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Difficulty breathing is called dyspnea Or shortness of breath. It is subjective sensation of uncomfortable breathing. Dyspnea is an umbrella term for a number of subjective experiences: including effortful respiration, a feeling of choking or asphyxiation, and hunger for air. And every patient can describe dyspnea its on way, and sometimes its difficult to define what is dyspnea exactly. But the main characteristic of dyspnea is uncomfortable breathing. Dyspnea can be caused by variety of underlying diseases. Including cardiac, pulmonary and other diseases, like anemia and psychiatric disorders. Most common causes of Dyspnea: 1. chronic obstructive pulmonary disease (COPD), which comprises emphysema and chronic bronchitis. Such patients generally have a long history of cigarette smoking and gradually progressive dyspnea over a number of years. Most patients do have stable symptoms, but they may have exacerbations during the winter months. A productive cough is a frequent associated symptom, and the sputum may become purulent during exacerbations. 2. Asthma, In asthma, periods of dyspnea frequently alternate with periods of normal breathing. There may be a family history of asthma. Asthma can have precipitating factors or events may be noted by the patient. Seasonal and diurnal variations in symptoms are common. Difficulty breathing is commonly combined with wheezing. A productive cough is frequent, particularly during recovery from an acute attack. 3. Pulmonary fibrosis. Patients with pulmonary fibrosis generally present with progressive and relentless dyspnea with a variable time course. Frequently the only associated symptom is a non-productive cough. Pulmonary fibrosis also can be associated with tiredness, loss of appetite and weight loss. rounded and swollen fingertips, clubbed fingers. Dyspnea frequently is combined with other symptoms, and it is crucial to consider accompanied symptoms. It will help to define underlying cause of dyspnea. For Example: If dyspnea accompanied with cough, you should think diseases affecting the airways and the lung parenchyma. Shortness of breath and fever means, pulmonary infection, e.g., pneumonia or acute bronchitis, exogenous allergic alveolitis or thyrotoxicosis. If there is dyspnea with Diminished or absent breathing sounds, it can be Chronic obstructive pulmonary disease, or severe asthma, or (tension) pneumothorax. Orthopnea, difficulty breathing when you're lying down indicates, acute congestive heart failure or pulmonary edema. Difficulty breathing with rales in the lungs means, acutely decompensated congestive heart failure, acute respiratory failure. If there is cyanosis alongside dyspnea, it can be respiratory failure, heart defect with right-to-left shunt, Eisenmenger syndrome. Shortness of breath with Exhaustion, generalized weakness, exercise intolerance, muscle weakness can be caused by, anemia, collagenoses, malignant disease (e.g., lung cancer), neuromuscular disease. If Dyspnea is accompanied with neurological deficits or Brainstem signs, it can be brain tumor, or hemorrhage in the brain. Hoarseness and dyspnea can indicate: disease of the glottis or trachea, recurrent laryngeal nerve palsy. rapid or deep breathing with difficulty breathing can be a sign of acidosis, sepsis, salicylate poisoning, psychogenic (including anxiety). Stridor an abnormal, high-pitched, musical breathing sound, if it is during inspiration, it can be a sign of croup, foreign body, or bacterial tracheitis. Stridor during expiration or combined with inspiration, can be caused by foreign body, epiglottitis and angioedema. Wheezing with difficulty breathing can be exacerbation of bronchial asthma, COPD, acutely decompensated congestive heart failure or foreign body. The pathogenesis of dyspnea is still not fully clear and is now under investigation. I Current explanatory hypotheses are based on the concept of a regulatory circuit that consists of several components like: chemoreceptors for pH, CO2, and O2 , as well as from mechanoreceptors in the musculature and the lungs (C fibers in the parenchyma, J fibers in the bronchi and pulmonary vessels) and a corresponding ventilatory response. By Scientific Animations - http://www.scientificanimations.com/w..., CC BY-SA 4.0, https://commons.wikimedia.org/w/index... By 7mike5000 - Animated gif was created from a video segment from Living With and Managing Asthma; an educational film by the Heart, Blood and Lung Institute, a division of the National Institute of Health. an agency within the United States Government., CC BY-SA 3.0, https://commons.wikimedia.org/w/index... By James Heilman, MD - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index...