Dyspnea is the feeling of an uncomfortable need to breathe. Shortness of breath is when the rate of respiration increases in order to meet the increased demand for oxygen by the body. Dyspnea is brought about by an interruption to the normal mechanism of breathing. When there is such an interruption, the distribution of oxygen to the tissues decreases and carbon dioxide starts to accumulate inside the body. This hypoxic and hypercapnic environment stimulates the respiratory center of the brain to increase the rate of respiration so that the required oxygen can be taken in rapidly and the unwanted carbon dioxide can be expelled out of the body without letting the carbon dioxide level to reach the toxic threshold. Thus, shortness of breath can be considered as an extension of the dyspnea. The key difference between dyspnea and shortness of breath is that dyspnea is the uncomfortable need to breathe whereas shortness of breath is increased rate of respiration in order to meet the oxygen demand of the body.
CONTENTS
1. Overview and Key Difference
2. What is Dyspnea
3. What is Shortness of Breath
4. Similarities Between Dyspnea and Shortness of Breath
5. Side by Side Comparison – Dyspnea vs Shortness of Breath in Tabular Form
6. Summary
What is Dyspnea?
Dyspnea is defined as the feeling of an uncomfortable need to breathe. According to the duration, dyspnea can be categorized into two categories as
- Acute severe breathlessness
- Chronic exertional breathlessness
Chronic Exertional Breathlessness
Dyspnea that lasts for long duration is called chronic exertional breathlessness. Features of this condition differ depending on the underlying pathology.
Diagnosis
Therefore several important questions should be asked during the history taking.
- How is your breathing at rest and at night?
In COPD, the breathlessness is minimum at rest but it is exacerbated by exercise. In asthmatics, dyspnea worsens at night resulting in sleep disturbances which the patient promptly complains of. There will be orthopnea if the patient is having a cardiac failure.
- How long can you walk without becoming breathless?
Progressive loss of exercise capacity is a feature of COPD. In asthma, a unique variability of the exercise capacity is seen. On the other hand, if the patient is dyspneic even at rest, then the patient is more likely to be suffering from interstitial fibrosis.
- Were there any respiratory problems during childhood?
Any allergen capable of eliciting an anaphylactic reaction should be identified.
- Are there any other associated symptoms?
Causes
- Chronic asthma
- Chronic heart failure
- Myocardial ischemia
- COPD
- Bronchial carcinoma
- Interstitial lung disease
- Chronic pulmonary thromboembolism
- Large pleural effusion
- Lymphatic carcinomatosis
- Severe anemia
Figure 01: Dyspnea
Acute Severe Breathlessness
This is a medical emergency.
History and Clinical Assessment
During the history taking questions should be asked about the,
- Rate of onset of breathlessness
- Severity
- Presence of associated symptoms such as chest pain
In paediatric patients, always consider the possibility of acute epiglottitis and a foreign body obstructing the airway.
Important features that should be assessed during the clinical assessment are,
- Level of consciousness
- Degree of central cyanosis
- Signs of anaphylaxis such as urticarial
- Patency of the upper airway
- Ability to speak
- Cardiovascular status
What is Shortness of Breath?
Shortness of breath is actually the increased rate of respiration where the inspiration and expiration happen at a rapid pace in order to meet the oxygen demand of the body and to rapidly remove the carbon dioxide that has accumulated in the tissues.
As previously mentioned, shortness of breath can be considered as an extension of the dyspnea. Here the pathological changes inside the body which give rise to breathlessness move one step ahead to cause shortness of breath by stimulating the respiratory center of the brain.
Figure 02: Inspiration and Expiration
Causes
- Asthma
- Pregnancy
- Deconditioning
- Hiatal hernia
- Pneumothorax
- Cardiac failure
- Pulmonary edema
- Sarcoidosis
- Interstitial lung diseases
What are the Similarities Between Dyspnea and Shortness of Breath?
- Dyspnea and shortness of breath share common causes.
- Pathological basis of both conditions is the same.
What is the Difference Between Dyspnea and Shortness of Breath?
Dyspnea vs Shortness of Breath |
|
| Dyspnea is the feeling of an uncomfortable need to breathe. | Shortness of breath is the increased rate of respiration in order to meet the increased demand for oxygen by the body. |
| Type | |
| Dyspnea leads to shortness of breath. | Shortness of breath is an extension of dyspnea. |
Summary – Dyspnea vs Shortness of Breath
From what we have discussed here it is obvious that there is only a subtle difference between dyspnea and shortness of breath. Since most of the causes of them are similar, it is more important to identify the relevant cause than trying to differentiate between the two conditions.
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Reference:
Image Courtesy:
1. “Man Wearing Polo Shirt Holding Left Chest” (CC0) via Pexels
2. “2316 Inspiration and Expiration” By OpenStax College – Anatomy & Physiology, Connexions Web site. Jun 19, 2013. (CC BY 3.0) via Commons Wikimedia