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Causes of Shortness of Breath After Walking Up a Flight of Stairs

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Last updated February 13, 2024

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Shortness of breath, also known as dyspnea, when climbing a flight of stairs can be caused by a respiratory condition like COPD or asthma. Cardiac conditions can also cause a fast heartbeat with shortness of breath. Read now for more information on causes and treatment options.

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Symptoms of shortness of breath after 1 flight of stairs

Experiencing shortness of breath after climbing one flight of stairs may be occurring simply due to fatigue. However, in order to rule out any underlying conditions, let's examine the following. Shortness of breath, or dyspnea, can best be described as breathing discomfort. Some people with shortness of breath describe it as chest tightness or difficulty catching their breath, while others may feel like they cannot get enough air.

Common accompanying symptoms

Shortness of breath can be frightening, especially because it is can often be associated with the following symptoms.

Is shortness of breath ever normal?

It is important to note that shortness of breath can be a normal physiological response in certain situations. For example, during intense exercise, the body responds by increasing the breathing rate to remove carbon dioxide (a waste product created when energy is produced), bring in oxygen, and maintain blood flow to the working muscles.

However, dyspnea during activities that you once completed without symptoms should create concern. For example, if you could walk up one flight of stairs or walk two blocks without experiencing shortness of breath, but now notice symptoms while doing these activities, you should make an appointment with your physician. Furthermore, if you experience dyspnea in the absence of physical activity, seek medical treatment promptly as well.

What causes shortness of breath after 1 flight of stairs?

The causes of shortness of breath vary and may be short-lived or chronic, even life-threatening conditions. You should see a physician if you experience shortness of breath after an activity that you once found easy or normal. The following details may help you better understand your symptoms in the meantime.

Pulmonary/Respiratory causes

The respiratory system requires the lungs, brain, and chest muscles to remove carbon dioxide from the body and provide oxygen for the blood. Any process that disrupts or damages this system can result in dyspnea [4,6].

  • Obstruction: If the lungs or the system of branching windpipes (bronchi) and blood vessels become obstructed, from blood clots or foreign objects, for example, this can result in acute (immediate) symptoms of dyspnea.
  • Inflammation: If the lungs become inflamed from irritants such as infections, allergens, or chronic conditions such as asthma, this can result in dyspnea. Pneumonia, for example, inflames the airways and fills the air sacs of the lungs with fluid, impairing proper oxygen exchange. In conditions such as chronic obstructive pulmonary disease (COPD), the airways can become inflamed, narrowed, and damaged over time due to activities such as smoking.

Cardiovascular causes

The cardiovascular system is responsible for pumping oxygenated blood from the lungs to all of the tissues in the body in an effective manner. Any process that disrupts or damages this system can also result in shortness of breath.

  • Obstructive: In order for the heart to pump blood effectively, it needs its own blood supply. A complex network of arteries supplies the heart with blood and the proper amount of oxygen and nutrients. In certain conditions such as atherosclerosis, a hardening or narrowing of the arteries, these vessels can become blocked and limit blood flow to the heart. When blood flow is limited, the heart muscle can become severely injured and result in myocardial infarction, or a heart attack. Heart attacks cause dyspnea because the heart is suddenly not pumping blood back to the lungs or body properly.
  • Weakness: Similarly, the heart's ability to pump blood to the body can be compromised because the heart muscles become functionally weak. This condition is known as heart failure or congestive heart failure (CHF). Heart failure is a chronic condition in which the heart does not properly pump blood forward to the body. Pressure and fluid build-up in the lungs, causing congestion and other problems such as swelling.

Environmental causes

Environmental causes can be related to lifestyle habits or certain events.

  • Deconditioning: A sedentary lifestyle that does not involve much physical activity can result in dyspnea even with small tasks. Your heart is rarely working at its maximal output, so over time, this maximum output lessens, and the heart needs to work harder and beat faster in order to pump the necessary blood needed to oxygenate the muscles and complete activities.
  • Weight: Individuals who are overweight can experience dyspnea related to deconditioning, but weight gain also related to pregnancy can result in shortness of breath. Pregnancy changes your circulatory and respiratory systems in order to account for the growing fetus.

This list does not constitute medical advice and may not accurately represent what you have.

Narrowing of the aortic valve

Narrowing of the aortic valve is also called aortic valve stenosis, aortic stenosis, or AS. The aortic valve controls the flow of blood from the heart into the aorta, the body's main artery. If the aortic valve is abnormally narrow, the blood being pushed through it is blocked. Pressure may build up within the heart, causing damage.

AS may be caused by a congenital malformation of the valve, or by calcium deposits and/or the scarring that occurs as a person ages.

Symptoms may not appear right away. There will be chest pain with the feeling of pounding heartbeat, as well as shortness of breath with fatigue, lightheadedness, or even fainting.

It is important to see a medical provider for these symptoms, since AS can lead to stroke, blood clots, and heart failure.

Diagnosis is made through physical examination, echocardiogram, CT scan, and sometimes a stress test.

Treatment may simply involve monitoring and medication, while making lifestyle improvements in diet, exercise, weight, and smoking. Surgery to repair or replace the faulty aortic valve may be recommended.

Rarity: Uncommon

Top Symptoms: fatigue, shortness of breath, chest pain, shortness of breath on exertion, decreased exercise tolerance

Urgency: Hospital emergency room

Viral pneumonia

Viral pneumonia, also called "viral walking pneumonia," is an infection of the lung tissue with influenza ("flu") or other viruses.

These viruses spread through the air when an infected person coughs or sneezes.

Those with weakened immune systems are most susceptible, such as young children, the elderly, and anyone receiving chemotherapy or organ transplant medications.

Symptoms may be mild at first. Most common are cough showing mucus or blood; high fever with shaking chills; shortness of breath; headache; fatigue; and sharp chest pain on deep breathing or coughing.

Medical care is needed right away. If not treated, viral pneumonia can lead to respiratory and organ failure.

Diagnosis is made through chest x-ray. A blood draw or nasal swab may be done for further testing.

Antibiotics do not work against viruses and will not help viral pneumonia. Treatment involves antiviral drugs, corticosteroids, oxygen, pain/fever reducers such as ibuprofen, and fluids. IV (intravenous) fluids may be needed to prevent dehydration.

Prevention consists of flu shots as well as frequent and thorough handwashing.

Rarity: Uncommon

Top Symptoms: fatigue, headache, cough, shortness of breath, loss of appetite

Urgency: Primary care doctor

Severe asthma attack

Asthma attack is also called asthma exacerbation. An attack causes the muscles of the airways to contract, the tissues to swell and produce mucus, and the bronchial tubes in the lungs to become narrow. This makes breathing very difficult.

Asthma is caused by an immune system that is too easily triggered by environmental factors, such as an upper respiratory infection (a cold or the flu;) tobacco smoke; dust; pets; cold air; and stress.

Most susceptible are those with repeated attacks, since the constant inflammation tends to cause further episodes.

Symptoms include wheezing, coughing, severe shortness of breath, chest tightness, chest pain, and inability to speak due to breathlessness.

A severe asthma attack is a life-threatening medical emergency. If the symptoms do not quickly respond to treatment with a fast-acting (rescue) inhaler, take the patient to the emergency room or call 9-1-1.

Treatment involves preventing colds, getting flu shots, and working with the medical provider to create a written set of instructions for whenever an attack might break out.

Rarity: Common

Top Symptoms: being severely ill, shortness of breath at rest, wheezing, irritability, cough with dry or watery sputum

Symptoms that always occur with severe asthma attack: shortness of breath at rest, being severely ill

Urgency: Hospital emergency room

Myocarditis

Myocarditis is an inflammation of the heart muscle, also called the myocardium.

It is a rare complication of any viral, bacterial, parasitic, or fungal infection. Reaction to drugs, medications, chemicals, or even radiation can bring about myocarditis.

Anyone with a weakened immune system or pre-existing heart condition is susceptible.

Symptoms include fatigue, chest pain, and shortness of breath, especially following a viral upper respiratory illness. Swelling of the feet and legs from poor circulation may be seen.

If symptoms are severe, take the patient to the emergency room or call 9-1-1. Myocarditis weakens the heart so that it cannot pump blood as it should. Blood clots, stroke, heart attack, abnormal heart rhythm (arrhythmia,) and sudden cardiac death can result without treatment.

Diagnosis is made by electrocardiogram (ECG,) chest x-ray, MRI, echocardiogram, and blood tests.

Short-term treatment is with rest and medication, depending on what kind of illness brought about the myocarditis. Sometimes, devices to support the heartbeat may be surgically implanted.

Long-term treatment may involve medicines such as ACE inhibitors, ARBs, beta blockers, and diuretics.

Rarity: Rare

Top Symptoms: fatigue, headache, shortness of breath, muscle aches, chest pain

Urgency: Hospital emergency room

Iron deficiency anemia

Iron deficiency anemia means that the body does not have enough iron to form hemoglobin, the protein in red blood cells that carries oxygen throughout the body.

The condition is caused by:

  • Acute blood loss through injury, surgery, or childbirth.
  • Chronic blood loss through an ulcer, overuse of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs,) or heavy menstrual periods.
  • Inability to absorb dietary iron due to intestinal surgery or disease, or interference from certain medications.
  • A diet low in iron-supplying foods.

Symptoms include fatigue, shortness of breath, lack of endurance, and chest pain with rapid and irregular heartbeat.

If not treated, iron deficiency anemia can lead to heart disease because the heart has to pump extra blood to get enough oxygen to the tissues. Developmental problems in children can also occur.

Diagnosis is made through physical examination and blood tests.

Treatment includes a diet higher in iron-rich foods, such as red meat and dark green leafy vegetables, along with iron supplements. Severe cases may require hospitalization for blood transfusion and/or intravenous iron therapy.

Chronic obstructive pulmonary disease (COPD)

Chronic obstructive pulmonary disease (COPD) is a progressive inflammation of the lungs that makes breathing difficult. It is caused by long-term exposure to irritating gases and/or dust particles, most often cigarette smoke.

Symptoms may take years to develop. They include a chronic cough with mucus (sputum), wheezing, chest tightness, fatigue, constant colds, swollen ankles, and cyanosis (blue tinge to the lips and/or fingernails.) Depression is often a factor due to reduced quality of life.

Treatment is important because there is a greater risk of heart disease and lung cancer in COPD patients. Though the condition cannot be cured, it can be managed to reduce risks and allow good quality of life.

COPD is commonly misdiagnosed and so careful testing is done. Diagnosis is made through patient history; physical examination; lung function tests; blood tests; and chest x-ray or CT scan.

Treatment involves quitting smoking and avoiding exposure to other lung irritants; use of inhalers to ease symptoms; steroids; lung therapies; and getting influenza and pneumonia vaccines as recommended.

Rarity: Common

Top Symptoms: fatigue, cough and dyspnea related to smoking, cough, shortness of breath, trouble sleeping

Symptoms that always occur with chronic obstructive pulmonary disease (copd): cough and dyspnea related to smoking

Symptoms that never occur with chronic obstructive pulmonary disease (copd): rectal bleeding

Urgency: Primary care doctor

Chest pain from reduced cardiac blood flow (angina pectoris)

Angina pectoris is chest pain that happens when heart muscle needs more blood than it is currently getting. This may result from coronary artery disease (CAD). CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls.

You should visit your primary care physician within the next 24 hours. Your doctor will perform a thorough physical exam as well as an EKG (electrocardiogram) to see how your heart is beating. Prescription medication may be used to relax blood vessels, easing the heart's workload. A referral to a cardiologist might be needed.

Rarity: Common

Top Symptoms: chest pain, chest pain, tight, heavy, squeezing chest pain, moderate chest pain, deep chest pain, behind the breast bone

Symptoms that always occur with chest pain from reduced cardiac blood flow (angina pectoris): chest pain

Symptoms that never occur with chest pain from reduced cardiac blood flow (angina pectoris): productive cough

Urgency: Primary care doctor

Atrial fibrillation

Atrial fibrillation, or AFib or AF, is a rapid, quivering, abnormal heartbeat. It occurs when electrical signals in the two upper chambers of the heart do not coordinate with signals in the two lower chambers.

Heart damage from high blood pressure, congenital heart defects, viral infections, and sleep apnea can cause atrial fibrillation. Other risk factors include increasing age, obesity, family history, and drinking alcohol.

The patient may notice a jerky, fluttering heartbeat; shortness of breath; and weakness. Chest pain is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Untreated atrial fibrillation may lead to heart failure. Blood clots can form in the stalled circulation within the quivering heart, travel to other parts of the body, and cut off the blood flow to other organs.

Diagnosis is made through electrocardiogram, echocardiogram, blood test, stress test, and chest x-ray.

Treatment involves cardioversion with mild electrical shock or medication to return the heart to normal rhythm. Surgery may be done. Blood thinners and medication to maintain heart rhythm will be prescribed.

Aortic valve regurgitation

The aorta is the large blood vessel which leads directly out of the heart. If the heart's aortic valve – which controls the flow of blood out of the heart and into the aorta – does not close tightly between heartbeats, some of the blood flows backward into the heart instead of out into the aorta.

This condition may be present at birth or develop through calcium deposits that build up as a person ages. Other causes are illnesses such as endocarditis, rheumatic fever, or lupus.

Symptoms may take years to develop and include fatigue and lightheadedness; chest pain and shortness of breath during exercise; swollen feet and ankles; and irregular, fluttering heartbeat.

Aortic valve regurgitation can lead to heart failure, which is life-threatening. If the above symptoms are present, the person should see a medical provider as soon as possible.

Diagnosis is made through patient history, physical examination, chest x-ray, stress tests, echocardiogram, and electrocardiogram.

Treatment involves lifestyle changes; some medications; and sometimes surgery to repair or replace the aortic valve.

Shortness of breath after 1 flight of stairs treatments and relief

When to see a doctor

Dyspnea is often the result of a combination of causes, and can also be acute or chronic, making it important to see a physician if it persists or worsens. Your physician will work closely with you in order to develop the appropriate treatment regimen for you, which may include the following.

  • Antibiotics: If your dyspnea is due to a lung infection, your physician will provide the appropriate antibiotics. Viral causes of pneumonia will not be treated with antibiotics and are best managed with supportive care (fluids, bed rest, etc.).
  • Steroids: Steroids are used for their anti-inflammatory properties and can help limit the effects of diseases such as asthma and COPD. These medications are often given in inhalers but can also be given in pill form or injected.
  • Bronchodilators: Bronchodilators are medications that open the airways and are commonly used to treat COPD and asthma. They are often given in an inhaler or nebulizer.

Prevention

Fortunately, there are many things you can do at home to both prevent and treat conditions related to shortness of breath.

  • Don't smoke: Smoking is the number one cause of diseases such as COPD and can irritate conditions such as asthma and pneumonia. Quitting smoking can go a long way in helping prevent and relieve symptoms.
  • Exercise: Exercise keeps the heart strong and allows it to pump effectively during various activities. The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic exercise for at least five days a week for adults.

When it is an emergency

Seek emergency medical attention if you notice the following symptoms.

  • You have shortness of breath and think you are having a heart attack: Due to chest tightness, nausea, or sweating
  • You have severe shortness of breath: Meaning it's even hard to breathe when you are sitting still
  • An allergic reaction with shortness of breath

FAQs about shortness of breath after 1 flight of stairs

Can I exercise with a lung condition?

Yes, in fact, exercising with a lung condition can often help improve symptoms. However, it is important to always consult your physician before starting an exercise regimen. Exercise programs must be adapted to your level of physical activity and change as you improve stamina and experience fewer symptoms.

Can I grow out of my asthma?

Many children do not completely "grow out" of their asthma [8]. Asthma symptoms can improve or worsen over time, and for some adults, symptoms may not be triggered for many reasons. However, symptoms such as coughing and wheezing can also occur due to allergens, weather changes, and other conditions such as pneumonia. It is important to follow up with your physician if you had asthma and believe it is recurring.

Is dyspnea life-threatening?

Dyspnea can be life-threatening in the setting of conditions such as a myocardial infarction (a heart attack), or a pulmonary embolism (a blood clot in the arteries of the lungs). Shortness of breath should never be ignored, especially if it occurs during activities you once completed with ease.

Is pneumonia contagious?

Yes, pneumonia is a lung infection that can be caused by bacteria, fungi, or viruses. Some of these pathogens can spread from person to person, especially through respiratory droplets created in the air from coughing and sneezing. This makes it very important to wash your hands, cover your mouth, and not share drinks or related items.

How is shortness of breath treated?

Shortness of breath is treated in different ways and depends on the cause. Your physician will discuss multiple options, such as oxygen, inhaled bronchodilators or steroids, antibiotics, etc., and develop a treatment plan tailored to you.

Questions your doctor may ask about shortness of breath after 1 flight of stairs

  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Do you notice your heart beating hard, rapidly, or irregularly (also called palpitations)?
  • Do you have a cough?
  • Any fever today or during the last week?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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  8. Asthma: Facts or fiction? Palo Alto Medical Foundation. PAMF Link
  9. Growing out of asthma. National Health Service. Published August 18, 2008. NHS Link