Shortness of Breath: When to See Your Doctor
Sep 30, 2019 Cara Martinez
"When searching for an undetected cause of shortness of breath, we first look to the heart, lungs, and circulatory system. Then, we look for 5 signs that will guide us toward the right diagnosis."
Here, Cedars-Sinai experts explain some of the conditions responsible for shortness of breath and when you should see your doctor.
A stiffening of the heart
Cardiac amyloidosis is an often overlooked medical condition—although it is becoming increasingly recognized. The most common form is usually diagnosed in men over the age of 70.
Amyloid proteins build up in the heart, causing stiffness and pressure. The condition often leads to heart failure.
"The first symptom for many patients with cardiac amyloidosis is shortness of breath," says Dr. Jignesh Patel, director of the Cardiac Amyloidosis Program.
That's because as amyloid proteins take up space in the wall of the heart, the heart's ability to fill up with blood between heartbeats becomes more difficult, leading to breathlessness.
Dr. Patel says that as many as a quarter of patients over the age of 80 may suffer from cardiac amyloidosis, but many aren't diagnosed for an average of 3 years—making it crucial to see a specialist if you or a loved one suspects the condition.
To diagnose cardiac amyloidosis, patients often undergo a series of tests, including imaging scans of the heart, blood and urine tests, and in many cases, genetic testing.
Treatment for the condition varies depending on the severity and type of the disease. It usually begins with medications, but can include a bone marrow transplant or a heart transplant.
A cough, chest pain, and shortness of breath
Shortness of breath is also a common symptom in patients with lung cancer, especially those with advanced stages of the disease.
"Lung cancer patients often have shortness of breath, but also have a cough, chest discomfort, pain, or the sensation of heaviness," said Dr. Ronald Natale, medical director of the Lung Cancer Program.
As lung cancer develops, Dr. Natale says it can compromise breathing in 3 ways: The tumor can block airway passages, blood clots can form and block blood flow to an area of the lung, or fluid can build up in the lungs and chest wall causing the lungs to partially collapse.
"A chest CT scan is usually the first step to investigate the cause of sudden-onset shortness of breath," says Dr. Natale.
When a diagnosis is more challenging to detect
If heart and lung conditions have been ruled out but you are still experiencing shortness of breath, it may be a circulation issue, says pulmonologist Dr. Zab Mosenifar.
"When searching for an undetected cause of shortness of breath, we first look to the heart, lungs, and circulatory system," says Dr. Mosenifar. "Then, we look for 5 signs that will guide us toward the right diagnosis."
Those 5 signs include infection, inhalation-related injuries, other injuries, immune system conditions, and idiopathic conditions—those that spontaneously happen with no known cause.
To rule out these conditions, Dr. Mosenifar typically puts patients on a stationary bicycle and collects gas samples from their mouths. These samples can often identify the root cause of a condition.
When to see a doctor
For most people, infrequent shortness of breath isn't reason to sound the alarm.
But if shortness of breath is suddenly keeping you from your daily activities, then it may be time to call your doctor.
Our experts recommend scheduling an appointment with your doctor if your shortness of breath is accompanied by swelling in your feet and ankles, trouble breathing when you lie flat, high fever, chills and cough, or wheezing. You should also see a doctor if you notice shortness of breath becoming more severe.
And if at any time your shortness of breath is accompanied by severe symptoms such as confusion, chest or jaw pain, or pain down your arm, call 911 right away.