From the Guidelines
Dyspnea with normal oxygen saturation levels can be caused by various factors, including anxiety, asthma, COPD, heart problems, or even certain medications, and it is essential to seek medical evaluation to determine the underlying cause. According to the most recent study 1, dyspnea is a complex symptom with contributions from physiologic, psychological, and environmental factors. The study highlights that dyspnea can be triggered by factors other than low blood oxygen, such as increased work of breathing or heightened sensitivity to carbon dioxide levels.
Some possible causes of dyspnea with normal oxygen saturation levels include:
- Increased respiratory drive due to stimulation of pulmonary receptors or chemoreceptors 1
- Impaired ventilatory mechanics, such as airflow obstruction or muscle weakness 1
- Cardiac causes, such as myocardial disease, valvular heart disease, arrhythmia, or pericardial pathology 1
- Anxiety or panic attacks, which can lead to hyperventilation syndrome 1
To determine the underlying cause of dyspnea, a medical evaluation is necessary. This may include:
- A physical examination
- Lung function tests (spirometry)
- Chest X-ray or CT scan
- Blood tests to check for anemia or other conditions In the meantime, patients can try to manage their symptoms by:
- Resting and avoiding strenuous activities
- Practicing deep breathing exercises
- Using a fan to circulate air, which may help ease breathlessness
- Sitting upright to help expand their lungs If symptoms worsen or patients experience chest pain, dizziness, or severe breathlessness, they should seek emergency care immediately.
From the Research
Causes of Dyspnea with Normal Oxygen Saturation Levels
Dyspnea, or shortness of breath, can be caused by a variety of factors, even when oxygen saturation levels are normal. Some possible causes include:
- Physiological, pathological, or social origins 2
- Increased work of breathing, stimulation of receptors in the upper or lower airway, lung parenchyma, or chest wall, and excessive stimulation of the respiratory centre by central and peripheral chemoreceptors 2
- Uncommon causes, such as those not typically associated with shortness of breath, which may require careful consideration and evaluation 3
Specific Conditions that May Cause Dyspnea with Normal Oxygen Saturation
Certain conditions, such as portopulmonary hypertension and hepatopulmonary syndrome, can cause shortness of breath, even in the absence of low oxygen saturation 4. Other conditions, such as giant cell arteritis, can also cause dyspnea, although this may be accompanied by other symptoms, such as reduced oxygen saturation 5
Evaluation and Management of Dyspnea
The evaluation and management of dyspnea are directed by the clinical presentation and underlying cause 2, 6. A thorough work-up, including imaging and laboratory tests, may be necessary to determine the etiology of dyspnea in a given patient 6. In some cases, the management of dyspnea may involve complex and individualized approaches, particularly in patients with multiple comorbidities and frailty 4