Take note if you are still noticeably breathless more than 5 to 10 minutes after stopping a routine activity. (Photo: iStock/Wiphop Sathawirawong)

Short of breath, or something more? Doctors explain when to get checked

Whether it’s a short flight of stairs or anxiety, breathlessness happens. But if it lingers or feels out of proportion, it might signal something more serious.

10 May 2026, 23:16 by Khoo Bee Khim · CNA · Join

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Many things can take your breath away. Like running for the MRT, being told to give a last-minute presentation, or simply getting up from the chair once you're past a certain age.

“Some degree of breathlessness during physical exertion is normal. The key consideration is how quickly you recover and whether the response is proportionate to the activity,” said Dr Aneez DB Ahmed, the director and a senior consultant surgeon at International Centre For Thoracic Surgery, Mount Elizabeth Novena Specialist Centre.

As a guide, you should be able to revert to your normal breathing rate within a few minutes after mild to moderate exertion, said Dr Ahmed. “You should take note if you are still noticeably breathless more than 5 to 10 minutes after stopping a routine activity.” Other red flags, he highlighted, include:

The intensity of breathlessness feels disproportionate to what you were doing.
You find yourself needing to stop and rest during activities you previously managed without difficulty.
Breathlessness occurs at rest or with very minimal movement.

As a guide, you should be able to revert to your normal breathing rate within a few minutes after mild to moderate exertion. (Photo: iStock/Arnav Pratap Singh)

In addition, it is worth a trip to the doctor’s, advised Dr Chew Si Yuan, a consultant with Singapore General Hospital’s Department of Respiratory And Critical Care Medicine, if you also have been experiencing:

breathlessness when lying flat
coughing for more than six to eight weeks
prolonged sputum or phlegm
coughing up blood
wheezing or sounding hoarse
chest tightness
leg swelling
unexplained appetite or weight loss

But before you jump to the conclusion you have tuberculosis (especially if you live in Bedok) or lung cancer (that nagging feeling is there for smokers), find out what the doctors say about breathlessness.

WHAT CAN CAUSE BREATHLESSNESS?

Simply getting older can leave you gasping like a fish out of water. “In most individuals, the lung function naturally declines with age, starting around the mid-20s,” said Gleneagles Hospital’s respiratory physician, Dr Kam Li Wei Michelle. “By the time most individuals are in their 60s, most would have lost between 20 per cent to 30 per cent of their peak lung function.”

On average, Dr Kam continued, healthy, non-smoking individuals lose approximately 30ml of their forced expiratory volume in one second (FEV1) per year. “FEV1 is a measurement, which shows the volume of air one can blow out of their lungs in the first second, after taking a maximal deep breath.”

The reason for that, explained Dr Ahmed, is that the muscles involved in breathing may weaken, and the airways, “slightly less efficient at clearing mucus and particles”. As a result, you may notice a “modest reduction in exercise tolerance compared to your younger years”. You may also require slightly more effort for the same physical activities, or a longer recovery time after exertion, he said.

Many things can take your breath away. Like running for the MRT. (Photo: iStock/Kokkai Ng)

“These changes are expected to some degree,” said Dr Ahmed. “However, it is important to distinguish between the gradual, predictable changes of normal ageing and a decline that is faster than expected or accompanied by other symptoms. The latter may suggest an underlying condition rather than ageing alone.”

WHAT MEDICAL ISSUES CAN BE BEHIND THAT BREATHLESS FEELING?

Naturally, you’d suspect issues that affect the lungs, which according to Dr Kam, include asthma (inflammation causing the airways to narrow), interstitial lung disease (autoimmune diseases damaging and scarring the lungs), bronchiectasis (infection leading to the abnormal enlargement of the airways) and pulmonary hypertension (elevated blood pressure in the lungs’ blood circulatory system).

If you've been following the news, tuberculosis (a bacterial infection that causes severe inflammation and tissue damage) can also be a culprit.

“Any of those conditions can cause breathlessness both with activity and at rest, with symptoms becoming more pronounced and occurring with little activity and at rest with increasing severity,” said Dr Kam.

Other issues that take the wind out of your breathing organs, said Dr Chew, can be pulmonary embolism, where the lungs’ blood vessels are obstructed by blood clots; or pulmonary hypertension caused by a wide range of medical causes that narrow the blood vessels and result in reduced blood flow to the lungs.

Lung cancer can be another reason, particularly late-stage lung cancer, said Dr Ahmed. “Late-stage lung cancer becomes symptomatic due to either a tumour mass or effusion (an abnormal buildup of fluid in the space between the lungs and the chest wall).”

Late-stage lung cancer can cause breathlessness due to either a tumour mass or abnormal buildup of fluid in the space between the lungs and the chest wall. (Photo: iStock/utah778)

Breathlessness can sometimes be a sign of issues affecting other organs as well, said Dr Chew, such as congestive heart failure. “The breathlessness occurs because the heart cannot increase the pumping of blood to supply oxygen to the muscles when there is increased physical exertion.”

Other non-lung-related conditions include anaemia, thyroid issues, neuromuscular diseases and even obesity, said Dr Kam.

HOW DO YOU CHECK YOUR LUNGS’ HEALTH?

“There are currently no clinical guidelines that recommend routine lung testing in a healthy adult,” said Dr Chew.

But if you have a history of smoking and lung diseases such as asthma, lung infections or tuberculosis, ask about including a pulse oximetry and risk profile for chronic lung diseases during your health screening, suggested Dr Kam. Your doctor may then recommend lung specific tests like spirometry, chest X-rays and CT scans, she said.

TOOLS FOR ASSESSING LUNG HEALTH

Spirometry - measures how much air you can breathe out and how quickly.
Forced vital capacity (FVC) - measures the total volume of air you can forcefully blow out in a maximal exhalation breath.
Forced expiratory volume in one second (FEV1) - measures the volume of air you can forcefully blow out in the first second of a maximal exhalation breath.
FEV1/FVC - the ratio between FEV1 and FVC, which can help determine the presence of underlying airflow obstruction.
Diffusion capacity - measures the efficiency of gas transfer from the lungs into the bloodstream.
Lung volume - measures the total capacity of the lungs.
Arterial blood gas analysis – measures oxygen and carbon dioxide levels in the blood.
Chest imaging - including chest X-rays and CT scans of the thorax. They allow for a detailed assessment of the lung structure and can detect nodules, scarring or other abnormalities.
Six-minute walk test - measures the distance you can walk in six minutes and how your body’s oxygen levels change with activity.
Pulse oximetry - home test that measures blood oxygen saturation using a finger probe.

HOW MUCH MORE VIGILANT SHOULD SMOKERS BE?

“Amongst a multitude of serious chronic illnesses, smokers are at risk of contracting chronic obstructive pulmonary disease (COPD) and lung cancer,” said Dr Chew.

If you have smoked at least 10 pack years (that translates into one pack a day for 10 years), and have symptoms such as prolonged cough, wheezing and breathlessness, Dr Chew suggested asking for the spirometry.

“Smokers and ex-smokers (who quit within the last 15 years) with a smoking history of at least 20 pack years should also consider lung cancer screening with CT scans,” he added.

In fact, Dr Ahmed recommended smokers to go for “earlier and more frequent spirometry” to catch symptoms of COPD before they become prominent. In addition, ask for a low-dose CT scan of the thorax, he said, for early lung cancer detection. “Current guidelines in many centres recommend this for individuals aged 50 to 80 with a meaningful smoking history, though the specific criteria may vary.”

Smokers should also get any new respiratory symptoms – including a new or changed cough, unexplained breathlessness, chest tightness or wheezing, or blood in the sputum – checked promptly, the doctors advised. “This will enable their doctors to recommend specific tests such as lung function testing, chest computed tomography scans and monitoring as appropriate,” said Dr Kam.

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