Can you have shortness of breath with normal oxygen levels

Summary

When you're short of breath, it's hard or uncomfortable for you to take in the oxygen your body needs. You may feel as if you're not getting enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense exercise. But shortness of breath can also be a sign of a serious disease.

Many conditions can make you feel short of breath:

  • Lung conditions such as asthma, emphysema, or pneumonia
  • Problems with your trachea or bronchi, which are part of your airway system
  • Heart disease can make you feel breathless if your heart cannot pump enough blood to supply oxygen to your body
  • Anxiety and panic attacks
  • Allergies

If you often have trouble breathing, it is important to find out the cause.

Start Here

  • Breathlessness (American Thoracic Society) - PDF
  • Shortness of Breath (American Academy of Family Physicians) Also in Spanish
  • Shortness of Breath (American Heart Association)
  • Shortness of Breath (Mayo Foundation for Medical Education and Research) Also in Spanish

  • Hypoxemia (Low Blood Oxygen) (Mayo Foundation for Medical Education and Research) Also in Spanish
  • Obesity Hypoventilation Syndrome
    Can you have shortness of breath with normal oxygen levels
    (National Heart, Lung, and Blood Institute)

  • ClinicalTrials.gov: Dyspnea
    Can you have shortness of breath with normal oxygen levels
    (National Institutes of Health)

  • Eldercare at Home: Breathing Problems (AGS Foundation for Health in Aging)

  • Blood gases (Medical Encyclopedia) Also in Spanish
  • Breath sounds (Medical Encyclopedia) Also in Spanish
  • Breathing difficulty (Medical Encyclopedia) Also in Spanish
  • Breathing difficulty - lying down (Medical Encyclopedia) Also in Spanish
  • How to breathe when you are short of breath (Medical Encyclopedia) Also in Spanish
  • How to Properly Put On, Take Off a Disposable Respirator (Centers for Disease Control and Prevention) - PDF Also in Spanish
  • Pulmonary function tests (Medical Encyclopedia) Also in Spanish
  • Rapid shallow breathing (Medical Encyclopedia) Also in Spanish
  • Wheezing (Medical Encyclopedia) Also in Spanish

On this page, we explain how the cause of breathlessness is diagnosed. It includes information on what will happen when you see your doctor, the questions they might ask, tests they’ll do and how long it will take to get a diagnosis.

Breathlessness is often dismissed as a normal part of ageing, so people don’t tell their doctor. Some people feel responsible for causing their illness and don’t feel they deserve help. While others don’t realise they can get any help for their breathlessness. But getting a diagnosis is very important. If you know what’s causing your breathlessness, you can find out what can help. The earlier you get a diagnosis, the better. And you may feel less anxious once you have a diagnosis.

Use our online breath test to find out if your breathlessness is something to get checked out with your doctor.

On this page:

  • What will happen when I see my doctor?
  • What questions will my doctor ask?
  • What tests will my doctor do?
  • How long will it take to get a diagnosis?

What will happen when I see my doctor?

You may not actually feel out of breath when you see your doctor - you’ll be sitting down and may have only walked a short distance. So, think about how you’ll describe your breathlessness. If you’d find it useful, you could bring someone with you who can help describe your breathlessness.

Your doctor should show you the MRC breathlessness scale to help describe how breathless you get.

The MRC breathlessness scale

The scale health care professionals usually use to measure breathlessness is the Medical Research Council (MRC) breathlessness scale. This does not recognise other aspects of breathlessness – such as how you think or feel about getting out of breath.

The MRC scale shows what your breathlessness stops you doing. Your grade is the one that describes you when you’re at your best.

Grade

Degree of breathlessness related to activities

1Not troubled by breathlessness except on strenuous exercise
2Short of breath when hurrying on the level or walking up a slight hill
3

Walks  slower than most people on the level, stops after a mile or so, or stops after 15 minutes walking at own pace

4Stops for breath after walking about 100 yards or after a few minutes on level ground
5Too breathless to leave the house, or breathless when undressing

It’s also important to tell the doctor:

  • what you used to be able to do that you can’t do any more
  • what people of your age around you do that you find difficult
  • what your personal goals are for your day-to-day activity

You might find it useful to use local landmarks such as bus stops, shops and hills to help you describe these things.

If you have a phone with a camera, you could record the sort of activities that make you out of breath so you can show your doctor what it looks or sounds like. 


What questions will my doctor ask?

These are the sort of questions your doctor may ask:

  • How long have you been feeling breathless and how quickly did it come on?
  • Does it come and go or is it there all the time?
  • Is there any pattern to your breathlessness? 
  • Does it start or get worse at any particular time of day?
  • Does it come on or get worse when you lie flat?
  • Does anything bring it on? For example, pollen, pets or medication?
  • Do you smoke?
  • Do you also have a cough or bring up phlegm?
  • Do you get chest pain, palpitations or ankle swelling?
  • How active are you usually? Don’t forget everyday activities, such as walking or DIY.
  • What’s your job or occupation (both current and previous)?
  • Is your breathlessness related to certain times at work?
  • Do you have a history of heart, lung or thyroid disease, or of anaemia?
  • Do you have any family history of breathlessness?
  • Have you made any changes in your life because of your shortness of breath? 
  • Do you feel worried, frightened, depressed or hopeless?
  • What have you done to help you cope with the way you’re feeling?

Your answers are important because they will help your doctor to understand what’s causing your breathlessness. It would be a good idea to take your answers to these questions with you to your doctor’s appointment.


What tests will my doctor do?

Your doctor is likely to do some tests to help diagnose what’s causing your breathlessness.

They may:

  • do some breathing and lung function tests
  • check the number of breaths you take every minute, listen to your chest, and look and feel how your chest moves as you breathe
  • check your heart rate and rhythm, and check if fluid is building up in your ankles or lungs
  • check your blood pressure and temperature
  • check your height, weight, waist and body mass index
  • examine your head, neck and armpits to see if your lymph glands are swollen
  • look at your eyes, nails, skin and joints
  • check your blood oxygen levels with a pulse oximeter

If your doctor spots signs that you’re anxious or depressed, they may also ask you to do a short questionnaire.

You might be referred for more tests at your GP surgery, a local testing centre or hospital. For example:

  • a chest X-ray
  • a spirometry test
  • an electrocardiogram or ECG - if your breathlessness is intermittent, you might be asked to wear a portable recorder for 24 hours or seven days to record your heart’s electrical activity
  • an echocardiogram - this is a non-invasive ultrasound of your heart which can tell how well it’s working
  • blood tests to detect anaemia, allergies or any thyroid, liver, kidney or heart problems.

How long will it take to get a diagnosis? 

Getting a diagnosis for the cause of long-term breathlessness can take some time. Your health care professional must consider all possible causes. You may need to take repeated tests and try various treatments before the cause is identified. 

Next: Treating breathlessness

Download our breathlessness information (PDF, 582KB)

What causes shortness of breath with normal oxygen saturation?

Shortness of breath is often a symptom of heart and lung problems. But it can also be a sign of other conditions like asthma, allergies or anxiety. Intense exercise or having a cold can also make you feel breathless.

Do oxygen levels drop with shortness of breath?

Very often, if you have a condition that causes breathlessness, you will experience a lower oxygen saturation and higher heart rate as a result.

What is the most common cause of shortness of breath?

Most cases of shortness of breath are due to heart or lung conditions. Your heart and lungs are involved in transporting oxygen to your tissues and removing carbon dioxide, and problems with either of these processes affect your breathing.

When should I be concerned about shortness of breath?

Seek emergency medical care if your shortness of breath is accompanied by chest pain, fainting, nausea, a bluish tinge to lips or nails, or a change in mental alertness — as these may be signs of a heart attack or pulmonary embolism.