If you run out of breath more quickly than before during physical activity, there can be many causes — from lack of training to issues with the lungs or cardiovascular system. Gradually increasing shortness of breath on exertion should be assessed by a doctor in a calm setting, as it can usually be investigated well. The time course and the question of what level of exertion triggers the breathlessness are important.
Possible causes
Low fitness or overweight
If regular training is lacking or overweight is present, exertion manifests more quickly as shortness of breath. This form usually improves with gradually built-up physical activity.
Cardiovascular causes
When the heart cannot cope optimally with exertion, this often first shows as shortness of breath when climbing stairs or walking uphill. Such causes are investigated by cardiology.
Pulmonary causes
The airways can also be responsible, for example in asthma or chronic bronchitis. Typical features are cough, wheezing or trigger-dependent symptoms.
Anaemia and other causes
A deficiency in red blood pigment or a thyroid disorder can reduce performance capacity and worsen shortness of breath. Such causes are also investigated through blood tests.
Typical steps at the doctor's office
- 1During the consultation, your doctor will ask how long the breathlessness has been present, what level of exertion triggers it, and whether accompanying symptoms such as cough, heart palpitations or swollen legs are present. The heart and lungs will be examined by auscultation.
- 2Assessment includes a blood pressure measurement, an ECG and blood tests; if needed, a pulmonary function test, cardiac ultrasound or exercise test may be added.
- 3Further management depends on the findings and is determined together with your general practitioner, cardiology or pulmonary medicine.
What you can do yourself
- Build up your endurance gradually — regular brisk walking, cycling or swimming increases your exercise capacity over time.
- Pay attention to smoking cessation: Giving up nicotine significantly relieves both the lungs and cardiovascular system.
- Aim for a healthy weight and eat a balanced diet, so that the cardiovascular system is less challenged during exertion.
- Dose exertion appropriately and ensure sufficient recovery, rather than suddenly overexerting yourself.
Sudden-onset shortness of breath, shortness of breath at rest, or shortness of breath together with chest pain is an emergency: call 144 immediately (see also the Shortness of Breath page). Have shortness of breath that increases with exertion or that has newly appeared medically assessed, especially if it worsens over weeks or limits your daily life. The first point of contact is the family doctor, who will refer you to cardiology or pulmonology if needed.
Frequently asked questions
- When does shortness of breath require investigation?
- If you become out of breath significantly more quickly than before, the symptoms increase over weeks, or you feel limited in your daily activities, a medical assessment is advisable — also to evaluate the heart and lungs.
- What investigations are usual?
- Commonly these include a physical examination with auscultation, blood pressure measurement, an ECG and blood tests. Depending on suspicion, a pulmonary function test, cardiac ultrasound or exercise test may follow.
- Can lack of training alone be the cause?
- Yes, low fitness or overweight are common and well-modifiable reasons. However, because cardiac or pulmonary causes can present similarly, a medical investigation is worthwhile before attributing it solely to lack of training.
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