Breathing Trouble

Is this your symptom?

  • Trouble breathing means working hard to breathe
  • Normal breathing should be easy and quiet

Trouble Breathing: Symptoms

Trouble breathing is a reason to see a doctor right away. Here are symptoms to watch for:

  • Struggling for each breath or short of breath.
  • Tight breathing so that you can barely speak.
  • Ribs are pulling in with each breath (called retractions).
  • Breathing has become noisy (such as wheezing).
  • Breathing is much faster than normal or there are long pauses in breathing (apnea attacks).
  • Lips or face turn a blue color.
  • Breathing trouble gets worse fast.
  • There are other symptoms, such as chest pain or coughing up blood.
  • Your usual breathing treatment(s) are not working.

Trouble Breathing: Importance

  • Trouble breathing is one of the most common reasons for getting admitted to the hospital.
  • Many of these people need oxygen.
  • Frail older people may get worse quickly.

Causes of Trouble Breathing

Trouble breathing comes from problems in the lower throat, voice box, windpipe, or lung airways. It can also be due to heart problems and other underlying conditions. Here are the common ones:

  • Anaphylaxis(severe allergic reaction). Suspect when there is a sudden onset of trouble breathing and widespread hives. Common causes are bee stings or food allergies such as peanuts. This can be life threatening and needs immediate treatment. Call 911.
  • Asthma. Symptoms of an asthma attack are wheezing, a cough, and trouble breathing. If your asthma symptoms are severe or getting worse, go to ER.
  • Bronchiolitis. A viral infection of the smallest airways in the lungs. Main symptoms are fast breathing and wheezing.
  • COVID-19. Some patients develop breathing trouble with COVID-19 infection. This may or may not be severe.
  • Cystic Fibrosis is a disease which causes severe damage to the lungs and other organs. Coughing and trouble breathing are main symptoms.
  • Chronic Obstructive Pulmonary Disease (COPD). Long-term inflammation of the airways which hampers airflow in and out of the lungs. The most common cause is smoking, but there are other causes. The problem gets worse slowly over time, but is treatable. Symptoms include cough, sputum and breathlessness.
  • Epiglottitis (very serious). A bacterial infection of the flap of tissue above the vocal cords. It normally covers the windpipe during swallowing. The main symptoms are severe sore throat, drooling, spitting and fever. It can shut off the airway. Call 911.
  • Foreign Object in Airway. Suspect when there is a sudden onset of coughing and choking.
  • Influenza. Main symptoms are a fever with a runny nose, sore throat, and bad cough. The flu virus can also cause problems such as pneumonia. Vaccine may prevent the disease.
  • Pneumonia (serious). This is a more serious infection of the lower parts of the airway (in the lung). It can be caused by viruses or bacteria. Symptoms include cough with brown or bloody mucus, breathlessness, chest pain and fever. Antibiotics may be needed to treat it.
  • Whooping Cough. A bacterial infection of the airway. Main symptoms are long coughing spells and choking. Very serious in infants. Can be prevented by vaccine.
  • Heart Failure (serious). This occurs when the heart is not pumping as well as it should. Fluid can build up on the lungs and other parts of the body. The main symptoms are shortness of breath, swelling and tiredness. Sudden shortness of breath and a cough with frothy pink mucus can also occur, especially at night.
  • Pulmonary Embolus (serious). This occurs when a clot from somewhere in the body (often the legs) travels round the blood flow and is trapped in the lungs. A large clot can be life threatening. Symptoms include breathlessness, chest pain and coughing up blood.
  • Lung Cancer (serious). Lung cancer is one of the main causes of death from cancer worldwide. People who smoke are most at risk from this. People who have worked in smoke filled places (clubs and bars) are also at risk. Cough is a common symptom. If you have a new cough that does not go away within 3 weeks or if you are coughing up blood. you should see your doctor.
  • Pneumothorax (collapsed lung). A lung can collapse from a chest injury, lung problems or for no clear reason. Oxygen can’t get into the collapsed part of the lung and the person has trouble breathing. Severity depends on how much of the lung has collapsed. It may need treatment in hospital to reinflate the lung. This can be life threatening and the breathing trouble gets worse very fast.

When to Call for Breathing Trouble

When to Call for Breathing Trouble

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak)
  • Stopped breathing or long pauses between each breath
  • Passed out or feeling like you are going to pass out
  • Lips or face are bluish when not coughing
  • Confused
  • Choking on a small object that could be caught in the throat
  • Trouble breathing started suddenly after bee sting, new medicine or an allergic food
  • Pain in the chest, neck or jaw
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Soft wheezing (high-pitched, squeaky sound with breathing out)
  • Breathing is much faster than normal
  • Sharp chest pain when you take a deep breath
  • You have travelled a long distance (flight, car) or been bedridden due to injury or illness in the past few weeks
  • You are pregnant, gave birth in the past 6 weeks or take estrogen (for hormone replacement or birth control)
  • You have a history of blood clots or have a close relative who has a history of blood clots
  • Any part of your leg has become swollen and painful for no clear reason
  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, diabetes, kidney problems.
  • You are having cancer treatment or have recently been in hospital for surgery or care
  • Coughing up mucus that has blood streaks or is pink and frothy
  • New trouble breathing when at rest, but not severe
  • Your usual breathing treatment has not helped as it normally would
  • Lips or face turn bluish when coughing
  • Nonstop coughing and not able to sleep or do normal activities
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Fever or chills; feeling hot or shivery
  • Breathing trouble is not severe, but is not getting better within 24 hours or is getting worse
  • You wake short of breath in the night or get short of breath when you lie down
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Breathing trouble (not severe) that happens once in a while or often
  • You have other questions or concerns

Self Care at Home

  • Mild breathing trouble that is getting better

Call 911 Now

  • Severe trouble breathing (struggling for each breath, can barely speak)
  • Stopped breathing or long pauses between each breath
  • Passed out or feeling like you are going to pass out
  • Lips or face are bluish when not coughing
  • Confused
  • Choking on a small object that could be caught in the throat
  • Trouble breathing started suddenly after bee sting, new medicine or an allergic food
  • Pain in the chest, neck or jaw
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Soft wheezing (high-pitched, squeaky sound with breathing out)
  • Breathing is much faster than normal
  • Sharp chest pain when you take a deep breath
  • You have travelled a long distance (flight, car) or been bedridden due to injury or illness in the past few weeks
  • You are pregnant, gave birth in the past 6 weeks or take estrogen (for hormone replacement or birth control)
  • You have a history of blood clots or have a close relative who has a history of blood clots
  • Any part of your leg has become swollen and painful for no clear reason
  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, diabetes, kidney problems.
  • You are having cancer treatment or have recently been in hospital for surgery or care
  • Coughing up mucus that has blood streaks or is pink and frothy
  • New trouble breathing when at rest, but not severe
  • Your usual breathing treatment has not helped as it normally would
  • Lips or face turn bluish when coughing
  • Nonstop coughing and not able to sleep or do normal activities
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Fever or chills; feeling hot or shivery
  • Breathing trouble is not severe, but is not getting better within 24 hours or is getting worse
  • You wake short of breath in the night or get short of breath when you lie down
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Breathing trouble (not severe) that happens once in a while or often
  • You have other questions or concerns

Self Care at Home

  • Mild breathing trouble that is getting better

Care Advice While Waiting to See Doctor

  1. What You Should Know About Trouble Breathing:
    • Breathing trouble that is getting worse fast, or not responding to usual treatment, needs to be seen now.
    • If you have to work hard to breathe, you can become exhausted. This can be life threatening. You should call 911 right away.
    • The causes of breathing trouble are often serious.
    • You may need oxygen.
    • Here is some care advice that may help until you talk with your doctor.
  2. Coughing Fits or Spells:
    • Breathe warm mist (such as with shower running in a closed bathroom).
    • Reason: relax the airway and loosen up any phlegm.
    • Caution: avoid breathing in steam (from using boiling water). There is a risk of scalding.
  3. Nasal Saline to Open a Blocked Nose:
    • Use saline (salt water) nose drops or spray to loosen up the dried mucus. If you don't have saline, you can use a few drops of bottled water or clean tap water.
    • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
  4. Avoid Tobacco Smoke:
    • Smoke makes coughing and trouble breathing much worse.
  5. Avoid Dust and Allergens:
    • Avoid things you are allergic to.
    • Stay indoors on days when the pollen count is high.
    • Keep pets out of the bedroom.
  6. Medicines:
    • If your doctor has prescribed meds for your breathing problems, take them as instructed.
  7. Call Your Doctor If:
    • Ribs start pulling in with each breath (retractions)
    • Wheezing becomes loud or tight
    • Trouble breathing gets worse
    • You start to feel or appear exhausted

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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