How do I know if my breathing difficulties while running is due to a nose or heart problem?

Doctor's Answers 4

Thank you for your question. Breathing difficulties during exercise can be dependant on several factors including:

1) Your age

2) Your fitness level

3) Your general health status. If you have a medical condition that may compromise the delivery of blood and oxygen to your vital organs, you can feel breathless on exertion or during exercise. There can be many reasons for these including conditions from the lungs (e.g Asthma, bronchitis) and heart (e.g. congenital defects) to conditions of the blood (e.g. low blood level).

4) Intensity of your exercise regimen

Blocked nose from a sensitive nose (Rhinitis) should not result in shortness of breath or difficulty in breathing. You may feel "more difficult to breathe" because you have to resort to mouth breathing when your nose is blocked which may be uncomfortable. However, this shouldn't lead to inadequate oxygen flow to your lungs as your mouth and throat which is part of your upper airway should be able to cope with the increased airflow to your lungs during exercise.

We do know that uncontrolled Allergic Rhinitis can worsen Asthma and their co-existence is often known as United Airway Disease. Inflammatory mucous from the nose and sinuses (from Rhinitis or Sinusitis) can result in exacerbation of common lung conditions such as Asthma and Bronchitis. Since you mentioned that there is increased mucous in your nose, you may want to see an ENT Specialist to have your nose checked. This will likely involve a nasoendoscopy, a scope through the nose under local anaesthesia. If your ENT Specialist suspect that you may have United Airway Disease, he/she may refer you to a Lung Specialist (Respiratory Physician) who will likely perform a lung function test to assess the ability of your lungs to breathe. Certain types of Asthma can be worse during exercise.

If you have other symptoms such as chest pain, palpitation or light headedness during your run, you may have to see a Cardiologist who can perform stress tests to determine if your difficulty in breathing is due to a heart condition (less likely in a young patient like yourself unless there is an unknown congenital problem).

If after reading this and you are still unsure, perhaps a visit to a General Practitioner will be a good start.

Hope this helps and all the best!

Agree with the answer by my ENT colleague.

From the perspective of the cardiologist, while it is unlikely that an active 17 year old who was able to carry out physical activities with no limitation until recently will have significant heart conditions, it is not entirely unknown.

If there is a heart condition, however, symptoms are longstanding and are usually present from birth. Other symptoms like palpitations and dizziness can accompany the breathlessness though chest pain is not common. Simple tests such as ECG and Echocardiography can be useful.

The fact that you have been using nasacort for a sensitive nose recently points towards nasal or airway issues as the more likely cause. Of course, general medical conditions such as anaemia etc have to be ruled out as well.

Your family physician who knows your medical history maybe the best person to guide you as a thorough history and examination are necessary to ensure the right diagnosis is reached.

Hope your issues are resolved at the earliest. Wishing you good health!

Regards

Dr Nandakumar

Thank you for your question - and a great one it is!

My colleagues have given you excellent answers and I certainly wont repeat them, but the one thing I might add is it might be worth seeing a respiratory/sports physician who is experienced with runners.

You see, sometimes breathing difficulties can also be due to exercise-induced asthma. If you are having a runny nose and congestion, you will most likely have an element of atophy (asthma, eczema, allergic rhinitis). Sometimes, this can manifest in exercise-induced asthma too.

Seeing someone and being assessed for this might be helpful!

Good luck with your running and symptoms.

BW

Dr Dinesh

Agree with the answer by my ENT colleague.

From the perspective of the cardiologist, while it is unlikely that an active 17 year old who was able to carry out physical activities with no limitation until recently will have significant heart conditions, it is not entirely unknown.

If there is a heart condition, however, symptoms are longstanding and are usually present from birth. Other symptoms like palpitations and dizziness can accompany the breathlessness though chest pain is not common. Simple tests such as ECG and Echocardiography can be useful.

The fact that you have been using nasacort for a sensitive nose recently points towards nasal or airway issues as the more likely cause. Of course, general medical conditions such as anaemia etc have to be ruled out as well.

Your family physician who knows your medical history maybe the best person to guide you as a thorough history and examination are necessary to ensure the right diagnosis is reached.

Hope your issues are resolved at the earliest. Wishing you good health!

Regards

Dr Nandakumar

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