Shortness of Breath

You are unable to get enough air, sometimes feeling a tightness in your chest, or you can’t take deep enough breaths. You have a −(IE) penalty on all saving throws against gas-based poison attacks and Constitution checks related to exertion. After three rounds of strenuous physical action such as melee combat, you must succeed on a DC 8 + (IE) Constitution saving throw or take one level of exhaustion until you stop the activity and rest for (IE)d10 minutes. Each round you continue, you need to succeed on an additional saving throw, and the DC increases by 1 each round. When traveling without a mount or vehicle, you cover (IE) × ten percent less distance. Travel in a low-oxygen area, like mountains, increases the IE by 1–2, depending on the elevation. Because you’re used to assessing your physical capacity and finding creative solutions to perform physical tasks, once per long rest, you can choose to roll a Strength, Dexterity, or Constitution check with advantage.

Real-world Examples

Anxiety, Asthma, Heart Arrhythmia, Anemia, Chronic Obstructive Pulmonary Disease, Cardiomyopathy, Congestive Heart Failure, Down Syndrome

Assistive Options

Some sitting, standing, and breathing exercises can help to fill the lungs more easily. If you use one or more of these techniques during a short rest, the IE reduces by one for 1d4 hours. Using these techniques consistently for a least three days will maintain the IE reduction for the whole day as long as you continue these exercises.