SHORTNESS OF BREATH - Clinical features

It is important to establish whether the shortness of breath is longstanding or acute. People with chronic lung problems like emphysema tend to develop shortness of breath over many years. In contrast, conditions such as asthma and heart failure usually cause more sudden or acute symptoms. An inhaled foreign body may cause very sudden breathing difficulties by blocking the upper airway.

The severity of the breathlessness is also important. Shortness of breath at rest is always a worrying symptom. Other factors like whether there has been a cough or a fever need to be considered, as well general health, occupation and whether the person smokes.

On examination, the person may be obviously distressed and working really hard to breathe. There may be the obvious, barrel-shaped chest that is seen in some people with chronic lung conditions. The person's lips may have a bluish colour. This is called cyanosis and it indicates that not enough oxygen is being exchanged in the lungs. Listening with the stethoscope may reveal wheezing or signs of congestion. There are numerous other signs we look for in anyone who complains of shortness of breath, but sometimes the physical examination may reveal no abnormalities at all.