The act of respiration involves several organs and processes that have to function in a step-by-step manner to ensure that sufficient oxygen is absorbed from the air and carbon dioxide is expelled from the body. However, like any part and process in the body, breathing can be affected in various ways due to a range of diseases.
What are breathing problems?
Breathing problems is a broad term to describe a range of conditions where the movement of air in and out of the lungs is affected. Sometimes the term breathing problems is also used to describe problems with the oxygenation of blood, the blood oxygen and carbon dioxide levels as well as with the control of respiration by the brain, nerves and muscles.
The airways and lungs do not function in isolation. Despite being vital organs, it also requires the optimal functioning of associated organs and systems. The cardiovascular system is essential for the respiratory system to deliver the oxygen and remove carbon dioxide. Similarly the musculoskeletal and nervous system ensure that the respiratory system can function optimally.
Therefore problems with these other organs and systems can affect breathing or the transport of oxygen and carbon dioxide. All of these disruptions can be incorrectly referred to as breathing problems although the airways and lungs are intact and breathing is normal. For example, with a heart attack the heart cannot pump blood properly and this may lead to shortness of breath. However, the airways and lungs are functioning normally.
Causes of Breathing Problems
The causes of breathing problems can be assessed according to the part of the respiratory system that is affected.
Also read more on abnormal breathing sounds.
The airway runs from the nose to the lungs. It includes the throat, larynx, trachea and bronchi in between. These passages are lined with a respiratory epithelium that produces mucus. Air is filtered as it moves through the airways to ensure that dust and germs do not reach the lungs.
One of the common causes is narrowing of the airways which may be due to inflammation of the respiratory walls which is often accompanied by excessive mucus build up along the passages, spasm of the muscles in the airway walls, growths and external compression.
This is seen with a host of conditions such as:
- Infections: Viral like the influenza (flu), bacterial as is the case with pertussis and sometimes protozoal and fungal.
- Allergies: Allergic rhinitis (nose) and asthma.
- Other: Chronic bronchitis, tumors, foreign bodies and compression from surrounding organs.
The expansion and contraction of the lungs draws air in and out of the lungs. The air enters the air sacs of the lungs where gas exchange occurs. Oxygen from the air is absorbed into the blood and carbon dioxide in the blood is passed out into the air within the lungs.
Some of the problems with the lungs involves loss of elasticity, hardening of portions of the lung tissue, accumulation of fluid in the air sacs and inflammation of the lungs tissue. The lung is surrounded by a potential space which is lined with membranes known as pleura. Problems within this space or of the pleura can also affect lung function.
The conditions where this may occur includes:
- Infections: Pneumonia – viral, bacterial and fungal, example tuberculosis (TB) and pleuritis.
- Allergies: Hypersensitivity pneumonitis.
- Pollution: Silicosis, coal worker’s pneumoconiosis and asbestosis.
- Other: Pulmonary edema, pleural effusion, hemothorax and pneumothorax.
Chest Wall and Muscles Problems
The chest wall which is made up of skin, muscles and bones plays an important role in respiration apart from protecting vital organs like the lungs and heart. The diaphragm is a flat sheet of muscle which is the main muscle of respiration. The chest wall muscles also contribute to breathing, especially with labored breathing.
With chest wall problems like a broken rib or flail chest the movement of the chest wall is impaired which in turn affects the expansion and contraction of the lungs. In diaphragmatic paralysis, the diaphragm muscle does not contract and relax which drastically affects breathing. This type of paralysis is often due to a problem with the nerves, like phrenic nerve palsy.
Nerves and Brain Problems
The respiratory centers in the brain control the depth and speed of respiration. These centers determine these factors based on the levels of oxygen and carbon dioxide in the bloodstream. In conditions like central sleep apnea, the respiratory center temporarily stops breathing until a person awakes and it is restored.
Impulses are relayed from the respiratory centers in the brain to the muscles of respiration around the lungs. This is done via the nerve pathways that run between the brain and muscles. Phrenic nerve palsy may affect control of the diaphragm as the nerve malfunctions for various reasons such as injury or inflammation.
Technically blood problems are not related to breathing problems. Breathing is the act of moving air in and out of the lungs with the goal of oxygenating the blood and expelling carbon dioxide from the body. Breathing may be normal but blood oxygen and carbon dioxide levels can be abnormal.
This can occur with with anemia where the hemoglobin levels are lower than normal. This means that the blood’s capacity to carry oxygen is impaired. Another problem is pulmonary embolism where a blood clot in the lung blood vessels hampers normal blood flow through the lungs.
The signs and symptoms of blood problems may appear similar to those of breathing problems.
Signs and Symptoms
Breathing problems are characterized by many similar symptoms despite the differences in the conditions that cause it. These signs and symptoms include:
- Shortness of breath, labored breathing and/or difficulty breathing.
- Wheezing, rhonchi, crackles and other abnormal breath sounds.
- Painful breathing.
- Rapid or slow breathing rate.
- Deep or shallow breathing.
- Mouth breathing.
- Alar flaring (nostrils flare out).
As a result of the breathing problem there may also be the following signs and symptoms:
- Paleness and in severe cases bluish discoloration of the skin.
- Rapid heart rate known as tachycardia.
- Lightheadedness and dizziness.
- Confusion, agitation and other forms of mental impairment.
It is important to note that certain red flag signs and symptoms needs immediate medical attention. This includes chest pain, worsening difficulty with breathing, severe dizziness and loss of consciousness.