Difficulty breathing is a respiratory disorder associated with an abnormal and unpleasant breathing perception. The respiratory rate is changed; it accelerates or it decelerates. Inspiratory time and expiratory time may be affected.

Often called “dyspnea”, but also “breathing difficulty”, difficulty in breathing results in a feeling of discomfort, tightness and shortness of breath. Each breathing movement becomes an effort and is no longer automatic

The main causes of difficult breathing are heart and lungs.

The pulmonary causes relate first of all to obstructive diseases:

• Asthma can interfere with breathing. In this case, the muscles surrounding the bronchi contract, which reduces the space where air can pass, the tissue lining the inside of the bronchi (= bronchial mucosa) is irritated and then produces more secretions (= mucus) , further reducing the space through which air can circulate.
• Chronic bronchitis can be the source of difficulty in breathing; the bronchi are inflamed and cause coughing and spitting.
• In pulmonary emphysema, the size of the lungs increases and expands abnormally. Specifically, the rib cage relaxes and becomes unstable, accompanied by collapse of the airways, i.e. difficult breathing.
• Complications from a coronavirus infection can also cause difficulty in breathing. 

Other pulmonary causes are restrictive diseases:

• Dyspnea can be caused by pulmonary fibrosis. It is a change in the lung tissue to pathological fibrous tissue. This fibrosis is located in the inter-alveolar spaces, where the gas exchange of oxygen takes place.
• Removal of a lung or muscle weakness as in the case of myopathy can cause breathing problems

Cardiac causes are as follows:

• An abnormality of the heart valves or heart failure which will cause a weakness of the heart and pressure changes in the vessels which will affect the lungs and may interfere with breathing.
• When the heart is malfunctioning, blood collects in the lung which is hampered in its respiratory function. Pulmonary edema then forms, and difficulty in breathing may appear.
• Dyspnea can occur during a myocardial infarction; the heart’s ability to contract is then reduced due to necrosis (= cell death) of part of the heart muscle which causes a scar on the heart.
• High blood pressure causes an increase in pulmonary arterial resistance which leads to heart failure and can make breathing difficult.

Certain allergies such as pollen or mold allergy or obesity (which promotes a sedentary lifestyle) can be a source of respiratory discomfort.

Difficulty breathing can also be mild and caused by high anxiety. This is one of the symptoms of an anxiety attack. If in doubt, do not hesitate to contact your doctor. 

Dyspnea can cause heart failure or pneumothorax (= disease of the pleura). It can also cause brain damage if the brain is not supplied with oxygen for a while.

More serious, respiratory discomfort can lead to cardiac arrest because in this case, oxygen no longer circulates properly in the blood to the heart.

First of all, it is recommended to treat the cause of the dyspnea to be able to alleviate it or even stop it. To do this, contact your doctor.

Then, regular physical activity can allow better breathing because it prevents a sedentary lifestyle.

Finally, consider making an appointment with your doctor to diagnose possible diseases such as pulmonary emphysema, pulmonary edema or even arterial hypertension that may be responsible for dyspnea.