Breathing Problems

Breathing problems range from mild breathlessness on exertion to life-threatening respiratory failure. Some are cardiac (heart failure), some are pulmonary (asthma, COPD, pneumonia, pulmonary embolism), some are metabolic (anaemia, acidosis), and some are anxiety-driven. Getting to the cause matters.

Red flags — emergency (dial 112)

• Sudden severe breathlessness — heart attack, pulmonary embolism, pneumothorax, severe asthma, anaphylaxis.
• Blue lips or fingertips, inability to speak in full sentences.
• Chest pain, crushing pressure, or radiating to arm/jaw — suspect heart attack.
• Swollen, painful leg + breathlessness — pulmonary embolism.
• After choking on food or a small object in a child — see Choking.
• Breathlessness with facial/tongue/lip swelling + hives — anaphylaxis, use adrenaline auto-injector.

Common causes to know

• Asthma and COPD — see their pages.
• Heart failure — worse lying flat, with leg swelling; see Heart Failure.
• Pneumonia — fever, cough, breathlessness; see Pneumonia.
• Anaemia — breathless on exertion with pale skin/tongue.
• Obesity, deconditioning — very common; improves with gradual activity and weight loss.
• Anxiety / panic — rapid shallow breathing, tingling fingers, sighing; after ruling out organic causes.
• Interstitial lung disease — dry cough, slow-onset breathlessness, sometimes post-COVID.
• Pulmonary hypertension — see that page.
• Tuberculosis — still a major Indian cause.
• Air pollution-related — rising in Indian cities.

What helps at the clinic

• Spirometry / PFT — measures airway obstruction.
• Oxygen saturation (SpO2) on a pulse oximeter — a quick, useful number.
• Chest X-ray, ECG, blood tests as clinically indicated.
• CT chest / echocardiography / D-dimer for specific indications.

Preventive

• Quit tobacco, avoid secondhand smoke.
• Annual flu shot; pneumococcal vaccine if eligible.
• Indoor air quality — ventilate when cooking, don't burn mosquito coils in closed rooms, use clean fuels.
• Outdoor air quality — mask during high-AQI days, limit outdoor exercise when AQI is hazardous.
• Move daily — sedentary life makes everything feel worse.