Common and uncommon causes of long-term shortness of breath

Difficulty in breathing can have many different reasons

When someone experience shortness of breath (SOB) for the first time or as a sudden occurrence, it can definitely be a frightening experience. However, when the shortness of breath is a common occurrence, at regular intervals, people tend to consider it a daily nuisance. You or one of your loved ones may be experiencing a similar problem and you may wonder, what exactly is causing this shortness of breath?

I have come across many patients who are suffering from SOB for most part of their lives and at times, they have not even considered that it may indeed be a medical issue. For instance, the SOB that results from a gradual depletion of red blood cells in the circulation, which is commonly known as ‘anemia’, might not even get noticed until late. 


The reason is that the body adjusts its systems in order to mask the stressful signs and symptoms of the lowering red blood cells. However, when a person loose lot of blood at a rapid rate, the development of SOB may be dramatic and noticeable. Another example is a gradual depletion in the heart’s pumping capacity as in the case of a ‘heart failure’. If the heart failure takes many months or even years to worsen, the SOB that may result can be ever so slight and be unremarkable. However, there is a point where the symptoms become worse and in some instances, this may be too late to do anything to prevent its progression.

While there are other causes of SOB that might manifest in a clandestine manner, it may not be the case with most patients. However, both anemia and heart failure can last for a longer duration and therefore the SOB as well. 

Some of the other common causes of long-lasting shortness of breath include obesity, lung problems such as chronic obstructive pulmonary disorder (COPD) and asthma. Among them, asthma is probably the commonest cause for long-term SOB although it can be revered and sometimes controlled through appropriate use of medications. COPD is a condition commonly associated with people who have been heavy smokers although many other people also suffer from this disorder due to many different and sometimes unknown reasons. 

Changes in the hearts rhythm and rate can also lead to SOB which can become a part of life for most patients. Conditions known as atrial fibrillation and supraventricular tachycardia are two such disorders that need medical attention to avoid any complications.

When it comes to less common causes of shortness of breath, airway widening disease known as ‘bronchiectasis’ and blockage of a blood vessel supplying to the lungs known as ‘pulmonary embolism’ can be highlighted. However, lung cancer can also cause SOB and may invariably become fatal if not detected early. Accumulation of fluids in the space between the lung and the body wall can also lead to a compromised lung and at times, a blockage in the main artery supplying the body can also lead to a long-lasting SOB.

In addition, I have seen few people who suffer from SOB for lengthier periods as a result of panic attacks although in most instances, the panic attacks can be resolved in variety of ways.