Complaints & connections · borters.ch
Dyspnoe
Breathlessness has many harmless reasons — but coming on suddenly it is always an emergency.
Also known as: shortness of breath · breathlessness · dyspnoea
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The feeling of not getting enough air. Some breathlessness on exertion is normal; unusual or increasing shortness of breath often has a treatable cause: asthma or COPD, a respiratory infection, heart weakness, anaemia (too few red cells), excess weight, or also anxiety and panic (often with tingling around the mouth and in the hands). Get help immediately or call emergency services (144) for sudden severe breathlessness, breathlessness with chest pain, bluish lips, or if speaking becomes hard. If breathlessness persists or occurs already with light exertion or when lying down, it should be assessed. More than twenty-five breaths a minute is among the signs of a pneumonia taking a severe course. One mix-up is worth knowing: with narrowed airways it feels as if nothing is getting in, although the obstacle is on the way out — the lung is already hyperinflated and has no room left. With a stiffened lung, by contrast, breathing in really is the hard part. Which direction is limited is shown by lung function testing; how much oxygen crosses into the blood is measured in addition by the diffusing capacity.
With sudden severe breathlessness, chest pain or blue lips, don’t wait.
Lungs (asthma/COPD), heart and anaemia can be checked specifically.
With asthma/COPD or heart failure, the right treatment clearly improves breathing.
With panic, slow exhaling helps — but still have the cause checked.
With sudden breathlessness and a racing pulse, especially after an operation, a cast, a long journey or after childbirth — suspicion alone belongs in the emergency department.
With fever, faster breathing and stabbing on breathing in — and in older people even when only confusion or a fall is noticed.
Breathlessness that arises within minutes is a different thing from breathlessness that grows over weeks — the time course is the main distinguishing feature here. Sudden means heart, pulmonary embolism, asthma attack or pneumothorax; over weeks to months it means heart failure, COPD, anaemia or excess weight. An oxygen reading below ninety-two per cent counts as abnormal, but a normal reading rules nothing out.
A rescue inhaler works within minutes for narrowed airways — for breathlessness from the heart, from anaemia or from anxiety it does not work. So the response itself says something. Water tablets work within hours for fluid in the lungs. Oxygen helps only if the oxygen level really is low; at a normal level it does not ease breathlessness. Low-dose opioids ease the sensation itself — a route of its own when nothing else is possible.
Sudden severe breathlessness, with chest pain or blue lips → call 144.
Points more to asthma or COPD.
Can point to heart weakness.
Points more to anaemia.
Low levels are common in chronic airway illnesses and go along with more infections. Correcting a deficiency is simple; for lung function itself it is no replacement for treatment.
Where blood is lost regularly the store empties long before the haemoglobin falls. Ferritin shows this earlier than the blood count — and refilling takes months, not weeks.
Relaxes the smooth muscle of the airways — which is why it is also given as an infusion in an emergency. For everyday use the tablet replaces no inhaler.
Clearly improves the uptake of plant iron. A glass of orange juice or some pepper with the iron-rich meal does more than the choice of preparation.
Drinking enough keeps the mucus thin and easier to cough up. That is the simplest and most often overlooked lever with sticky sputum.
Anaemia is one of the most common reasons breath runs short at small effort. Replaced by ferritin and haemoglobin, not by feel — 100 mg every second day is absorbed better than daily.
Widens the airways slightly and measurably — the effect lasts 2–4 hours. Too weak for everyday use, but it distorts lung function tests: no coffee for 4 hours beforehand.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
The heart releases this hormone when its walls are stretched. It is the one blood value that can separate breathlessness from the heart from breathlessness from the lung — a low value argues strongly against the cardiac cause.
With anaemia it is not the air that is missing but the carrier for the oxygen. The kidney tries to make up for it with more EPO — with kidney weakness that no longer succeeds, and the two reinforce each other.
Breathlessness on the stairs is often the first sign of anaemia. Ferritin and blood count clarify this in a single blood draw.
With heart or lung weakness a large meal presses up against the lung. Smaller portions and food that causes little gas make breathing after eating easier.
Breathlessness on the stairs is often the first sign of anaemia. Ferritin and blood count clarify this in one blood draw — with sudden breathlessness emergency assessment counts instead.
AWMF 053-013 · S3 · 2025-11 — in force
Akuter und chronischer Husten
checked 2026-09