to the Cause of Shortness of Breath
by Andrew Getzin, MD
Shortness of breath with exercise
is a common but perplexing problem for both patients and doctors. Apparently fit
athletes often struggle trying to figure out why they have problems with
exercise that would seem to be well within their capabilities. There are a number of possible causes
for shortness of breath, which makes this a very challenging diagnosis. Doctors don’t
always get it right.
The most common cause for
shortness of breath is asthma. Exercise is a trigger for 90% of
addition, non-asthmatics can often have an asthmatic-like response to exercise
called exercise-induced bronchospasm (EIB). Physicians often assume that when a
patient complains of shortness of breath the cause is asthma, and they appropriately
treat the problem with asthma medications. While this treatment can be effective
for some EIB patients, others are
left wondering why they are not getting relief.
What are the other
common causes of shortness of breath?
The most common causes, in
addition to asthma, are lack of fitness, vocal cord dysfunction, anemia, and
pulmonary or cardiac problems. The key to successfully helping
patients with shortness of breath is to obtain objective data that lead to an accurate diagnosis and
What is the
recommended diagnostic approach?
In the Department of Sports
Medicine and Athletic Performance at Cayuga Medical Center, we offer a special
multidisciplinary clinic to assess people who are troubled by shortness of
multi-specialty team is made up of Rob Strominger, MD (otolaryngology), Frank
Micale, MA (exercise physiology), a
respiratory therapist, and Andrew Getzin, MD (sports medicine). The key to
appropriate treatment is establishing a good assessment of the actual problem. We offer our
patients a maximum exercise treadmill test to assess their cardiac rhythm and
obtain their maximum oxygen uptake, the gold standard for cardiovascular fitness
couple this test with pre- and post-test
spirometry to assess for asthma and with
direct visualization of the patient’s vocal cords via a flexible fiber
optic tube to look for abnormal vocal cord closure. When indicated, we perform blood work
to rule out anemia and can obtain a chest x-ray to look for potential pulmonary
What happens once
the data are gathered?
With the information we are able
to collect, we can confirm an accurate diagnosis and
determine appropriate treatment. Depending on the specific problem, we may
recommend medications for asthma or anemia, speech therapy to address vocal
cord dysfunction, an exercise plan to develop a higher level of fitness, or
treatment for cardiac or pulmonary pathology that is revealed during the
We are very fortunate in Tompkins
County to be able to collaborate with experienced health-care professionals
from several different disciplines, working with a team approach to treat shortness
of breath in athletes.
We are helping people of all ages from around the upstate New
York region achieve better
performance in their chosen activities. The Shortness of Breath in Athletes
Clinic is held once a month at Cayuga Medical Center Sports Medicine, located
in the Island Health Center.
You can make an appointment by calling (607) 252-3580.
Getzin is clinical director of Cayuga Medical Center Sports Medicine and
Athletic Performance and is a member of the medical staff at Cayuga Medical
Center. He is
board certified in sports medicine, is a member of the American Society of
Sports Medicine, and serves as head team physician at Ithaca College and TC3. He is also a
competitive triathlete, earning All-American status with USA Triathlon.