Shortness of Breath (Dyspnea): Causes, Red Flags & When to Seek Care

Dyspnea is a subjective breathing discomfort with diverse etiologies. Seek immediate care if:

• Sudden, severe onset
• Chest pain, syncope, diaphoresis, hemoptysis
• Orthopnea, paroxysmal nocturnal dyspnea
• Stridor, drooling, tripod positioning

Common Causes

• Pulmonary: asthma, COPD, PE, pneumonia, pneumothorax, ILD
• Cardiac: HF, MI, arrhythmia, valvular, pericardial effusion
• Hematologic: anemia
• Metabolic: DKA, acidosis (Kussmaul)
• Psychogenic: anxiety, panic disorder
• Mechanical: obesity, kyphoscoliosis

Workup

History, exam, SpO₂, CXR, ECG, BNP, D-dimer, PFTs, echo, CT/CTPA as indicated. Treatment targets underlying cause.