity where the excessive fat in the abdomen and chest gets pressed, hindering the breathing process. The excess amount of weight or tissue also needs increased amount of oxygen.
  • Hypertension.
  • Liver diseases, such as cirrhosis.
  • Kidney disease where other than dyspnea on exertion or shortness of breath on exertion, patient also has electrolytes and fluid imbalance.
  • Psychological disorders, such as anxiety, depression which can cause panic attacks.
  • Environmental conditions, such as poor quality of air can also cause dyspnea on exertion or shortness of breath on exertion.

Signs & Symptoms of Dyspnea on Exertion or Shortness of Breath on Exertion

Other associated symptoms which the patient has along with dyspnea on exertion or shortness of breath on exertion include:

  • One of the signs and symptoms of dyspnea on exertion or shortness of breath on exertion is Paroxysmal nocturnal dyspnea where the patient wakes up suddenly in the middle of the night with shortness of breath.
  • Orthopnea is yet another sign and symptom where the patient has increased shortness of breath when lying down flat.
  • Hyperventilation.
  • Rapid pulse rate and palpitations.
  • Cough.
  • Wheezing.
  • Chest pain.
  • Excessive sweating.
  • Swelling in the legs.
  • Pallor or pale skin.
  • Electrolyte imbalances.

Serious symptoms accompanying dyspnea on exertion or shortness of breath on exertion which need immediate medical attention and are an indication of something serious include:

  • Extreme air hunger where the patient feels lack of sufficient air no matter how deep he/she breathes.
  • Patient gasps for breath.
  • Choking.
  • Patient feels pain in the chest.
  • Confusion.
  • Dizziness.
  • Fainting.
  • Profuse sweating.
  • Pale skin (pallor).
  • Cyanosis, where the skin turns a bluish color.
  • Patient coughs up blood.

Diagnosis of Dyspnea on Exertion or Shortness of Breath on Exertion

Finding the underlying cause of dyspnea on exertion or shortness of breath on exertion is important. The doctor takes a medical history and conducts a physical exam. The following investigations are done to determine the cause of dyspnea on exertion:

  • Chest x-rays.
  • CT scan.
  • Pulmonary function tests.
  • Exercise testing.
  • Blood tests.

Treatment of Dyspnea on Exertion or Shortness of Breath on Exertion

Treatment for dyspnea on exertion or shortness of breath on exertion depends on its underlying cause, which will be determined after conducting various medical tests.

Some of the treatment options for dyspnea on exertion or shortness of breath on exertion include:

  • If dyspnea on exertion or shortness of breath on exertion is due to asthma, then the doctor may prescribe an inhaler for treatment.
  • Oxygen is also given in some cases to ease dyspnea on exertion or shortness of breath on exertion.
  • Heart medications and diuretics are prescribed for heart and kidney problems that could be causing DOE or shortness of breath on exertion.
  • Antihypertensives are prescribed if the patient's high blood pressure is causing dyspnea on exertion or shortness of breath on exertion.
  • Bronchodilators are prescribed if the patient has wheezing and feels dyspnea on exertion due to it.
  • If the cause of DOE or shortness of breath on exertion is poor physical condition, then an appropriate fitness program is recommended.
  • If pregnancy causes dyspnea on exertion, then the breathlessness will improve or will be relieved after the baby is born.
  • If any psychological problems are causing dyspnea on exertion, then the patient is referred to a psychiatrist who will prescribe medications such as antidepressants or anxiolytics accordingly.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 27, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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