When Breathlessness Needs Medical Care: Warning Signs and What to Do

Urgent first

Go to the emergency room or call your local emergency number (911 in the US) if breathing difficulty comes on suddenly or seriously interferes with breathing and even talking, or if someone completely stops breathing. [1]

UK example, from the NHS: call 999 or go to A&E immediately for severe difficulty breathing, such as gasping, choking or not being able to get words out; chest that feels tight or heavy; pain spreading to the arms, back, neck or jaw; lips or skin turning very pale, blue or grey; or sudden confusion. [2] The NHS adds that you should not drive yourself, and should bring your medicines. [2]

Do not start a breathing exercise to "wait and see" when you have these signs.

Why this page exists

Breathlessness is a symptom, not a diagnosis. MedlinePlus lists many possible causes in the lungs, airways and heart, as well as anxiety, panic attacks, anemia and others. [1] The NHS says plainly: do not try to self-diagnose the cause of shortness of breath, and always see a GP. [2] A calm breathing practice can feel soothing, but it cannot tell you which cause you have.

Signs that call for a prompt medical visit

MedlinePlus says to see your provider if breathing difficulty comes with any of the following. [1]

• Chest discomfort, pain or pressure, which may be symptoms of angina. [1]
• Fever. [1]
• Shortness of breath after only slight activity or while at rest. [1]
• Shortness of breath that wakes you at night or needs you to sleep propped up. [1]
• Shortness of breath with simple talking. [1]
• Wheezing, or a barking, croupy cough with throat tightness. [1]
• A significant worsening of breathlessness you already have. [1]

The NHS also lists, for same-day advice (in the UK, via NHS 111): coughing up blood, pain or swelling in one leg, and heart palpitations. [2] For a routine appointment it lists breathlessness that worsens with normal activity or lying down, and breathlessness with swollen ankles. [2]

How the feeling is judged

MedlinePlus notes that breathing difficulty is a subjective feeling, and only the person feeling it can decide whether it is present. [1] That is a reason to take your own report seriously. The same page says to contact your provider for any breathing difficulty that is new or getting worse. [1]

If it might be panic

Panic attacks can cause shortness of breath, along with dizziness and chest pain. [3] That overlap is exactly why it can be hard to tell panic from a heart or lung problem. The first time, or if the symptoms are unusual for you, get checked. For how to tell the difference, see hyperventilation, panic attack or medical emergency. The NHS suggests seeing a GP if you have symptoms of panic disorder. [3] If panic and distress feel overwhelming and you are thinking of harming yourself, call, text or chat with the 988 Lifeline (US). [4]

If you already have a lung condition

People with asthma or COPD often have treatment plans. The NHS describes COPD as a condition that makes breathing increasingly more difficult, with flare-ups that can come on suddenly. [5] Follow your action plan and your provider's directions. [1] Never swap an inhaler or other prescribed medicine for breathing exercises. For what the research says about exercises in these conditions, see breathing exercises for shortness of breath, asthma and COPD.

Breathlessness during a breathing practice

If breathlessness, dizziness or chest tightness appears during a session, stop and breathe normally. If it does not settle quickly, treat it as the medical question it may be. See warning signs and when to stop.