Shortness of Breath on Exertion

Shortness of breath on exertion (SOBOE) is when you have difficulty breathing while performing a physical activity. SOBOE can occur during routine activities like walking up a flight of stairs.

You are more likely to feel shortness of breath when you exercise if you are not normally physically active. It is also common in late-stage pregnancy and in people who have asthma. It can also happen at higher elevations, where there is less oxygen, or because of a combination of physical and environmental factors.

Seek immediate medical attention if you experience SOBOE along with other symptoms like chest pain, confusion, or dizziness. Call 911 if you have difficulty breathing while at rest or if someone stops breathing.

Diagnosis will involve a thorough physical examination. Your doctor will check your airway passages, heart, and lungs. Depending on your symptoms, diagnostic testing may include chest X-ray, blood tests, or computed tomography (CT) scan. Treatment will be based on the diagnosis.

SOBOE is sometimes called breathlessness on exertion, exertional dyspnea, or dyspnea on exertion (DOE).

SOBOE is a warning sign that your lungs are not releasing enough carbon dioxide. This can happen for a variety of reasons, including:

• blocked air passages in your nose, mouth, or throat
• emotional distress
• high altitudes (where there is less oxygen)
• late-stage pregnancy
• poor physical conditioning

SOBOE can also be a symptom of:

• allergies
• anemia
• asthma
• bronchiolitis
• chronic obstructive pulmonary disease (COPD)
• heart disease
• heart failure/congestive heart failure (CHF)
• intersitial fibrosis
• kidney disease
• liver disease
• lung disease
• obesity
• panic attack
• pneumonia
• pulmonary embolism
• pulmonary hypertension
• tumor
• vocal cord dysfunction

According to the BC Medical Journal, as many as 90 percent of chronic asthma patients experience SOBOE. Exercise-induced asthma is the most common cause of SOBOE in active individuals (Koehle et al., 2003).

People with COPD are at increased risk of SOBOE if they continue to smoke.

A combination of physical, environmental, psychological, and social factors can sometimes cause SOBOE.

If you experience SOBOE, make an appointment for a physical examination. Seek emergency medical attention or call 911 if you experience shortness of breath along with other symptoms such as:

• chest pain
• choking
• confusion
• coughing up blood
• dizziness or fainting
• excessive perspiration
• fever
• gasping for breath
• skin turns pale
• skin turns blue
• swelling of the legs or ankles

A complete history and physical is needed to assess and treat an underlying condition. Your doctor will likely perform a thorough check of your heart, lungs, and upper airway passages.

Diagnostic testing may include:

• blood tests
• CT scan of the chest
• chest X-ray
• echocardiogram
• electrocardiogram (ECG)
• exercise testing and exercise tolerance testing
• pulmonary function studies

Any underlying conditions that are causing your SOBOE must be addressed.

You can't completely control all factors that lead to this symptom. However, you may decrease your risk if you avoid smoking and exercise regularly.