Shortness of breath or tightness in the chest can be scary. Sometimes it’s mild and fixable at home. Other times it’s an emergency. This page gives clear, practical steps to recognize common causes, calm your breathing, and know when you need urgent care.
Asthma: wheeze, chest tightness, worse with exercise or at night. A rescue inhaler (albuterol) often helps fast. COPD (emphysema or chronic bronchitis): long-term breathlessness that flares with infections or smoke exposure. Infections like bronchitis or pneumonia: cough, fever, and faster breathing. Heart problems (heart failure or heart attack): breathlessness that comes with swollen legs, chest pain, or sudden fatigue. Panic or anxiety attacks: rapid breathing, chest tightness, and a sense of doom but no fever or cough. Allergic reactions: sudden swelling, hives, difficulty breathing—this can progress quickly. Less obvious causes include anemia (low energy and breathlessness on exertion), obesity, and pulmonary embolism (sudden severe shortness of breath, often with sharp chest pain).
If someone is struggling to breathe, sit them upright and help them stay calm. Slow, controlled breathing helps: try pursed-lip breathing — inhale through the nose for two counts, purse lips, exhale slowly for four counts. If you have a prescribed rescue inhaler, use it exactly as shown and wait a few minutes for relief. Loosen tight clothing and get fresh air. If a known allergy is causing symptoms and an epinephrine auto-injector is available, use it immediately.
Know the emergency signs: inability to speak in full sentences, blue or gray lips or face, sudden confusion, fainting, severe chest pain, very fast breathing (over 30 breaths per minute) or very slow breathing (under 8). If any of these appear, call emergency services right away. For milder but persistent symptoms, contact your healthcare provider the same day.
At a clinic or hospital, expect quick checks: oxygen level with a pulse oximeter, lung exam, chest X-ray, spirometry for asthma/COPD, ECG if a heart problem is suspected, and blood tests if infection or pulmonary embolism is a concern. Treatments vary — inhaled bronchodilators and steroids, antibiotics for bacterial infections, oxygen therapy, blood thinners for clots, and guided breathing or pulmonary rehab for chronic conditions.
Prevention tips you can use: keep inhalers up to date, avoid smoke and strong fumes, get flu and pneumonia vaccines if recommended, manage allergies, maintain a healthy weight, and practice a simple breathing routine when calm so you can use it during stress. If anxiety triggers your breathlessness, learning paced breathing and working with a therapist can help.
Breathing problems deserve attention. If it feels different, worse, or comes on fast, act quickly. Trust your instincts — it’s better to get checked and be safe.
