Breath is the essence of life. Any difficulty with breathing is fearsome. Rapid or difficult breathing following an exercise is common and non-threatening. On the other hand, breathlessness can indicate the presence of a disease of the lungs, heart, blood or other organ systems.

Important causes of breathing difficulty

  • Physiological causes of rapid breathing:
  • Exercise
  • Menstrual periods in women; pregnancy
  • Fever of any cause
  • Anxiety and pain

Lung diseases causing breathlessness:

  • Bronchial asthma
  • Chronic obstructive pulmonary disease
  • Interstitial lung disease
  • Lung infections, pneumonias, tuberculosis
  • Lung tumours
  • Pleural diseases
  • Any other lung disease causing destruction of lung tissue

Heart diseases

Cardiac failure due to any cause – hypertension, ischemic heart disease, valvular heart disease, cardio myopathies


  • Anemia
  • Blood cancers
  • Any systemic disease of liver, kidneys other vital organ systems

It is important to find out the cause of breathlessness for an effective management following an algorithmic approach. A number of investigations directed to look into the possible cause may be required for this purpose. A good clinical history is essential to suspect the origin of the symptom. Routine blood examination and chest x-ray which constitute the baseline tests are almost always required. Specialized tests are done following the lead on clinical history and baseline investigations.

Treatment of breathlessness essentially depends on the cause. There are no general drugs which can be used for all kinds of breathing difficulties. Sometimes one tends to use bronchodilators (both oral and inhalational) for non-specific management. Their use should however  be limited to a short period before one arrives at a specific diagnosis.