Breathlessness and cough: Breathing problems you shouldn’t ignore

Breathlessness and cough are common breathing problems that can sometimes indicate more serious underlying health issues. Understanding these symptoms - why they occur, how they are assessed, and how they can be managed - is essential for health and wellbeing.

A distinguished consultant physician in respiratory and intensive care medicine provides a clear and informative guide to help you navigate these symptoms.

What is breathlessness, and why does it happen?

Breathlessness, also known as dyspnoea, is the sensation of difficulty breathing. It can occur during physical, at rest, or even during sleep. The causes are diverse and linked to several systems in the body.

For instance, respiratory conditions like asthma, chronic obstructive pulmonary disease (COPD), and infections such as pneumonia are common triggers. Cardiac issues, including heart failure or arrhythmias, can also result in breathlessness.

Other contributors include allergies, acid reflux, neurological conditions, anaemia, and musculoskeletal problems. Furthermore, even psychological factors like anxiety can intensify feelings of breathlessness.

How is breathlessness diagnosed and treated?

The diagnostic process begins with a detailed clinical history, physical examination, and complete assessment of your symptoms. Questions about when the breathlessness started, its triggers, and any accompanying symptoms such as chest pain will help guide the evaluation.

Any relevant investigations will then be ordered, including blood tests, chest X-rays or CT scans, breathing tests, echocardiograms, sleep studies, and cardiopulmonary exercise testing. These tests are done rapidly, followed by swift follow-up.

Depending on the underlying cause, management advice will involve treatment or onward referrals for opinions as needed. Treatment options may include medications such as bronchodilators for asthma or diuretics for heart failure. In some cases, lifestyle changes or oxygen therapy will be necessary.

When should I see a doctor about my cough?

Coughs are typically associated with minor infections, such as the flu or the common cold. Most cases resolve within one to two weeks. However, if you notice any of the following, it’s important to consult a specialist without delay:

• A chronic cough that lasts for more than 3 weeks.
• Night-time coughing that disrupts sleep.
• Coughing up blood.
• Shortness of breath or chest pain.
• Other worrying symptoms, such as unexplained weight loss or a persistent fever.

We provide a rapid and comprehensive assessment of cough symptoms. After your initial consultation, appropriate diagnostic tests will then be ordered, including blood tests, chest X-rays or CT scans, breathing tests, endoscopy, and any allergy tests. You can expect to begin treatment swiftly, often on the same day as your appointment.

How is a chronic cough treated?

The treatment for a chronic cough depends on its underlying cause and may involve a combination of approaches.

Medications like bronchodilators and inhaled corticosteroids are commonly prescribed for asthma, while proton pump inhibitors can help manage acid reflux. Antihistamines can manage allergies. Lifestyle changes, such as quitting smoking and reducing environmental irritants, are also crucial.

In some cases, physiotherapy will be recommended to improve breathing and control the cough reflex. Rarely, surgery will be necessary to address structural issues or remove tumours.

We will take a holistic view to treatment, providing ongoing care to effectively manage symptoms and support your wellbeing.