Dyspnea On Exertion: Definition, Causes, Treatment, And More

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What to know about dyspnea on exertion

Medically reviewed by Raj Dasgupta, MD — Written by Jennifer Huizen — Updated on September 18, 2023

Definition
Cause for concern?
Why it happens
Underlying conditions
Contacting a doctor
Summary

Dyspnea, or shortness of breath, that occurs during exertion has several possible causes. The sensation is not typically a cause for concern, but a person should seek medical help in certain cases.

Depending on the cause, dyspnea can occur alongside other symptoms, such as a tight chest and anxiety.

Read on to learn more about dyspnea on exertion, including the possible causes and when to see a doctor.

What is it?

Person bending over with shortness of breath. — Kathrin Ziegler/Getty Images

Dyspnea on exertion means that a person feels short of breath during exercise.

It can cause someone to feel as though they are running out of air and cannot breathe fast or deep enough while exercising or exerting physical effort.

Dyspnea on exertion can also cause:

uncomfortable or difficult breathing
chest tightness
a sensation of suffocating or gasping or gulping for air
anxiety and fear

Millions of people experience dyspnea of varying intensities and durations. When dyspnea occurs during exertion, it typically improves upon rest. As dyspnea is a sensation, each person may experience it differently.

While some people only experience dyspnea during intense exercise or exertion, others may develop it from simple activities, such as:

walking
going up steps
sitting still
jogging

Is it a cause for concern?

Dyspnea on exertion is a common, often harmless condition that usually gets better when a person rests.

However, if a person experiences dyspnea that comes on suddenly for no apparent reason or is very intense, they may require medical care.

Dyspnea can also be a sign of underlying conditions, some of which require intensive medical treatment.

Why does it happen?

According to a 2020 article, the sensation of dyspnea upon exertion occurs due to signal interactions between the:

central nervous system (CNS)
peripheral chemoreceptors
mechanoreceptors in the chest wall and respiratory tract

The medulla, a structure in the brain stem at the top of the spinal cord, primarily controls breathing. It senses changes in blood acidity using chemoreceptors that detect carbon dioxide (CO2) levels.

High CO2 levels make the blood more acidic. This lower pH causes the medulla to trigger hyperventilation, which is a rapid increase in breathing where the body exhales more air than it inhales. This action helps the body regain balance by reducing excess CO2.

On the other hand, when CO2 levels are too low, the medulla reduces respiration rates to help increase them. Three nerve groups in the medulla control different aspects of breathing.

Mechanoreceptors in a person’s airways, trachea, lungs, lung vessels, and chest wall detect how much these structures expand and contract with breathing. They communicate with the medulla, telling it how much space is available to fill with air.

The brain coordinates breathing rate and volume by sending signals to the respiratory muscles of the diaphragm and chest, as well as the muscles surrounding the lungs. It tells them how much and how quickly to expand and contract.

What underlying conditions cause it?

Some people may experience breathlessness or shortness of breath during exercise because they are not accustomed to that much exercise. Alternatively, they may be exercising in conditions that can affect breathlessness, such as higher altitudes or warmer climates.

However, a wide range of respiratory, cardiac, and systemic conditions can also cause or trigger dyspnea on exertion. These can interfere with the rate, volume, or general regulation of breathing.

The following conditions may cause dyspnea on exertion.

Respiratory conditions

Respiratory conditions are a common cause of dyspnea on exertion. Common respiratory causes include:

asthma
aspirated (inhaled) objects
acute exacerbation of chronic obstructive pulmonary disease (COPD)
pneumonia
lung cancer or injury
pulmonary embolism
pulmonary edema
pneumothorax, or a collapsed lung
croup
tuberculosis
pleurisy
sarcoidosis or other abnormal growths
hiatal hernia

Healthcare professionals will treat each case of dyspnea on exertion differently depending on its cause.

Common treatment options for respiratory causes include:

inhalers, such as antimuscarinics, corticosteroids, and short- or long-acting bronchodilator inhalers
supplemental oxygen therapy
chemotherapy or radiation therapy
surgery to remove cancerous lung sections, tumors, or abnormal growths
surgery to repair a collapsed lung, a hiatal hernia, pleurisy, pneumothorax, or a pulmonary embolism
antibiotics
rest and fluid therapy
emergency procedures to remove inhaled objects
thoracentesis, a procedure to remove excess fluid from the lungs

Cardiovascular conditions

As the cardiovascular system plays a role in respiration, several cardiac conditions are associated with dyspnea on exertion. These include:

acute coronary syndrome
congestive heart failure
cardiac arrhythmia
pericardial tamponade
intracardiac shunting
valvular heart defect
pulmonary hypertension
hypotension

Common treatment options for cardiovascular causes of dyspnea on exertion include:

aspirin
statins
beta-blockers
angiotensin converting enzyme (ACE) inhibitors
nitrates
heparin
diuretic medications
surgery to place shunts, correct defects, or repair damage
angioplasty
implantable cardioverter defibrillator (ICD) or left ventricular assist device (LVAD)
pacemakers

Systemic conditions

Researchers have also linked several systemic conditions, which are those that affect the whole body, to dyspnea on exertion.

Common examples include:

anemia
angioedema
acute renal failure
anaphylaxis
liver cirrhosis
metabolic acidosis
sepsis
thyrotoxicosis
epiglottitis
obesity

Treatments that target systemic causes of dyspnea on exertion include:

antihistamines
dialysis
intravenous antibiotics
medications and treatment to control vitamin, mineral, and fluid levels
epinephrine auto-injectors, such as EpiPen
diuretics
medications to lower blood pressure
radioactive iodine, beta-blockers, or carbimazole
surgery to remove part of the thyroid

A doctor may also recommend making changes to everyday habits, such as:

taking iron, vitamin B12, folic acid, and vitamin C supplements
reaching or maintaining a moderate body weight
avoiding or limiting alcohol intake
managing diabetes or metabolic syndrome properly, for those with these conditions
eating a healthful, balanced diet, including dietary sources of iron, such as dark leafy greens, beans and pulses, dried fruits, and fortified products

Chemical and environmental irritants

Chemical and environmental irritants can also cause dyspnea if a person has exposure to them or inhales them during exercise or exertion.

Examples of these irritants include:

air pollution
chemical fumes
dust
smoke
tobacco smoke
pollen
mold spores

The treatment for dyspnea on exertion that occurs due to chemical or environmental irritants depends on the specific cause, but common options include:

stopping smoking or avoiding exposure to tobacco smoke
wearing protective covering and breathing devices when exposed to chemical fumes
avoiding going outside or to places where pollution, dust, pollen, or smoke levels are high
spending as little time outside as possible when mold spores are in the air at high levels, which is often in summer or fall in the United States

When to contact a doctor

People should speak with a doctor if they experience frequent dyspnea that does not seem to be due to being unused to exercise, exercising too intensely, or exercising under challenging environmental conditions.

They should also talk with a doctor if dyspnea during exercise is severe or disabling or develops suddenly without a clear cause.

People who may be experiencing an asthma attack or an attack of another respiratory or cardiac condition, such as COPD, should seek emergency care.

A person should also seek emergency care if the following symptoms accompany dyspnea upon exertion:

nausea
loss of consciousness or unexplained sleepiness
chest pressure or chest pain
high fever or chills
irregular heartbeat
severe or worsening cough with or without mucus
bluish or discolored skin, starting at the lips and fingertips
increased urinary frequency at night
swelling in the abdomen, legs, ankles, or feet
unexplained exhaustion
coughing up blood
swelling of the tongue, lips, mouth, or throat
swelling with a rash
bruising more easily than usual
pale or yellowish skin
dizziness
cold hands and feet
confusion
unexplained weakness
chronic lack of appetite
unexplained weight loss
unexplained itchy skin
reduced urination
irregular menstruation
severe sore throat and trouble swallowing
abnormal, high pitched breathing sounds

Summary

Many people experience the sensation of breathlessness or restricted breathing while they are exercising. It is often harmless and goes away with rest.

However, for some people, dyspnea during exertion is a sign of an underlying respiratory, cardiac, or systemic condition, many of which require medical attention or emergency care.

It is important to consult a doctor when dyspnea during exertion is unexplained, sudden, severe, or disabling, or if one of the more serious symptoms listed above accompanies it.

Asthma
Lung Cancer
Respiratory
Tuberculosis
Sports Medicine / Fitness

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Acquired angiodema. (2018).https://rarediseases.info.nih.gov/diseases/8605/acquired-angioedema
Acute coronary syndrome. (2015).https://www.heart.org/en/health-topics/heart-attack/about-heart-attacks/acute-coronary-syndrome
Anemia. (n.d.).https://www.hematology.org/education/patients/anemia
Asthma symptoms. (2018).https://acaai.org/asthma/asthma-symptoms
Chronic obstructive pulmonary disease (COPD). (2019).https://www.lung.ca/lung-health/lung-disease/copd/symptoms
Cirrhosis. (n.d.).https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis
Early detection, diagnosis, and staging. (n.d.).https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging.html
Epiglottitis. (2018).https://www.nhs.uk/conditions/epiglottitis/
Heart failure. (n.d.).https://www.heart.org/en/health-topics/heart-failure
High blood pressure. (n.d.).https://www.heart.org/en/health-topics/high-blood-pressure
Hives (urticaria) and angiodema overview. (2020).https://www.aaaai.org/conditions-and-treatments/library/allergy-library/hives-angioedema
Iordanova, R., et al. (2020). Neuroanatomy, medulla oblongata.https://www.ncbi.nlm.nih.gov/books/NBK551589/
Iqbal, M. A., et al. (2020). Cardiogenic pulmonary edema.https://www.ncbi.nlm.nih.gov/books/NBK544260/
Kidney failure. (n.d.).https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure
McKnight, C. L., et al. (2020). Pneumothorax.https://www.ncbi.nlm.nih.gov/books/NBK441885/
Outdoor allergens. (2020).https://www.aaaai.org/conditions-and-treatments/library/allergy-library/outdoor-allergens
Pneumonia. (n.d.).https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia
Sharma, S., et al. (2020). Dyspnea on exertion.https://www.ncbi.nlm.nih.gov/books/NBK499847/
Wahls, S. A. (2012). Causes and evaluation of chronic dyspnea.https://www.aafp.org/afp/2012/0715/p173.html

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Medically reviewed by Raj Dasgupta, MD — Written by Jennifer Huizen — Updated on September 18, 2023

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