What causes sudden dizziness and shortness of breath

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The combination of fatigue, shortness of breath and dizziness usually points to a problem involving the cardiovascular system, meaning the heart and circulatory system. In collaboration with the lungs, this system supplies the body tissues with oxygen as well as nutrients. It also enables removal of metabolic waste products. A significant problem in one or more components of the cardiovascular system can lead to fatigue, shortness of breath and dizziness usually due to reduced oxygen delivery to the brain and other body organs and tissues.

Heart Valve Disorders

The heart contains 4 valves that control blood flow between the upper and lower heart chambers, and outflow from the lower heart chambers. Heart valve disorders that significantly impair blood flow through or out of the heart can lead to fatigue, shortness of breath and dizziness. Symptoms typically develop and worsen gradually. They usually occur due to insufficient oxygen delivery to the body or fluid leakage into the air sacs caused by increased lung circulation blood pressure, or both. Most heart valve disorders affect those of the left side of the heart. The mitral valve separates the left upper and lower heart chambers. The aortic valve controls flow from the lower left heart chamber into aorta, the body's largest artery.

Heart Rhythm Abnormalities

Normal heart function depends on regular, coordinated contraction of the upper then the lower heart chambers. This process is regulated by a specialized electrical conduction system in the heart. Some intermittent and infrequent heart rhythm abnormalities, or arrhythmias, pose no serious health risk and cause no symptoms. Arrhythmias that compromise the amount of blood pumped by the heart, however, can lead to fatigue, shortness of breath and dizziness or fainting. This can occur if the heart beats too slowly or too rapidly. People with other heart problems, such as a prior heart attack or coronary artery disease, are at increased risk for serious arrhythmias.

Heart Failure

According to a 2017 report from the American Heart Association, an estimated 6.5 million adults in the US have heart failure. With this condition, the heart cannot pump enough blood through the circulation to keep up with the body's demands in certain situations. Initially, this occurs only during strenous physical activity. As the condition progresses and the heart grows weaker, even ordinary activities cause shortness of breath and fatigue becomes more prominent. With advanced heart failure, symptoms occur with even minimal activity or might be present at rest. Dizziness when sitting up or standing can occur, which might be due to the heart condition itself or a side effect of medications used to treat it.

Other Causes

There are other possible causes of fatigue, shortness of breath and dizziness. Some examples include:

  • Severe anemia
  • Blood clot in a lung artery, or pulmonary embolism
  • Inflammation of the heart sac, or pericarditis
  • Infection of the heart lining, or infective endocarditis
  • Pneumonia

Warnings and Precautions

Call your doctor as soon as possible if you experience shortness of breath, fatigue and dizziness. Seek immediate medical care if your shortness of breath is sudden, worsening or severe, or if you experience any warning signs or symptoms, including:

  • Chest, neck, jaw or left arm pain
  • Cold clammy skin or fever
  • Sense of impending doom
  • Coughing up bloody or foamy phlegm
  • Racing or irregular pulse
  • Fainting

Overview

Hyperventilation is breathing that is deeper and more rapid than normal. It causes a decrease in the amount of a gas in the blood. (This gas is called carbon dioxide, or CO2.) The decrease may make you feel lightheaded. You may have a rapid heartbeat and be short of breath. It also can lead to numbness or tingling in your hands or feet, anxiety, fainting, and sore chest muscles.

Some causes of sudden hyperventilation include anxiety, fever, some medicines, intense exercise, and emotional stress. It also can occur because of problems caused by asthma or emphysema or after a head injury. But it occurs most often in people who are nervous or tense, breathe shallowly, and have other medical problems, such as lung diseases or panic disorder. It occurs more often in women than men. Most people who have it are 15 to 55 years old. It may occur when people travel to elevations over 6000 ft (2000 m). Symptoms can be like ones from another more serious medical problem, such as a lung problem.

Acute (sudden) hyperventilation is usually triggered by acute stress, anxiety, or emotional upset. Chronic (recurring) hyperventilation may be a lasting problem for people with other diseases, such as asthma, emphysema, or lung cancer.

Many women have problems with hyperventilation when they are pregnant. But it usually goes away on its own after the baby is born.

In many cases, hyperventilation can be controlled by learning proper breathing techniques.

Symptoms of hyperventilation

Symptoms usually last 20 to 30 minutes. They may include:

  • Feeling anxious, nervous, or tense.
  • Frequent sighing or yawning.
  • Feeling that you can't get enough air (air hunger) or need to sit up to breathe.
  • A pounding and racing heartbeat.
  • Problems with balance, lightheadedness, or vertigo.
  • Numbness or tingling in the hands, feet, or around the mouth.
  • Chest tightness, fullness, pressure, tenderness, or pain.

Other symptoms may occur less often. You may not realize that they are directly related to hyperventilation. These symptoms can include:

  • Headache.
  • Gas, bloating, or burping.
  • Twitching.
  • Sweating.
  • Vision changes, such as blurred vision or tunnel vision.
  • Problems with concentration or memory.
  • Loss of consciousness (fainting).

Hyperventilation isn't a disease. But you may need to be checked by your doctor if you keep having symptoms. If you have recurring symptoms, you might be diagnosed with a condition called hyperventilation syndrome (HVS).

Treatment for hyperventilation depends on the cause. Home treatment is usually all that's needed for mild symptoms. Medical treatment may be needed for hyperventilation symptoms that are moderate to severe, that last for a long time, that come back, or that interfere with your daily activities. Treatment usually includes reassurance, stress reduction measures, breathing lessons, or medicine.

Check Your Symptoms

Do you have problems with hyperventilation?

Hyperventilation is breathing that is faster than normal.

How old are you?

Less than 12 years

Less than 12 years

12 years or older

12 years or older

Are you male or female?

  • If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.

Have you noticed irregular heartbeats or heart rate changes even when you are not hyperventilating?

Yes

Arrhythmia or heart rate changes when not hyperventilating

No

Arrhythmia or heart rate changes when not hyperventilating

Do you think there could be a breathing problem other than hyperventilation?

Yes

Respiratory problem other than hyperventilation

No

Respiratory problem other than hyperventilation

Do you think you have a breathing problem other than hyperventilation?

Yes

Respiratory problem other than hyperventilation

No

Respiratory problem other than hyperventilation

Did you pass out completely (lose consciousness)?

If you are answering for someone else: Is the person unconscious now?

(If you are answering this question for yourself, say no.)

Are you back to your normal level of alertness?

After passing out, it's normal to feel a little confused, weak, or lightheaded when you first wake up or come to. But unless something else is wrong, these symptoms should pass pretty quickly and you should soon feel about as awake and alert as you normally do.

Yes

Has returned to normal after loss of consciousness

No

Has returned to normal after loss of consciousness

Did the loss of consciousness occur during the past 24 hours?

Yes

Loss of consciousness in past 24 hours

No

Loss of consciousness in past 24 hours

Are you having trouble breathing (more than a stuffy nose)?

Yes

Difficulty breathing more than a stuffy nose

No

Difficulty breathing more than a stuffy nose

Would you describe the problem as severe, moderate, or mild?

Severe

Severe difficulty breathing

Moderate

Moderate difficulty breathing

Mild

Mild difficulty breathing

Can you control your breathing?

Some people can control their hyperventilation by breathing into a paper bag or using different breathing techniques.

Yes

Able to control hyperventilation

No

Not able to control hyperventilation

Do you feel lightheaded or dizzy, like you are going to faint?

It's normal for some people to feel a little lightheaded when they first stand up. But anything more than that may be serious.

Are you still hyperventilating after 30 minutes of home treatment?

Yes

Has tried more than 30 minutes of home treatment without improvement

No

Has tried more than 30 minutes of home treatment without improvement

Do you hyperventilate often?

Does the problem interfere with your daily activities?

Yes

Hyperventilation interferes with daily activities

No

Hyperventilation interferes with daily activities

Are you having more frequent or severe problems with hyperventilation?

Yes

Symptoms are becoming more frequent or severe

No

Symptoms are becoming more frequent or severe

Have you had problems with hyperventilation for more than a week?

Yes

Hyperventilation problems for more than a week

No

Hyperventilation problems for more than a week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can't get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It's hard to talk in full sentences.
  • It's hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It's becoming hard to breathe with activity.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Lightheadedness or sudden weakness.
  • A fast or irregular heartbeat.

For men and women, the most common symptom is chest pain or pressure. But women are somewhat more likely than men to have other symptoms, like shortness of breath, nausea, and back or jaw pain.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Respiratory Problems, Age 12 and Older

Respiratory Problems, Age 11 and Younger

Change in Heartbeat

Self-Care

Home treatment may help you control your breathing and stop hyperventilation.

Always try steps to control your breathing or belly-breathe first. If these techniques don't work and you don't have other health problems, you might try breathing in and out of a paper bag that covers your nose and mouth.

First, sit down and concentrate on your breathing.

  • Control your breathing.

    Breathe through pursed lips, as if you're whistling.

    Or pinch one nostril, and breathe through your nose. It's harder to hyperventilate when you breathe through your nose or pursed lips, because you can't move as much air.

  • Slow your breathing to 1 breath every 5 seconds.

    Or breathe slowly enough that symptoms gradually go away.

  • Try belly-breathing.
    • Place one hand on your belly just below the ribs. Place the other hand on your chest. You can do this while standing, but it may be more comfortable while you are lying on the floor with your knees bent.
    • Take a deep breath through your nose. As you inhale, let your belly push your hand out. Keep your chest still.
    • As you exhale through pursed lips, feel your hand go down. Use the hand on your belly to help you push all the air out. Take your time exhaling.
    • Repeat these steps 3 to 10 times. Take your time with each breath.
  • Breathe into a paper bag.
    • Use a paper bag to control your breathing. Take 6 to 12 easy, natural breaths, with a small paper bag held over your mouth and nose. Then remove the bag from your nose and mouth and take easy, natural breaths.
    • Next, try belly-breathing (diaphragmatic breathing).
    • Switch between these techniques until your hyperventilation stops.

    But don't use a paper bag if:

    • You have any heart or lung problems, such as coronary artery disease, asthma, chronic obstructive pulmonary disease (COPD, emphysema), or a history of deep vein thrombosis, stroke, or pulmonary embolism.
    • Rapid breathing occurs at a high altitude [above 6000 ft (2000 m)]. Breathing faster than normal is a natural response to an increased altitude.

    If you use the bag method, follow these precautions.

    • Don't use a plastic bag.
    • Don't breathe continuously into a paper bag. Take 6 to 12 natural breaths, with a paper bag held over your mouth and nose. Then remove the bag from your nose and mouth.
    • Don't hold the bag for a person who is hyperventilating. Allow the person to hold the bag over his or her own mouth and nose.

If you have episodes of hyperventilation that last a long time or occur often, talk to your doctor about your symptoms.

When to call for help during self-care

Call a doctor if any of the following occur during self-care at home:

  • Symptoms don't improve with home treatment.
  • Symptoms occur more often or are more severe.

Learn more

  • Belly-Breathing (Diaphragmatic Breathing)
  • Causes of Hyperventilation

Preparing For Your Appointment

Credits

Current as of: March 9, 2022

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine

Why do I suddenly feel dizzy and weird?

Dizziness has many possible causes, including inner ear disturbance, motion sickness and medication effects. Sometimes it's caused by an underlying health condition, such as poor circulation, infection or injury. The way dizziness makes you feel and your triggers provide clues for possible causes.

How do I know if my dizziness is heart related?

In most cases, dizziness associated with heart problems is accompanied by other symptoms. These may include shortness of breath, swollen extremities, frequent fatigue or chest pain. In the event heart disease is suspected, you will undergo one or more tests to get to the root of your problem.

Should I go to the hospital for sudden dizziness?

Generally, see your doctor if you experience any recurrent, sudden, severe, or prolonged and unexplained dizziness or vertigo. Get emergency medical care if you experience new, severe dizziness or vertigo along with any of the following: Sudden, severe headache. Chest pain.

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