Shortness οf Breath

In order to reach our lungs, air passes successively through:

1. From the nose or mouth into the pharynx, larynx, trachea and bronchi.
2. Inside the lungs, the bronchi branch out into ever-smaller branches and they end at the alveoli.
3. Gas exchange takes place in the alveoli (we expel carbon dioxide and take in oxygen)

• Lung cancer
• Heart conditions (such as heart failure)
• Chronic obstructive pulmonary disease
• Chronic obstructive pulmonary disease (COPD) in smokers
• Interstitial pulmonary fibrosis
• Pleural effusion
• Disorders of the pharynx, larynx and trachea
• Pulmonary embolism
• Acute myocardial infarction (AMI)
• Cardiac tamponade
• Phrenic nerve paralysis

Furthermore, causes not originating from the thoracic organs must also be taken into account:

• Metabolic acidosis (Kussmaul’s respiration)
• Respiratory tract damage (tumours, encephalitis, cerebrovascular accidents)
• Anaemia
• Conditions with increased oxygen requirements (hyperthyroidism, exercise)
• Inhalation of toxic substances
• States of distress and anxiety (hyperventilation syndrome)
• Salicylate poisoning
• Chronic kidney failure

Sometimes shortness of breath may be the result of treatments carried out for the disease, such as chemotherapy and radiotherapy.

If you experience shortness of breath for the first time or if your symptoms become more severe, please inform your care team. Try to give them as much information as possible to help them find the best way to manage it.

Some questions that will help you describe your shortness of breath more clearly to your care team are:

• When did it first appear?
• How long does it last?
• When and how does it improve (e.g. with medication, a change of position, warmth/cold)?
• When does it become more difficult (more severe)?

If you already have instructions on what to do about your shortness of breath but it does not improve or it is getting worse, inform your care team as soon as possible. If necessary, they will reassess your shortness of breath and adjust your treatment accordingly.

Sometimes certain symptoms require immediate attention, which is why it is very important to know the contact details of your healthcare professional or an emergency number, to get in touch with them day or night in case you need help.

Alongside the treatment your doctor will recommend, there are also some practical ways that can help you reduce shortness of breath when it occurs:

• Get some cool air on your face. Open a window or use a small fan to increase the airflow in the room.
• Adjust your posture to an upright position. Don’t forget to support your head, neck and shoulders so that you can rest comfortably.
• Sit down and rest your arms on a small table.
• Reduce the number and pace of your activities so as not to put too much strain on yourself.
• When climbing stairs or walking uphill, breathe in on one step, breathe out on the next, and then pause for a moment. Then repeat the same process.
• Keep the things you use frequently within reach.
• Do not lift heavy objects.
• Listen to relaxing music.
• Walk slowly, at a pace that allows you to catch your breath.
• Eat healthy and watch your weight.
• Try to avoid spicy foods.

• Sit comfortably and support your neck, shoulders and back.
• Lower your shoulders, let them sink and feel their weight.
• Use the abdominal or diaphragmatic breathing technique
  • Place the palm of your hand on your stomach
  • Cough gently. The muscle you feel is the diaphragm.
  • Close your mouth and take a slow, deep breath in through your nose, counting to 3. You will feel your abdomen expanding as your lungs fill with air.
  • Hold your breath for a few seconds, then breathe out through your mouth as slowly as possible, counting to 6.
  • Repeat the exercise 5 to 10 times.

If you’re finding it very difficult to breathe, try this:

• Take a slow breath in, through your nose.
• Form an “O” shape with your lips and exhale softly as if you were gently blowing out a candle.
• Exhale slowly and calmly through your mouth with lightly puckered lips. Try to make the exhalation last longer than the inhalation.

This helps to release any air that is trapped in your lungs. This makes breathing easier and reduces shortness of breath.

You can repeat this type of breathing, several times a day, whenever you want to relax or feel calm.