What causes shortness of breath on exertion? 52 possible conditions

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Shortness of Breath on Exertion Overview

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).

Causes of Shortness of Breath on Exertion

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.

Diagnosing Shortness of Breath on Exertion

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

Treating Shortness of Breath on Exertion

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

Preventing Shortness of Breath on Exertion

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.

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See a list of possible causes in order from the most common to the least.


Asthma Overview

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Chronic Bronchitis

Your bronchial tubes are responsible for delivering air to your lungs. When these tubes become inflamed, mucus can build up. The coughing and shortness of breath this causes is known as bronchitis. People often develo...

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COPD Overview

Chronic obstructive pulmonary disease (COPD), is a lung condition usually caused by smoking. It makes breathing difficult, and wheezing, tightness in chest, and chest infections are common.

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Emphysema is a lung disease that, along with chronic bronchitis, represents a type of chronic obstructive pulmonary disease (COPD). Lack of oxygen may give skin and lips a bluish hue.

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Congestive Heart Failure (CHF)

Congestive heart failure is a chronic condition that affects the four chambers of the heart. Early symptoms include fatigue and weight gain. Irregular heart beat and wheezing indicate a worsening.

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Dissection of the Aorta

This condition is considered a medical emergency. Urgent care may be required.

The aorta is a large artery that carries blood out of your heart. If you experience a dissection of the aorta, it means that blood has entered the wall of the artery, between the inner and middle layers. This can happe...

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Cor Pulmonare

Cor pulmonale causes the right ventricle to enlarge and pump blood less effectively than it should. Shortness of breath, chronic cough, and a blue tint to the mouth and fingernails are all symptoms.

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Pulmonary Embolism

This condition is considered a medical emergency. Urgent care may be required.

A pulmonary embolism is a blood clot that affects blood flow to the lungs. It can damage part of the lung due to restricted blood flow, decrease blood oxygen. The most common symptom is shortness of breath.

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Ischemic Cardiomyopathy

Ischemic cardiomyopathy is a condition that occurs when the heart muscle is weakened due to insufficient blood flow to the heart's muscle. This inhibits the heart's ability to pump blood and can lead to heart failure.

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Mitral Valve Prolapse

In mitral valve prolapse the flaps of the heart's mitral valve do not close correctly, which can make blood leak from one chamber into another. Lifelong heart abnormalities likely contribute to this condition.

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Iron Deficiency Anemia

Anemia occurs when a person has lower-than-normal levels of red blood cells (RBCs) in the blood. According to the American Society of Hematology, there are many factors that can contribute to lower-than-normal RB...

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Aortic Valve Stenosis

The aorta is the main artery of the body. Oxygenated blood leaves the heart by way of the aorta and is carried to all parts of the body. The left ventricle is the chamber of the heart that pumps blood into the aort...

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End-Stage Kidney Disease

A diagnosis of end-stage kidney disease means that you are in the final stage of kidney disease, and your kidneys are not functioning well enough to meet the needs of daily life. Your kidneys are responsible fo...

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Hemorrhoids are swollen veins located around the anus or in the lower rectum. According to the American Society of Colon and Rectal Surgeons, millions of Americans suffer with hemorrhoids.

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Pulmonary Fibrosis

Pulmonary fibrosis is a condition that causes lung scarring and stiffness. This keeps the body from getting enough oxygen.

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The thyroid gland is an important endocrine gland that controls the body's metabolism. It is a small butterfly-shaped gland located in the front of the neck just below the Adam's apple. The thyroid gland produces th...

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Sarcoidosis is an inflammatory disease where granulomas (clumps of immune cells, usually macrophages) form in various organs. This causes organ inflammation. Doctors believe that sarcoidosis may be caused by an abnorma...

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Bronchiectasis is a condition where the bronchial tubes of your lungs are permanently damaged and enlarged. These damaged air passages allow bacteria and mucus to build up in your lungs, which result in infections an...

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Hypovolemic Shock

This condition is considered a medical emergency. Urgent care may be required.

Hypovolemic shock is a life-threatening condition that results when you lose more than 20 percent (one-fifth) of your body's blood or fluid supply. This severe fluid loss makes it impossible for the heart to pum...

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Bleeding Esophageal Varices

This condition is considered a medical emergency. Urgent care may be required.

Bleeding esophageal varices occur when swollen veins (varices) in your lower esophagus, the muscular tube that connects your mouth with your stomach, rupture and bleed due to excess pressure. This condition constitute...

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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