Breathing difficulty, whether sudden or long term, should always be taken seriously. Though many causes are harmless and are easily corrected, and difficulty breathing requires a thorough medical evaluation.

Follow prescribed therapy to treat the underlying cause.

Go to the emergency room or call the local emergency number (such as 911) if difficulty breathing comes on suddenly or seriously interferes with breathing or if someone completely stops breathing.

Call your health care provider if any of the following accompany breathing difficulties:

• There is any unexplained shortness of breath.
• There is any chest discomfort.
• There is shortness of breath after only slight exertion or while at rest.
• You awaken in the night out of breath or have to sleep propped up on several pillows to avoid becoming short of breath.
• You are wheezing (may be an indication of asthma or early emphysema).
• A young child may have inhaled or choked on an object (foreign object aspiration or ingestion).
• There is tightness in the throat or a barking, croupy cough.
• You develop a fever or a significant cough.

• Quality
  • Do you notice shortness of breath?
  • Do you make grunting sounds while breathing?
  • Do you seem to be having to work hard to breathe?
• Time pattern
  • Has it been present for months or years?
  • Did it slowly progress over weeks to months?
  • Did it begin recently?
  • Did it begin suddenly?
  • Did it come on slowly (gradual onset)?
  • Is there a sequence of separate occurrences (episodic)?
    • How long does each last (for how many hours)?
    • Does each repeated episode have a similar pattern (recurrent)?
  • Has the breathing difficulty worsened recently?
  • Does breathing difficulty cause you to awaken at night (paroxysmal nocturnal dyspnea)?
  • Does the amount of breathing difficulty change (variable over hours)?
  • Does breathing difficulty occur at rest?
  • How long does each episode last?
• Aggravating factors
  • Is it worse when lying flat (orthopnea)?
  • Is it worse with a change in body position?
  • Did it develop within 4 to 6 hours after exposure to something that you are or may be allergic to (antigen)?
  • Is it worse after exercise?
  • Does shortness of breath occur only when wheezing?
• Other
  • Is the breathing pattern irregular?
  • Do you draw back the chest muscles with breathing (intercostal retractions)?
  • What other symptoms are also present?

• Blood tests including arterial blood gases
• Measurement of blood oxygen saturation (pulse oximetry)
• ECG
• X-ray of the chest
• Pulmonary function tests
• Exercise testing
• CT scan of the chest
• Echocardiogram

In severe cases of difficulty breathing, hospitalization may be required. Many different medications, aimed at treating the cause of breathing difficulty, may be used in treatment.

In situations where the blood oxygen level is significantly low, supplemental oxygen is helpful. High doses of supplemental oxygen may be hazardous for some patients, however, and is not necessary in all cases of shortness of breath.