The most common causes of labored breathing and when to see a doctor

• Labored breathing can be normal if it's during exercise or intense activity.
• However, labored breathing can also be caused by heart attacks, heart failure, or COPD.
• Therefore, seek medical attention for labored breathing to properly treat the underlying cause.

Breathing generally requires no deliberate effort, but if you suddenly feel like you're straining to inhale and exhale, you may be experiencing labored breathing.

"Simply breathing fast is not labored breathing. Labored breathing in the medical sense is thought of as 'work of breathing,'" says Panagis Galiatsatos, MD, MHS, an assistant professor in the Division of Pulmonary & Critical Care Medicine at the Johns Hopkins School of Medicine.

If labored breathing occurs abruptly for no apparent reason, or it happens during activities that didn't previously cause breathing difficulties, it may be a cause of concern.

Here are the symptoms, causes, and treatment of labored breathing.

What is labored breathing?

Labored breathing can be subjective, but in general, describes the sensation of being uncomfortable when you breathe, says Galiatsatos.

Labored breathing may be accompanied by other symptoms, such as:

• Grunting
• Wheezing
• Adjusting body position to take deeper breaths
• Cold sweat
• Nose flaring
• Bluish or pale color on the mouth, fingernails, or skin
• Using the chest, neck, and spinal muscles to breathe in addition to the diaphragm and rib cage muscles

Labored breathing isn't always a cause for concern because it can occur during normal exertion or physical activity, says Mayank Tickoo, MD, a pulmonologist at Yale Medicine and assistant professor of medicine at the Yale School of Medicine.

However, if it happens during activities that weren't previously strenuous - like walking or climbing a flight of stairs - you should seek medical attention.

"Any sudden onset shortness of breath, especially if accompanied by chest pain or pressure, lightheadedness, dizziness, breaking out in a sweat, and grey out or vision changes should be evaluated by a medical professional," says Tickoo.

Seeing a doctor if you have labored breathing is especially important because it could signal an underlying condition. In fact, according to a 2019 study in Denmark, 47.3% of the patients that required urgent medical assistance due to breathing difficulties were diagnosed with respiratory disease in the hospital.

Causes of labored breathing

• Asthma attack: Asthma is a chronic disease where the airways narrow and swell, which makes it difficult to breathe. It affects about one in 13 Americans.
• Panic attacks: Anxiety-induced panic attacks come on suddenly and often cause shortness of breath, tightness in the throat, and increased heart rate.
• Chronic obstructive pulmonary disease (COPD) flare-up: COPD is a chronic, progressive disease where airflow from the lungs is obstructed, resulting in breathing difficulties.
• Pulmonary embolism: Pulmonary embolism occurs when a blood clot travels to the lungs and decreases oxygen levels in the blood, causing sudden breathing difficulties.
• Heart attack: Labored breathing may occur during a heart attack, which is caused by a blockage in the arteries that interrupts blood flow to the heart. According to a 2016 study, 45% of heart attacks in the United States are "silent," which means that they show mild or no symptoms.
• Heart failure: When the heart doesn't pump blood as efficiently, fluids may build up in the body and cause breathing difficulties.

Note: According to Galiatsatos, people with severe cardiopulmonary diseases, like congestive heart failure, or those with underlying conditions where the lungs can't easily adapt to the demands of physical exertion, such as emphysema, are more likely to experience labored breathing.

How to treat labored breathing

There are plenty of reasons why labored breathing occurs, so the treatment will vary depending on the cause. According to Tickoo, some common treatments include:

• Rescue inhalers: Albuterol, a short-acting medication that opens and relaxes airways to the lungs, can provide quick relief for people with asthma.
• Diuretics: Taking diuretics or "water pills" will help the body get rid of excess fluid, which causes shortness of breath for individuals with heart failure.
• Cardiac catheterization: In this medical procedure, a long, thin tube called a catheter is threaded to the heart to diagnose and treat heart conditions. This may address labored breathing from a heart attack.
• Oxygen therapy: Supplemental oxygen can be administered through a face mask or nasal cannula to relieve breathing discomforts of people with lung diseases like COPD.

How quickly treatments will reduce labored breathing depends on which one you receive, says Tickoo. For instance, rescue inhalers for asthma attacks relieve symptoms within minutes, but oxygen therapy may be needed for a few weeks if you're recovering from a COPD flare-up.

Insider's takeaway

If you feel like you have to work hard to breathe, you may be experiencing labored breathing. It is caused by many different factors, which include asthma attacks, COPD flare-ups, or heart attacks. The treatment will vary depending on the underlying cause of your labored breathing.

Keep in mind that sudden breathing problems accompanied by chest pain or pressure, weakness, and loss of consciousness are emergency symptoms that require immediate medical attention.