Sunday, May 14, 2023 05:45 [IST]

Last Update: Sunday, May 14, 2023 00:10 [IST]

Why does breathlessness occur?

Dr. K. K. PANDEY Senior Thoracic & Cardiovascular Surgeon Indraprastha Apollo Hospitals, New Delhi

Quite often you must have heard about complaint of breathlessness from your friends. Wherever you go, you would hear for sure the problem of difficulty breathing. You would have concluded by now, that a breathing difficulty or sudden and recurrent episodes of breathlessness are quite routine a problem occurring every day especially to elderly people.

Why an episode of breathlessness?

An incidence of breathlessness means your body is not getting enough oxygen and your lungs are under extreme stress. In such a scenario, the attempt by lungs to draw in required oxygen from the atmosphere to fulfil the need for the whole body leads to increased rate of breathing which is in common language called breathlessness. If this occurrence of breathlessness is not controlled promptly in time, it may result into a fatal outcome. There are two ways to control breathlessness. Either extra oxygen from outside source should be given to the body or demand for oxygen requirement itself is curtailed. In other words, either the cause of breathlessness should be tackled or otherwise a management strategy to abolish the cause itself of breathlessness to be evolved.


Causes of Breathlessness

There are two main reasons of breathlessness in our country especially. One is extreme obesity (too much fat in the body) and secondly anaemia (the deficiency of red blood cells in the body which carries oxygen from one place to another). If haemoglobin level is below normal in the body, the chain of oxygen supply will be disturbed. Majority of the women in our country are suffering from malnutrition. Many women do suffer from some or the other diseases of uterus and unwanted bleeding from vagina. In our country the incidence of increased number of child births and decreased time gap in between the two successive child births plays a major role in causing anaemia and subsequent complaint of breathlessness. If malnutrition is abolished, the incidence of breathlessness will drastically be curtailed.

Obesity or overweight

Lack of regular daily morning walk, lack of physical exercise and at the same time intake of alcohol and fatty food items-all are causing excessive weight gain at a very fast rate. Besides, excess weight means extra load of water and liquid on the body that will naturally lead to breathlessness on mild exertion.

It is not as a rule for every obese person to essentially have a heart disease. One can get rid of problem of breathlessness if malnutrition is corrected and obesity or an excess weight is brought under control in time.

Besides, extra weight, the other culprit responsible for putting extra load on the heart is the disease of kidney. A person suffering from kidney disease develops breathing difficulty when he walks fast or upstairs. Commonly you would have heard obese and fatty person complaining of breathlessness while walking up the staircase.

Lung disease is a major cause

The foremost reason of breathlessness especially in our country is the lung infection such as pneumonia and tuberculosis. The inflammatory swelling of inside lining wall of wind pipe and its branches also causes breathing difficulty. This condition is called in medical terms asthmatic bronchitis. Sometimes external pressure on wind pipe exerted by any lymph node or any tumour mass inside the chest may create breathing difficulty. Quite often, in a road traffic accident, if an effective and prompt treatment of chest injury is not initiated in the beginning, blood or pus gets collected inside the chest. This creates undue pressure on lung leading to breathlessness as well as complaints of frequent or persistent coughing.

Scleroderma is one of the diseases that affect lung very badly. In this disease, inside lining wall of the lung undergoes change. This results in a drastic drop in capability of lung membrane to absorb oxygen from the atmosphere, with the result a simple short walk leads to breathlessness.

Sometimes people, who remain in contact with a substance called ASBESTOS, suffer from a tumour of outer covering of lung. This tumour of lung membrane encircles and compresses the lung from all sides. This tumour in medical language called PLEURAL MESOTHLIOMA which is the main culprit for breathlessness in such patients.

Diseases of heart which are responsible for breathlessness

If the part of the wall of your heart has become either very weak or destroyed completely due to previous heart attack, such a weakened heart is unable to withstand the simple pressure load of water and blood and this becomes the sole cause of breathing problem and above all if the sufferer happens to be an overweight, problem becomes worse.

One must understand the right side of the heart is a temporary store house of impure blood which is deficient in oxygen. The function of this right side of the heart is to collect all impure blood coming back from all the  body organs and then propel it with each heart beat towards lung for the purpose of purification and replenishment of This pure oxygen-rich blood after purification then comes back to the left side of the heart which then supplies this pure blood with each heart beat to every organ of the body. This collection (loading) and then distribution (off loading) of blood go on uninterruptedly with every heartbeat.

If due to any reason, valves (doors) inside the various heart chambers do not either open or close properly with each heartbeat, the delicate balance between heart and lung is disturbed. With the result, an unnecessary extra load and pressure are exerted on heart and this leads to breathlessness.

If anybody had defect in the partition walls existing between chambers of the heart since birth, this will result into an abnormal mixing of impure and pure blood. The whole body especially nails and lips will turn slight blue in colour and breathlessness will develop with growing age...


There are thousands of investigations available in medical world, but only some specific investigations are really required to understand the exact cause of breathlessness and subsequently to decide the course of exact treatment. These investigations are: Chest X-ray, HRCT of chest, Pulmonary function test, Dobutamine–induced stress Echocardiogram (D.S.E) and blood tests like haemogram, vitamin D estimation, lipid profile, kidney profile, thyroid profile, and blood gas analysis. Sometimes C.T coronary or pulmonary angiography may be required for assessment.


What to do when breathless?

Always go to those hospitals where facility for above- mentioned investigations is available. If after detailed assessment, lung is found to be culprit, consult a thoracic (chest surgeon) surgeon. If lung is found to be either damaged partly or completely or under compressive pressure, do not waste time and avoid lame excuses and be prompt to get your lung surgery done, otherwise due to your carelessness, normal lung of the opposite side will be damaged. If your diseased heart is found responsible for breathlessness go to an experienced Cardiologist. You may require coronary stenting or heart surgery. If kidney is the sole cause of breathing difficulty, consult nephrologists (kidney specialist). For other causes of breathlessness consult an internal medicine specialist.

Some fundamental Points to understand

If from the age of 20 years onwards, if you start following these below-mentioned points, believe me you can keep yourself away from breathlessness to a great extent

·         Walk daily for two hours (one hour at least in the morning time.)

·         Expose your body to sunlight for two to three hours every day. In summers, morning sunlight exposure from 6 A.M. to 9 preferable.

·         Keep away from dust and pollution

·         Do  not put fat and  become overweight

·         Daily you should take 350gm salads and 350gm fruits

·         Take adequate proteins  daily ( calculated as  one gram of protein per kilogram of your body weight)

·         Eat regularly green leafy vegetables in adequate amount

·         Avoid smoking and tobacco chewing

·         No alcohol intake

Sikkim at a Glance

  • Area: 7096 Sq Kms
  • Capital: Gangtok
  • Altitude: 5,840 ft
  • Population: 6.10 Lakhs
  • Topography: Hilly terrain elevation from 600 to over 28,509 ft above sea level
  • Climate:
  • Summer: Min- 13°C - Max 21°C
  • Winter: Min- 0.48°C - Max 13°C
  • Rainfall: 325 cms per annum
  • Language Spoken: Nepali, Bhutia, Lepcha, Tibetan, English, Hindi