Shortness of breath is a feeling experienced when one cannot breathe well enough. Clinically, it is called dyspnea. Normally we breathe without having to think about it. Dyspnea may occur at rest, after exercise or any form of activity and it is usually associated with certain disease conditions. This is why it is very important to visit a doctor once you show any signs of difficulty breathing, that one visit may save your life.
The most common causes of dyspnea are diseases of the heart. These include rhythm disturbances, accumulation of fluid around the heart due to pericardial effusions, a myocardial infarction or a complete heart failure. All these conditions cause the heart not be able to pump blood effectively to the tissues. Since blood delivers oxygen to the tissues, the lungs will work harder to supply it with oxygen and this can lead to difficulty breathing. Hypertension is a common cause of heart failure in the Gambia therefore long standing hypertensive patients should visit the clinics regularly and should seek medical attention if they show any sign of dyspnea.
Conditions of the lung can also affect breathing.
Examples of these asthma and chronic obstructive pulmonary diseases like emphysema and chronic bronchitis. Other causes are pleural effusion which is when fluid accumulates in the lung due to an infection or a tumor; A collapsed lung due to an accident or a tumor, this is called a pneumothorax; Pulmonary emboli or blood clots in the lungs and lung damage from other chronic diseases or radiation. Other causes include anemia (this is commonly seen in pregnant or mensturating women and malaria), fear, anxiety or exercise even in a perfectly normal person.
Symptoms associated with dyspnea include tightness in the chest area, air hunger or feeling g of breathlessness. Wheezing sounds when breathing, fever and chills, headache, muscle pain or pain on your sides while taking a deep breath, tiredness or easy fatiguability, coughing with or without sputum which may be rusty or greenish yellow, trouble lying down flat and swelling of the lower limbs are all symptoms which can be associated with the dyspnea and it is important to mention them to your doctor as fast as you can.
Risk factors associated with dyspnea include cigarette smoking and environmental irritants like hair spray and chemicals.
Several tests can be done to find out the cause of the dyspnea once you reach the hospital. Respiratory function test like spirometry can show how much air is being taken in or blown out by the lung; imaging studies like the chest X-ray, CT scans, MRI can be done to see if there are any structural deformities in the lung which could cause the dyspnea; laboratory test to be done include the arterial blood gasses to see how much oxygen or carbon dioxide is present in the blood. Treatment of dyspnea depends on the underlying cause.
The mMRC breathlessness scale classifies dyspnea on a scale of 0-4 depending on the severity. They are:
0- no dyspnea except with strenuous exercise.
1-dyspnea when walking up an incline or hurrying on the level.
2- walks slower than most on the level, or stops after 15 minutes of walking on the level.
3- stops after a few minutes of walking on the level.
4- with minimal activity such as getting dressed, too dyspneic to leave the house.
Dyspnea is classic in the presentation of many diseases and it is very important for people to take note of this and visit the hospital any time they feel unusual dyspnea, stay safe.