Shortness of breath and breathlessness are common respiratory conditions that can lead to oxygen deficiency, fatigue, chest tightness, and irregular breathing. While often a normal physiological response to strenuous activities such as intense exercise, mountain climbing, or stair climbing, these symptoms can also signal various underlying medical conditions.

For instance, heart failure can cause shortness of breath. When the heart muscle is damaged, its ability to pump blood to organs is compromised. This reduced pumping function leads to fluid accumulation in the pulmonary blood vessels, hindering gas exchange in the lungs and causing difficulty breathing.

Smokers, especially long-term ones, frequently experience shortness of breath and breathlessness. Tobacco smoke damages the respiratory tract lining, diminishes lung function, and impedes oxygen exchange. This often makes individuals feel breathless, experience shallow breathing, or become fatigued even with mild exertion. Initially, breathlessness may only occur during physical activity, but over time, it can manifest even at rest.

A doctor reads and analyzes a lung X-ray for a patient. Illustration: Tam Anh General Hospital

A doctor reads and analyzes a lung X-ray for a patient. Illustration: Tam Anh General Hospital

Lung cancer can also present with shortness of breath and breathlessness. Malignant tumors in the lungs can compress airways, reduce lung capacity, or cause pleural effusion (fluid around the lungs), thereby obstructing respiration and making breathing difficult even during rest. This sensation of breathlessness often appears in later stages of lung cancer, particularly with central tumors that narrow major airways or when mediastinal lymph nodes (in the chest) compress the respiratory tract.

Patients may also experience heavy wheezing. This condition often accompanies prolonged coughing, chest pain, unexplained fatigue, weight loss, or coughing up blood. Approximately 90% of lung cancer patients have a history of smoking. However, a smoking history combined with shortness of breath and breathlessness alone does not confirm a diagnosis of lung cancer.

Given your three weeks of persistent shortness of breath and breathlessness, it is important to visit a hospital for a comprehensive examination. Doctors will conduct a multi-specialty diagnosis involving respiratory and cardiovascular specialists to determine the underlying cause. You should inform the doctor about the frequency, duration, and severity of your breathlessness. In addition to a physical examination, the doctor may order several tests to identify the cause, including a chest X-ray, low-dose lung CT scan, electrocardiogram, spirometry, and blood tests. If a tumor is detected, a biopsy and pathological analysis will be performed to confirm whether it is lung cancer.

Master, Doctor Dang Thanh Do

Department of Respiratory Medicine

Tam Anh General Hospital Hanoi