Category: Respiratory & Lung Health

Asthma and chronic obstructive pulmonary disease (COPD) are common long-term lung conditions. Both can cause breathlessness, coughing and wheezing, but their causes, patterns and treatment are not identical.

Asthma

Asthma involves inflammation and narrowing of the airways. Symptoms can vary over time and may be triggered by exercise, allergens, respiratory infections, smoke, cold air or other irritants.

COPD

COPD causes persistent airflow limitation and includes emphysema and chronic bronchitis. Tobacco smoke is an important risk factor, although occupational and environmental exposures can also contribute.

Why the distinction matters

Inhaled medicines are important in both conditions, but treatment differs. Correct inhaler technique is essential. If you use an inhaler, ask a healthcare professional to periodically check how you use it.

Reducing risk

Avoiding tobacco smoke is one of the most important measures for lung health. Vaccination, appropriate physical activity and pulmonary rehabilitation where indicated may also form part of care.

When to seek urgent help

Severe or rapidly worsening breathlessness, difficulty speaking because of breathlessness, confusion, blue or grey lips or skin, or poor response to prescribed rescue treatment requires urgent medical attention.

This is general information and does not replace individual diagnosis or treatment.

Ask for an action plan

An individual action plan explains everyday treatment, signs of worsening symptoms and what to do next. Ask the team to watch you use each inhaler: devices have different techniques. Check how to tell when a device is empty and whether a spacer is appropriate. Keep prescribed treatment available when travelling or away from home.

Review the diagnosis and the environment

Breathing tests can help distinguish causes of persistent symptoms. Tell the clinician about tobacco smoke, dust, fumes, workplace exposures and indoor cooking smoke. If symptoms continue despite treatment, the next step may be reviewing technique, adherence, triggers or the diagnosis, rather than simply using more reliever medicine.

Practical checklist

1. Bring every inhaler to the appointment.
2. Demonstrate your usual technique and ask for corrections.
3. Request a written worsening-symptom plan.
4. Discuss smoking cessation, vaccination and rehabilitation if appropriate.
5. Check medicine access before supplies run out.

Common question

Can breathing exercises replace inhaled medicines?

No. They may support some people, but should not replace prescribed treatment or delay emergency help for severe breathlessness.

Sources and further reading

• WHO: asthma
• WHO: chronic respiratory diseases

Related support

Use our appointment preparation guide, resources and community support to plan your next step.

Sources checked 22 September 2026. General education, not individual medical advice. International service arrangements may differ from South Africa. Featured artwork is illustrative, not a patient testimonial.

Breathlessness can range from feeling slightly winded to feeling as though you cannot get enough air. It may occur with exertion, at rest, suddenly or gradually. Because the lungs, heart, blood and nervous system all contribute to breathing, there are many possible causes.

Common causes

Respiratory causes include asthma, respiratory infections, chronic obstructive pulmonary disease and other lung conditions. Breathlessness can also occur with heart disease, anaemia, blood clots, anxiety or panic, deconditioning and a range of less common conditions. More than one factor may be present at the same time.

When breathlessness is an emergency

Seek urgent medical care for severe or rapidly worsening difficulty breathing, blue or grey lips or skin, confusion, fainting, significant chest pain, coughing up blood, or breathlessness accompanied by signs of a serious allergic reaction. Sudden unexplained breathlessness also deserves urgent assessment, particularly when accompanied by chest pain, a very fast heartbeat or one-sided leg swelling.

What a clinician may ask

Useful details include when the problem began, whether it is getting worse, what triggers it, whether you wheeze or cough, whether you have fever or chest discomfort, and whether you become breathless when lying flat. Tell the clinician about smoking or vaping, recent infections, travel or immobility, medications and existing heart or lung conditions.

Possible investigations

Depending on the situation, assessment may include oxygen saturation, examination of the heart and lungs, blood tests, an ECG, chest imaging or lung-function testing. Not everyone needs every test; the pattern of symptoms and examination findings guides the investigation.

Living with chronic breathlessness

If breathlessness is caused by a long-term condition, treatment should address the underlying cause. Pulmonary rehabilitation, appropriate physical activity, breathing techniques and correct inhaler use can be important for some people. Ask for your inhaler technique to be checked periodically if you use one.

Do not assume it is anxiety

Anxiety can cause genuine breathlessness and can amplify symptoms from other conditions, but new or unexplained breathing difficulty should not automatically be attributed to anxiety. A medical assessment can help determine what is happening.

This article is general information. Severe or sudden breathing difficulty requires urgent medical attention.

What to do while arranging help

If breathing is severe, suddenly worsening, or accompanied by collapse, chest pain or confusion, call emergency services now. In South Africa, call 112 from a cellphone or 10177 for an ambulance. Follow the dispatcher’s instructions and avoid driving yourself. Sit in a position that makes breathing easier and use your own prescribed rescue treatment according to your action plan. Do not borrow medicines or assume that breathing exercises will treat an unknown cause.

A useful symptom record

1. Write down whether symptoms began suddenly or gradually.
2. Describe what you could do before and what you can do now, such as walking to the bathroom.
3. Note fever, cough, wheeze, chest pain, ankle swelling or difficulty lying flat.
4. List recent surgery, prolonged travel, infections and medicine changes.
5. Bring inhalers and ask someone to check technique.

A home oxygen reading cannot explain the cause or reliably rule out a serious problem. Seek help for worrying symptoms even when a device gives a reassuring number.

Sources and further reading

• NHS: shortness of breath and emergency warning signs (UK service numbers differ from South Africa).
• Western Cape Government: emergency numbers.

Related support

Explore our practical resources and community support. For nutrition questions, browse Keto & Metabolic Health.

Sources checked 22 September 2026. General education; individual care should be discussed with a qualified healthcare professional.