Dyspnea, also known as shortness of breath or breathlessness, is a subjective sensation of breathing discomfort. There are multiple sensations of dyspnea; the best described can be grouped together into:[1]
- Sensation of work or effort
- Tightness
- Air hunger/unsatisfied inspiration.
Dyspnea is a common symptom, present in up to half of patients admitted to acute, tertiary care hospitals and in one quarter of medical outpatients.[1] In 2021, dyspnea accounted for 5.92 million emergency department visits in the US.[2] In 2020, the comparable figure was lower (4.86 million); COVID-19 may have contributed to reduced demand for hospital-based emergency services during 2020.[3] [4]
The etiology of dyspnea covers a broad range of pathologies from mild, self-limited processes to life-threatening conditions. Diseases of the cardiovascular, pulmonary, and neuromuscular systems are the most common. Dyspnea may be acute (e.g., acute exacerbation of congestive heart failure, acute pulmonary embolism, acute heart valve insufficiency), subacute (e.g., worsening asthma, exacerbation of chronic obstructive pulmonary disease [COPD]) or chronic (e.g., stable COPD, stable interstitial lung disease).
The evaluation and management of dyspnea is directed by the clinical presentation, findings from the history and physical exam, and preliminary investigation results.[5]
