Should I go to the ER for my breathing difficulties and other symptoms?

Should You Go to the ER for Breathing Difficulties?

Yes, you should go to the emergency department immediately if you have breathing difficulties, especially given the duration and associated symptoms you describe.

Immediate ER Evaluation is Warranted

Your presentation requires urgent assessment because:

• Dyspnea accounts for 8.4% of emergency department visits and frequently indicates serious underlying disease, most commonly pulmonary or cardiovascular conditions that require prompt diagnosis 1
• Breathing difficulties lasting hours with associated symptoms represent a potentially unstable situation that needs immediate evaluation to rule out life-threatening causes 2
• The initial goal in acute dyspnea is determining severity with respect to need for oxygenation, which can only be properly assessed in an emergency setting 2

Warning Signs That Demand Immediate ER Care

You should seek emergency care right now if you have any of these accompanying symptoms:

• Altered mental status, confusion, or difficulty staying alert 3
• Chest pain or pressure (ischemic chest discomfort) 3, 4
• Severe shortness of breath at rest 1
• Rapid heart rate (>150 beats per minute) or irregular heartbeat 3, 4
• Lightheadedness, near-syncope, or feeling like you might pass out 4, 5
• Inability to speak in full sentences due to breathlessness 1
• Bluish discoloration of lips or fingertips (cyanosis) 2

What the ER Will Assess

The emergency department evaluation will focus on:

• Vital signs including oxygen saturation, as hypoxemia is a common reversible cause of breathing difficulty 3, 2
• Physical examination focusing on heart sounds, lung sounds, and signs of respiratory distress (such as intercostal retractions, use of accessory muscles) 1, 2
• 12-lead ECG to evaluate for cardiac causes, as dyspnea can indicate heart failure, arrhythmias, or ischemia 1, 3
• Chest radiography to identify pulmonary causes including pneumonia, pulmonary edema, or pneumothorax 1, 2
• Laboratory testing including complete blood count (to check for anemia as a cause) 2

Common Cardiac and Pulmonary Causes Requiring Urgent Care

Cardiac causes that present with dyspnea include:

• Heart failure with pulmonary edema 1
• Acute coronary syndrome 3
• Arrhythmias causing hemodynamic compromise 3
• Valvular heart disease 1

Pulmonary causes requiring immediate evaluation include:

• Pneumonia or other respiratory infections 1
• Pulmonary embolism (blood clot in the lungs) 6
• Asthma exacerbation or chronic obstructive pulmonary disease (COPD) flare 1
• Pneumothorax (collapsed lung) 2

Critical Pitfall to Avoid

Do not assume your breathing difficulty is "just anxiety" without proper medical evaluation, as conditions like supraventricular tachycardia and serious cardiac arrhythmias present with nearly identical symptoms to panic attacks 4. Even if anxiety is contributing, the ER must first rule out life-threatening causes 4, 2.

When Telephone Triage Suggests Immediate ER Visit

Call 911 or go to the ER immediately rather than waiting for an office appointment if you have:

• Breathing difficulty severe enough that you're considering whether to seek emergency care 2
• Any of the warning signs listed above 3, 4
• Progressive worsening of symptoms over hours 2

The emergency department is equipped to provide supplemental oxygen, establish IV access, perform immediate diagnostic testing, and provide life-saving interventions if needed 2. Stable patients can be managed based on the underlying cause once identified, but determining stability requires professional assessment 2.