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I'm not sure if this is the right site to ask this, but it seemed like the best option.
I've observed on myself that, if I stand on a train platform and a cargo train drives by, creating strong, short gusts of wind, it becomes harder to breathe for me during the gusts, almost like fighting my body into breathing.
A commenton parenting.se leads me to believe this is due to the mammalian diving reflex.
1) is this assumption correct? 2) what causes the change in breathing?
So I'm going to go ahead and tell you outright that it is not the diving reflex.
What you are experiencing is the effect of air pressure.
Our lungs work off of pressure. Specifically our lungs inflate by using "negative pressure" (a word I've always hated). The pressure is not actually negative it is simply lower than the surroundings. Since there is less air in your lungs the air from the atmosphere rushes in because the pressure is higher outside your lungs. This is Boyle's Law (not the pressure outside being higher, but what happens when your lungs expand). Where an increase in Volume means a decrease in Pressure (if all else remains unchanged). In fact plants pull water up using negative pressure.
However to push out the air from our lungs we supply pressure using our muscles that overcomes the outside pressure and forces the air out.
The reason you feel your breathing change is because when that train passes by you correctly observed the strong gust of wind. This gust of wind has some force behind it that normally is not in the air you are breathing from the atmosphere. It has more force which increases the air's velocity. This actually decreases the pressure, but there's no need to get into that here (Bernoulli's).
The reason it feels like your body is "fighting to breath" is because the air is traveling in a direction with some force that you need to overcome by opening up your lungs just enough to "suck" the air in with negative pressure. This is more than the pressure you usually need to produce in order to breath in air that is "still".
What is funny to think about is we don't really have a muscle that "pulls" air in, even though it feels like you are actively doing that. The air actually rushes in on its own. All you do is expand your rib cage, which your lungs are attached to (look up on how, it's actually pretty cool), thereby making inhalation occur.
Now an interesting question for you to ask yourself is why is cold air harder to breathe?
Heavy Breathing: Common Causes and Treatments
Disclaimer: Results are not guaranteed*** and may vary from person to person***.
Sometimes you might find that you are breathing more than normal—but what causes heavy breathing? Although certain situations, such as having performed physical activity (i.e. jogging or jumping jacks) can cause temporary labored breathing, this is normal and expected.
It is when you become out of breath despite having not engaged in stimulating activities that can indicate a problem.
Heavy breathing during periods of inactivity suggests that you’re not getting enough oxygen, which could be caused by a number of conditions.
A stuffed nose or sinus infection from a cold, flu, or allergies could be the culprit, or it could be something more serious like chronic obstructive pulmonary disorder (COPD), pneumonia, or even a heart attack.
What does shortness of breath feel like, exactly?
There is actually a medical term for shortness of breath: dyspnea. It&rsquos usually described as an intense tightening in your chest, feeling like you&rsquore &ldquohungry&rdquo for air, having difficulty breathing, or feeling breathless, the American Lung Association (ALA) says. &ldquoIt feels like you&rsquore not getting enough air,&rdquo says David Cutler, M.D., a family medicine physician at Providence Saint John&rsquos Health Center in Santa Monica, Calif.
People can experience shortness of breath when they walk, climb stairs, run, or even when they stand still, the ALA says. &ldquoYou can experience it sometimes, all the time, and it can be off and on,&rdquo Dr. Cutler says.
How Cold Weather Can Spell Trouble for Your Heart and Lungs
We know to guard our skin against frostbite by covering up when we go outside in sub-freezing temperatures.
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But extreme cold also can impact vital organs, such as the heart and lungs. For example, cold can make your heart beat faster, which makes your blood pressure go up, says interventional cardiologist Leslie Cho, MD.
“It’s really how the body reacts to the cold,” Dr. Cho says. “The body’s first reaction is to try to keep warm. So blood vessels constrict to keep in the heat. The heart also beats faster, which can increase blood pressure. All of that can have an impact on the heart.”
Hypothermia and the heart
A severe wind chill only makes things harder on your heart because the wind can steal even more body heat, which could lead to hypothermia, Dr. Cho says.
Hypothermia is when your body’s core temperature falls to lower than 95 degrees. It occurs when your body can’t produce enough energy to keep the internal body temperature warm enough. Symptoms include lack of coordination, mental confusion, slowed reactions, shivering and sleepiness.
For people with underlying heart disease, the extra work your body has to do to stay warm could cause chest pain and possibly even a heart attack, Dr. Cho says.
If this is you, be sure to discuss exercise guidelines with your physician, especially strenuous activity, she adds.
But even experienced winter sports enthusiasts who don’t take certain precautions can suffer accidental hypothermia. Heart failure is the cause of most hypothermia-related deaths, according to the American Heart Association.
Your heart is under even greater stress when you combine cold weather with a vigorous activity like shoveling snow or walking through heavy, wet snow or snow drifts. Take frequent rest breaks during shoveling so you don’t overstress your heart.
You should treat this type of strenuous work as you would vigorous exercise.
So it’s important to stay well hydrated by drinking fluids and to dress warmly, she says.
Cold air and your lungs
Cold air also can impact your breathing – especially if you have a lung disease like asthma or chronic obstructive pulmonary disease (COPD).
For people with COPD, cold air can trigger spasms in the lung, creating symptoms similar to an asthma attack, says pulmonologist Rachel Taliercio, DO.
“You might be more breathless, or feel out of breath, you might cough or start to wheeze. You also may feel a bit of tightness in the chest,” Dr. Taliercio says. “All of these can be signs that you should get indoors.”
Both doctors agree it’s important to dress warmly when the mercury drops and that layers are a good way to insulate your body. The layers trap warm air next to your body.
It’s also a good idea to wear a hat so heat doesn’t escape through your head. Cover your nose and mouth with a scarf so the air is warm before it enters your lungs.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Causes of tight chest and restricted breathing
The main organs of the cardiovascular and respiratory system lie next to each other in the chest cavity and are closely linked in terms of functioning. Blood low in oxygen returns to the right side of the heart and is then routed to the lungs. Here it is re-oxygenated and the blood returns to the left side of the heart. It is then pumped out to the rest of the body. It is these actions of the heart and lungs that are essential for life. Failure of one of these systems will ultimately lead to death. It is, however, difficult to isolate symptoms like a tight chest and restricted breathing to a specific condition solely based on these two symptoms.
A tight chest sensation and restricted breathing is present in all of these conditions. Additional symptoms are discussed with each disease.
- Heart attack or myocardial infarction is death of a portion of the heart muscle due to an interruption of its blood supply via the coronary arteries. Other symptoms include :
– Chest pain that radiates to the neck or jaw, down the arms especially the left arm, to the back of upper middle abdominal region.
– Excessive sweating
– Nausea and sometimes vomiting
- Angina pectoris is a constricting chest pain associated with physical activity and eased with rest and nitrates. It is a symptoms of coronary artery disease and many of the other symptoms of a heart attack may be present except for fainting. Angina pectoris can exist for months or years prior to a heart attack.
- Pericarditis is inflammation of the lining that forms a sac around the heart. Other symptoms include :
– Chest pain
– Persistent dry cough
– Swelling in the abdomen and legs
– Pericardial friction rub
- Arrhythmia is a disruption of normal heart rate and rhythm often associated with a problem of the heart’s electrical conduction system. Most arrhythmias are asymptomatic. Other symptoms when present includes :
– Chest pain
– Fluttering in chest
– Abnormal heart rate
- Heart valve disease is a problem with the valves between the heart chambers or between the heart and great blood vessels that prevents backward flow of blood when the heart contracts and relaxes. Other symptoms that may be present depending on the type of heart valve disease includes :
– Chest pain
– Rapid breathing
- Pulmonary embolism where a blood clot, usually from the leg veins, causes a blockage of the arteries of the lungs. It is a life-threatening condition. Other symptoms includes :
– Cold clammy skin
– Excessive sweating
- Aortic dissection is where a tear forms in the inner wall of the major blood vessel from the heart known as the aorta. It is more commonly seen in the elderly. Other symptoms includes :
– Excessive sweating
– One-sided paralysis
– Difficulty speaking
– Loss of vision
Other symptoms are discussed with each disease where tightness of the chest and restricted breathing are present.
According to the National Center for Complementary and Integrative Health, "12.7 percent of American adults [have] used deep-breathing exercises. for health purposes,"  which it describes as follows, "Deep breathing involves slow and deep inhalation through the nose, usually to a count of 10, followed by slow and complete exhalation for a similar count. The process may be repeated 5 to 10 times, several times a day." 
According to the University of Texas Counseling and Mental Health Center, "Diaphragmatic breathing allows one to take normal breaths while maximizing the amount of oxygen that goes into the bloodstream. It is a way of interrupting the 'Fight or Flight' response and triggering the body's normal relaxation response."  They provide a video demonstration. 
Diaphragmatic breathing has a physiological effect on the body by assisting in blood flow, lowering pulse rate and blood pressure "by improving vagal activity and reducing the sympathetic reaction." 
Some practitioners of complementary and alternative medicine believe that particular kinds of breathing they identify as diaphragm breathing can be used to bring about health benefits. 
Deep breathing exercises are sometimes used as a form of relaxation, that, when practiced regularly, may lead to the relief or prevention of symptoms commonly associated with stress, which may include high blood pressure, headaches, stomach conditions, depression, anxiety, and others. 
Due to the lung expansion being lower (inferior) on the body as opposed to higher up (superior), it is referred to as 'deep' and the higher lung expansion of rib cage breathing is referred to as 'shallow'. The actual volume of air taken into the lungs with either means varies.
Hatha Yoga, tai chi and meditation traditions draw a clear distinction between diaphragmatic breathing and abdominal breathing or belly breathing.  The more specific technique of diaphragmatic breathing is said to be more beneficial. 
This deep breathing technique has an effect on the physiology of stress, a process that can be detrimental to a "person's physical and/or mental health". Stress can increase the secretion of cortisol which leads to a domino effect of increasing respiratory rate, heart rate and systolic blood pressure. Diaphragmatic breathing helps decrease the cortisol levels through its technique of expanding the lungs into the diaphragm in order to decrease respiratory rate by developing a pattern of inhalation and exhalation. According to WHO, there is an increasing cost of psychosocial counselling and medication to aid in the treatment of stress but researchers have found that diaphragmatic breathing could provide a cost-efficient and accessible way of helping those combat high stress. 
There is also evidence that diaphragmatic breathing has an effect in managing and reducing symptoms of irritable bowel syndrome (IBS), a chronic condition with symptoms of "abdominal cramping, discomfort or pain, bloating, loose or frequent stools and constipation, and can significantly reduce the quality of life." This breathing technique helps increase a balance in the sympathetic and parasympathetic systems. A case study on a patient with IBS has shown that it helps relieve discomfort of the bowel through the increasing blood flow that enters the abdomen thus warming it to relax the body and relieve pain in the stomach. 
The use of diaphragmatic breathing is commonly practiced, especially in those patients with chronic obstructive pulmonary disease, to improve a variety of factors such as pulmonary function,  cardiorespiratory fitness,  respiratory muscle length,  and respiratory muscle strength.  Specifically, diaphragmatic breathing exercise is essential to asthmatics since breathing in these patients is of the thoracic type in association with decreased chest expansion and chest deformity [ clarification needed ] as a result of a deformed sternum like pectus excavatum (funnel chest) a shortened diaphragm, intercostals and accessory muscles from prolonged spasm causing stenosis of the major airways leading to an abnormal respiratory pattern. 
Diaphragmatic breathing is also widely considered essential for best possible singing performance.  Diaphragmatic breathing also allows wind instrumentalists to maximise intake of air, minimising the number of breaths required for progressing players.
You May Be Strong . . . But Are You Tough?
With our archives now 3,500+ articles deep, we’ve decided to republish a classic piece each Sunday to help our newer readers discover some of the best, evergreen gems from the past. This article was originally published in October 2013.
Editor’s Note: This is a guest post written by Khaled Allen.
As a little boy, I was scrawny, weak, and prone to illness (much like a certain former president). For a long time, I thought I was just doomed to be pathetic, until my dad took me canoeing. In the mucky, hot, poorly maintained trails and portages of the Boundary Waters in the north woods of Minnesota, I learned that I could be tough, scrappy, and indomitable. I took a brutal pleasure in carrying the heaviest pack I could over long and steep portages, willing my toothpick legs to take one step, then another, then another, until I saw the blue expanse of the next lake peeking through the trees. That was all I had to work with: a willingness to push myself harder than anyone else, to charge headlong into the roughest terrain, and to ignore cold, rain, heat, bugs, and my own internal discomfort.
With the popularity of high-intensity workout programs, military-inspired training, and brutal adventure races, mental toughness is in the spotlight. The gold standard of a hardcore athlete is how much pain they can tolerate. But what about simple, plain old ruggedness? What does it mean to be physically tough, as well as mentally tough? Is it enough to simply be strong, or is there something more to it?
Strong But Weak
I will always remember the day I dropped in on a CrossFit class and went out for the warm-up jog with no shoes on. One of the other guys there, massively strong and musclebound, was shocked and asked me if it hurt or if I was scared of broken glass. I explained that I’d toughened up my feet over the last few years and it didn’t bother me at all. If I was caught shoeless in an emergency, the few seconds I needed to put on shoes could make the difference between life and death. It didn’t matter how fast I could sprint if my feet were too tender to handle the asphalt.
I see that reaction all the time: big guys with lots of muscles who wince as soon as the shoes come off or who insist on wearing gloves whenever they lift weights. They are immensely strong within their particular domain, but have very strict limits on their comfort zone. As soon as they are forced out of it, their performance drops drastically.
Men in particular often confuse toughness with strength, thinking that being strong is automatically the same as being tough, when in fact the two are distinct qualities. As Erwan Le Corre, founder of MovNat, says, “Some people with great muscular strength may lack toughness and easily crumble when circumstances become too challenging. On the other hand, some people with no particularly great muscular strength may be very tough, i.e., capable of overcoming stressful, difficult situations or environments.”
Toughness is the ability to perform well regardless of circumstances. That might mean performing well when you are sick or injured, but it also might mean performing well when your workout gear includes trees and rocks instead of pull-up bars and barbells. “Toughness . . . is the strength, or ability, to withstand adverse conditions,” according to Le Corre.
Being able to do that requires both mental and physical toughness. No amount of mental toughness alone will keep you from freezing in cold temperatures, but if you’ve combined mental training with cold tolerance conditioning, for example, then you’ll fare much better.
Toughness Is a Skill
It is a myth that you’re either born tough or you’re not. The truth is, toughness, both mental and physical, can and should be trained and cultivated, just like any other skill. There are certain mental techniques that help you cultivate an indomitable will, patience, and the ability to stay positive and focused no matter how bad things look. There are also certain training techniques you can use to condition your body to withstand discomfort and tolerate environments that would normally cause injury.
Mental toughness boils down to how you respond to stress. Do you start to panic and lose control, or do you zero in on how you are going to overcome the difficulty?
Rachel Cosgrove, co-owner of Results Fitness and a regular contributor to Men’s Fitness, stated in an article on mental toughness, “World-class endurance athletes respond to the stress of a race with a reduction in brain-wave activity that’s similar to meditation. The average person responds to race stress with an increase in brain-wave activity that borders on panic.”
Similarly, the biggest determining factor in whether or not a candidate for the Navy SEALs passes training is his ability to stay cool under stress and avoid falling into that fight-or-flight response most of us drop into when we’re being shot at. Developing ways to counteract the negative response to stress helps us stay in control of our bodies so that we can maintain the high performance needed to do well in any situation. That is real mental toughness.
Another way to look at mental toughness is willpower. When everyone else has decided they are too tired, you decide to keep going. In sports, this is called the second wind, when an athlete determines that they don’t care about their fatigue and decides to push harder despite it. When a football team is behind two touchdowns but picks up the effort anyway, determined to win despite all signs to the contrary, that’s an example of willpower in action. They may still lose, but they are much more likely to make a comeback with this approach.
So, how can you cultivate mental toughness?
One of the best ways to develop mental toughness is to accept small discomforts on a regular basis. Take only cold showers or occasionally fast. In the book Willpower, Dr. Roy Baumeister recounts the training regimen of famed endurance artist David Blaine. Before doing his stunts — some of which have included being encased in ice for over 63 hours, being suspended over the Thames in a clear plastic box for 44 days, and holding his breath for 17 minutes on live TV — Blaine will start to make up little inconvenient routines for himself simply to strengthen his willpower. These are usually small things, like touching every overhanging tree branch on his walk to work, but they get his mind in the habit of making extra effort even when he doesn’t feel like it, exercising will, and doing things when it would be inconvenient or uncomfortable.
Examples of this include sticking to an inconvenient diet, living without a car, or shaving with a straight razor.
There’s a lot to be said for simple acclimatization to discomfort as well. The little nicks and bruises you get from training in wild environments can be hugely distracting when you’re just getting started, but if you keep heading back out, you eventually find them little more than useful feedback on positioning and technique.
Most of us have an internal monologue going on in our heads, telling our own story. How this sounds depends on our view of ourselves and external stimuli. If you’ve always been good at schoolwork, you might envision yourself as “smart,” but maybe not “strong” or “charming.”
The thing is, these definitions are mostly arbitrary. Anyone who works hard enough at academics can do well in school, and anyone who trains hard enough can do well in sports. Whether or not we are willing and able to push ourselves hard enough to do well often depends on that internal story.
So, the simple solution is to only accept positive self-talk. This is a common tactic of the super-successful, and is standard fare in such personal development classics as Dale Carnegie’s How to Win Friends and Influence People, Napoleon Hill’s Think and Grow Rich, and Stephen R. Covey’s The 7 Habits of Highly Effective People.
Have a Reason
One of the most powerful motivators in training and life is knowing why you cannot fail. Jack Yee, who writes specifically about mental toughness and has been featured on T-Nation and Mark’s Daily Apple, remembers his time at the famous Gold’s Gym in Venice Beach, where he saw not only old school greats like Tom Platz, Lou Ferrigno, and Arnold Schwarzenegger, but also a large number of promising amateurs, many of whom had more impressive physiques. However, they rarely lasted long: after one defeat at a competition, they would give up. One discouraging setback was enough to shatter their confidence.
The antidote is to remind yourself why you’re out there in the first place. A common trick I used to use in my running when I was feeling defeated was to imagine that my girlfriend was being threatened by kidnappers and if I didn’t get to her in time, they would kill her. Since my motivation for exercising was to be useful to those I cared about, this worked for me. No matter how beat up I felt, I would always run faster.
Mental Toughness Training Summary
- Allow (or seek out) small inconveniences and discomforts in your everyday life. Learn to tolerate them.
- Start to judge your internal monologue, rather than simply accepting it for what it is. Actually listen to what you’re saying and decide if it’s a belief you want to let into your life.
- When you’re feeling tired and talking yourself out of your workout, remind yourself why you’re training. Weigh the importance of the inconvenience against the importance of the why and get out there.
Compared to mental toughness, there is considerably less talk about physical toughness out there, probably because it is wrapped up into strength and conditioning. But the truth is, being physically tough is very different from being strong, fast, or powerful. Physical toughness includes the ability to take abuse and keep functioning, to recover quickly, to adapt to difficult terrain and contexts, and to tolerate adverse conditions without flagging.
Le Corre’s method of training, MovNat, emphasizes the value of developing a tough body by training in environments that do not accommodate the trainee. Training outdoors, in adverse (or simply not climate-controlled) conditions, is a core tenet of MovNat’s methods. Le Corre says of physical toughness, “[it] is the ability of the body to withstand hardship, such as food or sleep deprivation, harsh weather conditions such as cold, heat, rain, snow or humidity, and difficult terrains (steep, rocky, slippery, radiating heat, dense vegetation etc.).”
Physical toughness boils down to the changes your body makes to make it more resilient. This has the effect of unloading your willpower so that you can push yourself harder mentally, since your threshold has effectively increased.
A very simple example of physical toughness — and one that is used as a euphemism for toughness in general — is thick skin. Men who train hard in gyms rarely develop calluses beyond those along the base of the fingers that are the result of the bar pinching the grip. Men who train with tough objects, like stones, logs, or in nature tend to develop thick skin all over their fingers and palms. The same goes for the feet. Accompanying this change is an alteration in the sensitivity of the pain receptors in those areas. As you become accustomed to walking barefoot, what used to be painful becomes a comfortable massage.
Exposure to the elements is the best way to develop this very real form of physical toughness. Train barefoot with minimal clothing, with rough implements. Start with shorter durations and forgiving surfaces so you don’t get to the point of actual injury, and increase the time and ruggedness of the environment. You will learn to tell the difference between discomfort and real pain. You’ll also learn how to be gentle when dealing with rock and dirt, but you’ll get tougher as well.
An oft-overlooked form of toughness combines mobility, flexibility, and durability. Hard training puts a lot of stress on the body, but this stress is multiplied when every movement stretches a muscle close to its full range or pushes a joint near its limit. Flexible joints can move farther without incurring stress on their support structures, reducing fatigue and the wear and tear that adds up to leave you sore and whimpering on the ground.
To that end, give mobility training serious consideration in your workout routine. Not only will it save you pain, it will allow you to absorb more punishment and do more reps without feeling the effects, which makes you that much harder to bring down.
Hormonal and Adrenal Changes
Another example of physical toughness is harder to see. It consists of the metabolic and hormonal changes that go along with hard training. These can manifest in better energy management, so that you fatigue more slowly, and recover quicker, so that you can come back hard with surprisingly little time to recuperate. When most people would be down for the count, you’re back in the ring, having already caught your breath and cooled off.
The simplest way to train this kind of toughness is by limiting your rest between workouts or exercises, sometimes even at the expense of your performance. Be careful, however: there is a fine line between stimulating adaptation and overtraining, so remember that you need to give your body time and resources to build itself up stronger than before. Eat well and sufficiently, and get enough sleep. These habits will build up a store of resources you can lean on when rest isn’t so easily available. Occasionally, apply an acute stress, like intermittent fasting, to teach your body to adapt quickly and be efficient with energy, or train with little sleep. But in general, you’ll be able to handle more if you’re well-rested and well-fed.
Another interesting technique I’ve recently been using to improve my cardiorespiratory durability is nasal breathing. This involves restricting myself to only breathing through my nostrils, even during hard workouts. The result is more efficient oxygen usage. This technique causes me to regulate my pacing somewhat, but I’ve noticed that I don’t get out of breath nearly as quickly, even when I switch to regular breathing for a particular workout.
A relatively rare form of physical toughness is environmental tolerance. The most well-known variety is altitude acclimatization, in which athletes train at elevation and compete at sea level. This is normally seen as a way to gain an advantage in sports, but adaptation to low oxygen is also an example of physical durability, the ability to handle a difficult environment.
Another example is cold tolerance. The body will literally increase its ability to generate heat if you habitually go without excessive clothing and expose yourself to acute cold shocks. Even in the winter, it is possible to train with only a t-shirt and shorts. You’ll learn to distinguish between the superficial sensation of cold on your skin and the deep chill that threatens hypothermia. The first gives you feedback about your environment while the second is an indicator of potential danger.
In addition to training with less clothing, I also only take cold showers, which has also improved my ability to tolerate a wider range of temperatures without feeling real discomfort. Of course, both of these are pretty uncomfortable at first, but over time, they become less so, and you will find yourself becoming noticeably more hardy in general.
Physical Toughness Training Summary
- Expose yourself to rough environments and forgo the usual protection, increasing the intensity of exposure slowly over time.
- Learn and implement mobility and self-maintenance exercises into your regular training routine.
- Train with less rest between sets or workouts, but take excellent care of yourself in the meantime.
- Train outside in all weather with as little protection as you can tolerate.
My favorite way to develop pure toughness, both physical and mental — what I call ruggedness — is through outdoor training with minimal protection. Inspired by Erwan Le Corre and the MovNat method of training to approach exercise the same way I approached camping as a kid, I frequently train in a wild environment with nothing on but a pair of shorts, climbing trees, hoisting and throwing rocks, scrambling up and over boulders, and running over gravel-covered trails.
The constantly shifting terrain and objects challenge my body, but they also challenge my patience and focus. When a relatively small rock becomes nearly impossible because of its shape, it is frustrating. When I’m trying to sprint up a hill but keep slipping on loose sand, it is frustrating. When a gnarly tree branch makes pull-ups into a twisted mockery of the pristine movement I rock at the gym, it’s really frustrating. Slight pain from scratches or harsh ground is a constant, and with no clothing, the cold is often an issue, especially if there’s snow.
Everything is harder, or rather, I should say everything is more complex. The result is that I learn how to tolerate stress, both mental and physical, and how to adapt to make something work despite the fact that the environment is not cooperating. I deal with it or fail. When I’m out there, it doesn’t matter that I can deadlift 3x my bodyweight on a bar, because that doesn’t change the fact that a rock is completely off-balance and seems to be actively trying to roll onto my toes. And that doesn’t change the fact that I’m picking it up and carrying it up the mountain anyway.
That is the definition of tough.
Khaled Allen is a writer and adventurer who explores the ways human potential can be unlocked. He currently lives in Boulder, CO, where is hikes, teaches self-defense, and meditates . . . a lot.
What Causes Stabbing Pain When Breathing?
According to Dr. Boka, anything that irritates the lining of the lungs can cause pleuritic pain. There are many different things that may cause this type of irritation, including:
- Prolonged coughing
- Early signs of lung infection (including pneumonia or empyema)
- Pulmonary embolism, aka a blood clot in the veins of the lung
- Chest or rib injury or trauma (such as a seat belt injury during a motor vehicle accident)
- Irritation to the lining of the heart
Here is a closer look at some of the causes of stabbing pain when breathing.
Viral infections are the most common cause of pleuritic pain, Dr. Boka says. Infections that can irritate the lungs include influenza, RSV (respiratory syncytial virus) and the common cold viruses that lead to pneumonias. He adds that the risk for these types of viruses is the highest during flu season (November through March) and in individuals who have weakened immune systems.
Infection with other less-common viruses — such as cytomegalovirus (CMV), Epstein-Barr virus (EBV) and parainfluenza virus — can also lead to pleuritic pain. Tuberculosis and bacterial or viral pneumonia also sometimes cause stabbing chest pain.
Treatment for these conditions typically includes nonsteroidal anti-inflammatory medications, such as ibuprofen (Advil, Motrin), and antibiotics for bacterial pneumonia and tuberculosis.
2. Pulmonary Embolism
Pulmonary embolism (PE) refers to a sudden blockage of a lung artery caused by a blood clot that traveled from elsewhere in the circulatory system. Most PEs occur due to blood clots that formed in the deep veins of the legs.
A PE is a potentially life-threatening condition, as large clots can block oxygen to your body. According to Dr. Boka, signs that you may have a PE include:
- hemoptysis (coughing up blood)
- increased heart rate
- rapid breathing
- sudden/abrupt chest pain
- shallow or deep pain while breathing in
- in extreme cases, loss of consciousness, lightheadedness, dizziness, vision changes and headache
Pain or crampy pain in the legs may signal a deep venous thrombus (DVT), which is usually a blood clot in the leg that has a risk of coming loose and traveling to the lungs to become a PE. If you're experiencing any of these symptoms, see your doctor as soon as possible.
As Dr. Boka explains, a pneumothorax is an air leak from the lungs into the chest wall cavity. Often known as a "collapsed lung," this condition can allow air bubbles to leak into the layers of skin around the neck and upper chest and back, which can be painful. In severe cases, he also adds that a pneumothorax may lower blood pressure and may stop the heart.
A pneumothorax can occur spontaneously (particularly in tall, thin young men) as a result of an injury or chronic lung condition and, in rare cases, within 48 hours of beginning menstruation before menopause or estrogen therapy after menopause. Smoking increases the risk for a spontaneous pneumothorax.
Symptoms of a pneumothorax depend on the extent of lung collapse and may include:
- Sudden pleuritic chest pain that might radiate to the shoulder or back, and often transitions to more constant, aching pain
- Shortness of breath, which might be mild to severe
- Rapid heart rate
A large pneumothorax can quickly become life-threatening. Treatment typically involves removal of the accumulated air in the chest through a needle or tube. In the case of small amounts of air leakage, treatment might not be needed, although observation is needed to ensure the condition doesn't worsen. See your doctor immediately if you suspect you might have a collapsed lung.
4. Other Causes
A number of other conditions can cause pleuritic pain, some minor and others more serious. Examples of these conditions include:
- Musculoskeletal: Rib fracture, sore chest muscles
- Inflammatory: Lupus, rheumatoid arthritis, pericarditis (inflammation of the sac around the heart)
- Cardiovascular: Heart attack (although most people do not feel pain while breathing in with a heart attack), aortic dissection (tear of the large artery that carries blood from the heart to the rest of the body)
- Cancer: Lung cancer, mesothelioma
Shortness of Breath
Shortness of breath is a common symptom of allergy, infection, inflammation, injury, or certain metabolic conditions. The medical term for shortness of breath is dyspnea. Shortness of breath results when a signal from the brain causes the lungs to increase breathing frequency. Shortness of breath may come on suddenly, within seconds or, it may occur over days, weeks or months. Severe shortness of breath can be frightening. You may feel like you're being suffocated, with a tight chest and a feeling of ‘air hunger’—that you can't take in the air that you need.
You may experience shortness of breath because of conditions affecting the lungs, the entire pulmonary system, or in association with more generalized conditions, such as obesity or low blood pressure (hypotension).
Sometimes shortness of breath has common, relatively non-serious causes, such as following a bout of intense exercise. Shortness of breath in pregnancy is also a common and usually harmless condition, which occurs most often in early and late pregnancy due to hormones and other factors related to the growing baby. Other times, being short of breath indicates a severe condition requiring medical attention.
Inflammation of the lungs and bronchial tubes are common causes of shortness of breath, as is injury to the respiratory tract caused by smoking or other toxins. Shortness of breath may occur with injury to the lungs, such as a collapsed lung (pneumothorax).
Allergic asthma reactions lead to shortness of breath, which can be severe and even life-threatening. Most, if not all lung diseases involve shortness of breath and, in rare cases, shortness of breath may present as a symptom of serious infections of the lungs or bronchial tubes. Shortness of breath can also be an indication of lung cancer, especially if accompanied by hemoptysis (coughing up blood).
Numerous heart conditions that lead to low oxygen levels in the blood (hypoxia) also result in shortness of breath. Depending on the cause, you may experience shortness of breath only while lying down or when either lying down or sitting up. Congestive cardiac failure may be accompanied by shortness of breath in addition to other symptoms, including pink, frothy mucus, rapid breathing (tachypnea), wheezing, and rapid heartbeat.
Seek immediate medical care (call 911) if you have shortness of breath accompanied by any life-threatening symptoms, including bluish coloration of lips fingernails or skin confusion or loss of consciousness for even a brief moment high fever (higher than 101 degrees Fahrenheit) sudden swelling of the face, tongue or lips chest pain or pressure or rapid heart rate (tachycardia).
If your shortness of breath persists, worsens, or causes you concern, seek prompt medical care.
What other symptoms might occur with shortness of breath?
Shortness of breath may accompany other symptoms, which can vary depending on the underlying disease, disorder or condition. Symptoms known to commonly affect the respiratory system may also involve other body systems.
Respiratory symptoms that may occur along with shortness of breath
Shortness of breath may accompany other symptoms affecting the respiratory system including:
- Cough that gets more severe over time
- Coughing up blood (hemoptysis)
- Coughing up clear, yellow, light brown, or green mucus
- Sore throat
- Stuffy nose or nasal congestion
- Wheezing (whistling sound made with breathing)
Cardiovascular symptoms that may occur along with shortness of breath
Shortness of breath may accompany symptoms related to the cardiovascular system including:
- Bluish coloration of the lips, fingernails or skin (cyanosis)
- Chest pain or pressure
- Irregular heart beat (arrhythmia)
- Rapid heart rate (tachycardia)
Serious symptoms that might indicate a life-threatening condition
In some cases, shortness of breath may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms:
- Bluish coloration of the lips, fingernails or skin
- Chest pain or pressure
- Confusion or loss of consciousness for even a brief moment
- Heart palpitations
- High fever (higher than 101°F)
- Rapid heart rate (tachycardia)
- Sudden swelling of the face, lips or tongue
What causes shortness of breath?
Common causes of shortness of breath include asthma, allergic reactions, COPD (chronic obstructive pulmonary disease), infections (such as viral or bacterial pneumonia), and obesity. Cardiovascular conditions, such as an abnormal rhythm (arrhythmia), heart attack and heart failure, can cause shortness of breath, but usually along with other symptoms.
Categories of shortness of breath causes include respiratory, cardiovascular, life-threatening, acute, chronic, and other, with some overlap between them.
Respiratory causes of shortness of breath
Shortness of breath may be caused by respiratory conditions including:
- Airway obstruction
- Asthma and allergies
- Bronchiolitis (inflammation of the small airways known as bronchioles) or bronchitis
- Bronchiectasis (dilation of the airways)
- COPD, which includes emphysema and chronic bronchitis
- Empyema (accumulation of pus around the lungs)
- Hemothorax (blood in the lung)
- High altitude
- Infection such as COVID-19
- Inhalation injury
- Lung cancer
- Pneumothorax (collapsed lung)
- Pulmonary embolism (blockage of a pulmonary artery due to a blood clot)
- Pulmonary fibrosis (interstitial lung disease)
- Pulmonary hypertension (high blood pressure in the arteries of the lungs)
- Tuberculosis (serious infection affecting the lungs and other organs)
Cardiovascular causes of shortness of breath
Shortness of breath can also be caused by cardiovascular disorders including:
- Arrhythmia (irregular heart beat)
- Cardiogenic shock (shock caused by heart damage and ineffective heart function)
- Cardiomyopathy (weakened or abnormal heart muscle and function)
- Cardiovascular disease (due to atherosclerosis, or hardening of the arteries, or other causes)
- Congenital heart defects
- Congestive heart failure (deterioration of the heart’s ability to pump blood)
- Heart attack
Other causes of shortness of breath
Shortness of breath can also have other causes including:
- Dehydration (loss of body fluids and electrolytes, which can be life threatening when severe and untreated)
- Diabetic ketoacidosis (life-threatening complication of diabetes)
- Electrolyte imbalance
- Fluid overload
- Kidney or liver failure
- Pregnancy (more likely in the first and third trimesters)
- Sepsis (life-threatening bacterial blood infection)
Causes of sudden (acute) shortness of breath
When you feel short of breath over hours to days, some common causes include:
- Airway obstruction
- Asthma (bronchospasm)
- Carbon monoxide poisoning
- Heart attack
Causes of chronic shortness of breath
When shortness of breath occurs over days to weeks and lasts longer than 4 to 8 weeks, some common causes include:
- Cardiovascular conditions such as heart failure
- Poor fitness level (“out of shape”)
- Pulmonary hypertension
- Lung cancer
Serious or life-threatening causes of shortness of breath
Some causes of shortness of breath are life threatening and should be immediately evaluated in an emergency setting. These include:
- Anaphylaxis (severe allergic reaction)
- Cardiogenic shock
- Diabetic ketoacidosis
- Pulmonary embolism
When should you see a doctor for shortness of breath?
You should always see a doctor for shortness of breath, unless it’s a minor, one-time event or tied to intense exercise and goes away when you are at rest.
Shortness of breath with any of these symptoms might be signs of a life-threatening condition. Seek immediate care, including calling 911 if necessary, if you have:
- or pressure, fainting or nausea
- Bluish coloring in your lips, fingernails or skin
- Loss of consciousness, even if it's very brief
- Rapid heart rate
- Severe shortness of breath that comes on suddenly and makes it difficult to function
- Sudden swelling of your face, lips or tongue
See a doctor promptly
Some worrisome symptoms that you should bring to your doctor's attention include:
- Trouble breathing when lying flat
- Waking up in the night with shortness of breath
- Experiencing shortness of breath with daily activities
- Having shortness of breath along with swelling in your feet or ankles
- Feeling short of breath or wheezing along with a high fever, chills and cough
- Breathlessness that doesn't go away after resting for 30 minutes
Your primary care physician can address your shortness of breath concerns, but also may refer you to a specialist. Doctors who specialize in lung conditions are pulmonologists. If your shortness of breath is related to heart problems, you may need to see a cardiologist.
Whichever health professional you choose, it's important not to deny or downplay symptoms, especially regarding something as potentially serious as shortness of breath. Your doctor can answer your questions and provide treatment to help relieve your symptoms.
How do doctors diagnose the cause of shortness of breath?
Diagnosing the cause of shortness of breath brings you a step closer to relief, as treatment depends on the underlying problem. Your doctor will listen to the sound of your lungs and heart with a stethoscope, check your oxygen levels, then perform a more comprehensive physical exam.
Your doctor will take a detailed medical history and ask you questions to learn more about your symptoms, such as how long you’ve been experiencing breathing difficulties and if it comes and goes or is constant.
Questions for diagnosing the cause of shortness of breath
In order to diagnose your condition, your healthcare provider will ask you a series of questions related to your shortness of breath including:
- What does it feel like when you breathe?
- How long have you felt shortness of breath?
- Do you have any other symptoms?
- What medications are you taking?
- Do any particular activities cause you to feel short of breath?
- How much exercise can you do before you become short of breath?
- Does your shortness of breath prevent you from performing your normal activities?
- Are you experiencing any other symptoms, such as chest pain or nausea?
Tests and procedures
In-office tests and other procedures to evaluate your lungs and heart and diagnose the underlying cause include:
- Blood tests to look for markers of inflammation or disease
- Breathing and pulmonary function tests, such as spirometry to measure your lung function
- Chest X-ray and other imaging tests, such as MRI (magnetic resonance imaging) or CT (computed tomography)
- (ultrasound of your heart) to evaluate heart structure and function
- to evaluate heart function during exercise
It is not always possible to diagnose an underlying cause or condition. If the problem persists and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.
How is shortness of breath treated?
Treating the underlying cause of shortness of breath can usually improve your symptoms. In most cases, the cause is short-lived, not serious, and there is an effective treatment strategy. Examples include respiratory infections and allergies.
Depending on the cause and severity of dyspnea, medical interventions may include:
- Breathing exercises
- with a nebulizer
- Bronchodilators, including asthma and COPD inhalers
- Heart medicine
- Pulmonary rehabilitation with a respiratory therapist
- Supplemental oxygen
- Surgery and minimally invasive procedures
Shortness of breath treatment at home
To ease your shortness of breath or keep it from getting worse, there are several self-care steps including:
- Address any other medical problems you have that may be contributing to your shortness of breath.
- Increase the amount of cool air around you, such as using a fan or cool mist humidifier or by sitting near an open window (if the outside air is cool).
- If you are at elevations above 5,000 feet, use caution or avoid exerting yourself.
- Keep any supplemental oxygen you may use well-stocked and in working order.
- Lose weight if you are overweight. Ask your doctor for guidance on safe methods of weight loss.
- Stop smoking and avoid tobacco (such as secondhand exposure).
- Stay away from other environmental irritants, like allergens that affect your breathing.
Alternative treatments for breathlessness, such as yoga, mindfulness and acupuncture, are not significantly better than control treatments, according to a review of dyspnea management by the American Thoracic Society. However, alternative treatments may be helpful for specific underlying causes of shortness of breath or in combination with medication, oxygen and other treatments.
What are the potential complications of shortness of breath?
It is vital to seek prompt treatment if you experience shortness of breath as it can be a sign of a serious disease and, left untreated, may put you at risk of serious complications and even permanent damage.
Once your doctor has diagnosed the underlying cause, you should make every effort to follow the recommended treatment plan precisely in order to minimize risk of potential complications including:
The effect of diaphragmatic breathing exercise on attention, negative affect and stress level: a preliminary randomly controlled study on occupational population was approved by the ethical broad of school of psychology, Beijing Normal University. The method, experiment design, and safety of participants were strictly approved by the ethical broad of school of psychology, Beijing Normal University.
G-XW and Y-FL designed the work, drafted and finalized the manuscript. XM, Z-QY, HZ, N-YD, Y-TS, and Z-QG collected and analyzed the data, and revised the manuscript.