Overview
Breathing faster during physical activity is normal because the body needs more oxygen and produces more carbon dioxide. However, breathlessness that seems disproportionate to the level of activity, develops suddenly or progressively worsens may require medical evaluation. Exercise-related breathlessness can occur with asthma, COPD, respiratory infections, anemia, heart conditions, obesity, reduced fitness and other conditions. Identifying the underlying cause is important when symptoms are persistent or interfere with normal activities.
Causes
Possible causes include: Asthma, including exercise-induced bronchoconstriction COPD Respiratory infections Pneumonia Heart conditions Anemia Obesity Reduced physical fitness Anxiety or panic Interstitial lung diseases Pulmonary hypertension Smoking-related lung problems Certain medications Other conditions affecting the lungs, heart or blood
Risk Factors
Risk may be increased by: Chronic lung disease Heart disease Asthma Smoking or long-term exposure to secondhand smoke Recent respiratory infection Excess body weight Anemia Physical inactivity or low fitness Increasing age Occupational exposure to dust, fumes or other respiratory irritants
Diagnosis
A doctor will ask about when breathlessness occurs, how quickly it develops, how severe it is and whether other symptoms are present. Evaluation may include: Medical history and physical examination Pulse oximetry Blood tests, including assessment for anemia when appropriate Chest X-ray Lung function tests such as spirometry Exercise testing when indicated ECG Echocardiogram Additional imaging or tests based on the suspected cause
Treatment
Treatment depends on the underlying cause. Possible treatments include: Inhaled medicines for asthma or COPD Treatment of respiratory infections Appropriate treatment of anemia Management of heart conditions Pulmonary rehabilitation or supervised exercise programs when appropriate Weight management when appropriate Smoking cessation Avoidance of known respiratory triggers Treatment of other underlying lung or heart conditions People with known asthma should follow their prescribed asthma action plan and use medicines as directed.
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Prevention
Some causes of exercise-related breathlessness may be reduced by: Staying physically active and increasing activity gradually Following treatment plans for chronic lung or heart conditions Avoiding smoking and secondhand smoke Avoiding known asthma or respiratory triggers Maintaining a healthy weight Getting recommended vaccinations Treating respiratory infections appropriately Using appropriate protective measures around workplace dust, fumes or chemicals
Complications
Persistent or worsening breathlessness can limit physical activity, exercise tolerance and daily activities. If caused by an underlying lung or heart condition, untreated breathlessness may indicate worsening disease or lead to reduced physical conditioning and quality of life.
When to See a Doctor
Consult a doctor if breathlessness: Is new or unexplained Occurs with mild activity that previously did not cause symptoms Is progressively getting worse Limits normal activities or exercise Occurs with persistent cough or wheezing Is associated with unusual fatigue Occurs with chest discomfort or palpitations Continues after recovery from a respiratory infection Seek emergency medical attention for sudden or severe difficulty breathing, severe chest pain, fainting, confusion, blue or grey lips or skin, or rapidly worsening symptoms.
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