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home : columns : dr. k June 24, 2016

11/30/2013 11:10:00 AM
Unusual shortness of breath could signal serious problem

DEAR DOCTOR K: I sometimes get short of breath. Should I worry that it's serious?

DEAR READER: Shortness of breath is often no big deal. It's normal to be short of breath for a little while after strenuous exercise or at high altitudes. Some people breathe hard when they're anxious. When should you worry that shortness of breath might indicate a serious heart or lung condition?

I tell my patients that they know their own bodies a lot better than I do. Their bodies are sending their brains signals every minute. If they think they are getting short of breath in situations that never made them short of breath before, that's a red flag.

Maybe they have to stop to catch their breath after climbing one flight of stairs, and that never used to happen. Maybe they sometimes feel winded even when they've just been sitting, and that never used to happen. Maybe they suddenly feel short of breath for no apparent reason. The key question to ask yourself: Is this new for you? If so, talk to your doctor. There still may not be a serious underlying problem, but you need to be sure of that.

The other really important question to ask yourself when you become unusually short of breath is whether you are also experiencing other worrisome symptoms:

-- Chest pain or discomfort

-- Swollen ankles and feet

-- Fever

-- Unusual fatigue

-- Painful cough with blood or yellow, green or reddish mucus

-- Wheezing and coughing

When these symptoms occur along with unusual shortness of breath, you should contact your doctor promptly. They raise the likelihood you may be having a serious, even life-threatening, problem: a heart attack, heart failure, pneumonia, a blood clot in the lungs (pulmonary embolism) or an asthma attack.

Before you call your doctor for shortness of breath, be prepared to answer the following questions. They will help your doctor assess the urgency of your situation. If your doctor doesn't ask these questions, volunteer the information:

(1) Is there chest pain, and what does it feel like? Is it a sharp and stabbing pain? Or does it feel more like a dull pressure? Does it travel anywhere (like into your neck, jaw, shoulder, arm or back)?

(2) Are you sweating profusely?

(3) Do you have trouble breathing when you lie down?

(4) Are your legs or ankles swollen?

(5) Do you have a cough or fever?

(6) How fast are you breathing?

You don't want to get terrified every time you have a potentially serious symptom. But you also don't want to miss an early signal that something serious may be wrong. You need to know when, and when not, to worry.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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