Centers of Excellence

The Lung Center

Dyspnea/Shortness of Breath

People who experience dyspnea feel short of breath. Dyspnea can range from mild to severe. If this condition is chronic and persistent, it may seriously limit activity and reduce quality of life.

Dyspnea can be a result of lung, heart, vascular, neuromuscular and metabolic disease. Because shortness of breath can be a result of several different medical conditions, it can be difficult to discover the accurate cause(s). Without knowing the cause(s), it can be very difficult to treat. Learn more about dyspnea.

The physicians who treat patients at the Dyspnea Center at Brigham and Women’s Hospital (BWH) provide expert care, collaborating with specialists in pulmonary and critical care medicine, thoracic surgery, cardiovascular medicine, neurology and cardiovascular and thoracic imaging. This collaboration ensures that patients experiencing shortness of breath will get prompt answers about the cause of their symptoms and will receive targeted treatment.

Dyspnea/Shortness of Breath Topics

Risk Factors for Dyspnea/Shortness of Breath

Shortness of breath is a normal symptom during intense exercise or exertion. If it occurs while the patient is at rest—or during unexpected situations—it can be a symptom of a serious medical condition. If you suffer from dyspnea, you may also have any of these health issues:

  • Heart disease
  • Respiratory infection or pneumonia
  • Cancer, especially lung cancer
  • Emphysema or chronic bronchitis
  • Asthma
  • Allergies
  • Reflux
  • Obesity

Learn more about risks for dyspnea/shortness of breath.

Causes of Dyspnea/Shortness of Breath

Dyspnea can be caused by many conditions, some more serious than others, including:

Diagnosis of Dyspnea/Shortness of Breath

Dyspnea has many causes, which can make it difficult to find a diagnosis. In some cases the diagnosis can be made with chest imaging, an echocardiogram and pulmonary function testing. In those patients who have unexplained dyspnea, the most accurate way to make a diagnosis is through advanced cardiopulmonary exercise testing. This test uses catheters during exercise (stationary cycling or treadmill) to assess how the body is utilizing oxygen, and to measure heart and lung function.

Many standard diagnostic tests for shortness of breath, including noninvasive cardiopulmonary testing, electrocardiogram (EKG), computed tomography (CT), and pulmonary function testing (PFT), can be inconclusive.  As a result, sometimes patients are given an incorrect diagnosis. Brigham and Women’s Hospital is one of the few hospitals in the nation to offer advanced cardiopulmonary exercise testing.

Once a patient presents to our program with dyspnea, the underlying cause will be determined by our multidisciplinary team of clinicians. We will then develop a personalized care plan based on state-of-the-art approaches.

Treatment for Dyspnea/Shortness of Breath

Dyspnea is treated by addressing the underlying disease or condition. For example, if dyspnea is caused by pleural effusion, draining fluid from inside the chest can reduce shortness of breath. Depending upon the cause, dyspnea can sometimes be treated with medication or by surgical intervention.

Medication 
Your doctor may prescribe one of the following medications, depending on the underlying cause of the dyspnea:

  • Bronchodilators to open airways
  • Steroids to reduce swelling
  • Pain medications

Patient Management
You can help manage shortness of breath with relaxation and breathing exercises. Be sure to talk with your doctor before trying these techniques.

  • Relaxation exercises 
    Difficulty breathing may cause feelings of anxiety and panic and, conversely, any feelings of anxiety and panic may cause you to have increased shortness of breath. Relaxation, meditation and other techniques to manage your emotions may help decrease the severity of dyspnea.
  • Breathing exercises
     Taking the time to focus on your breathing will help you to become more aware of your breath and lung function. Two helpful exercises include:
    • Abdominal breathing: Find your diaphragm (the dome-shaped muscle below your lungs). While inhaling, focus on filling your lungs completely and feel your stomach move outward away from you. While exhaling, feel your stomach fall slowly and your lungs empty.   
    • Pursed-lip breathing: Breathe in through your nose. Pucker your lips and breathe out through your mouth slowly. You may find it helpful to count as you inhale and exhale. 

Learn more about managing shortness of breath.

Surgical Intervention
Surgery may play a role in the treatment of shortness of breath. Certain conditions such as chronic blood clots to the lung or structural heart disease can contribute to breathing difficulty. These causes of shortness of breath can often be corrected with highly specialized surgical interventions. In many instances, surgery not only helps with symptom relief but can improve long term survival; for example, in certain patients with chronic structural lung conditions such as severe emphysema

What You Should Expect

The Dyspnea Center brings together the full range of BWH's services and expertise. Our team of experts will examine your lung function to determine the severity of your shortness of breath. Your team will then diagnose the cause and collaborate with a range of specialists to treat this condition. Some causes of unexplained dyspnea are due to structural abnormalities including blood clots, structural heart disease, valvular heart disease, structural lung disease and abnormalities due to congenital heart and lung disease that could be treated with surgery.

In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities. 

Multidisciplinary Care

Dyspnea patients benefit from the Dyspnea Center's clinical team and the wide range of specialists at The Lung Center and Heart & Vascular Center, including pulmonary and critical care medicinethoracic surgerycardiovascular medicine, neurology and thoracic and cardiovascular imaging. This collaboration ensures world-class, comprehensive care for dyspnea — as well as its underlying causes.

Resources

Visit our health library to learn more about dyspnea.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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