Health: Dr Melanie on the reasons you may be breathless

Breathlessness is rarely normal. it could mean that you’re under pressure and may need help

Our bodies constantly monitor our blood levels of oxygen, carbon dioxide and acidity, adjusting breathing as necessary – for example when we’re exercising or oxygen levels are low (high altitude). But unexplained rapid/laboured breathing, at rest or on slight exertion, should ring alarm bells.

Lung problems

When we inhale, air travels down to the alveolar sacs where oxygen passes into the blood and carbon dioxide is collected for breathing out. Conditions that narrow the airways (eg asthma, chronic obstructive pulmonary disease), damage the alveoli (fibrosis) or target lung tissue (pneumonia, cancer, TB, immune-system disorders, blood clots or toxins) force us to breathe more rapidly. There may be other symptoms such as a cough, wheezing, chest pain, weight loss, blood-stained sputum, sweats or cyanosis (blue lips, tongue or nails). Treatment may include inhalers, antibiotics, steroids, anticoagulants, chemo/ radiotherapy, immune suppressants, pulmonary rehabilitation, and/or long-term oxygen therapy.

Heart problems

The heart is a muscular pump with internal one-way valves; it sends blood to the lungs to collect oxygen, then out to the body. If its own blood supply (coronary arteries) get blocked, triggering a heart attack, you’ll develop sudden breathlessness, central crushing chest/arm/jaw pain and sweating. Narrowed/leaky heart valves, an irregular heartbeat and heart failure (weakened heart muscles) reduce pumping efficiency, and can cause breathlessness, often with dizziness, palpitations, pain, ankle swelling or cyanosis, too. Medication can strengthen heart