Agonal breathing is a sign of a life-threatening medical emergency. 

Medical or rescue personnel tend to refer to breathing as respirations. So, they use the term agonal breathing interchangeably with agonal respirations. And, to a layperson, the best description might be that an individual is simply gasping for air. 

Anytime you see someone in this condition, it is a sign that they are in extreme distress. It’s likely that there is no longer an adequate amount of oxygen reaching an agonal breather’s brain and that cardiac arrest is either ongoing or imminent. They may be near death. 

Call emergency services immediately, and if trained to do so, you should initiate CPR according to your training protocols. This post is part of our Breathwork series of helpful guides.

Agonal Breathing: What’s Happening?

It’s impossible to precisely know what is happening inside of a person who is experiencing agonal breathing. But, their life is almost certainly in jeopardy. 

To understand what’s causing this abnormal respiratory pattern, let’s do a quick biology review.

Our heart acts as a pump, moving our blood throughout the body. In the simplest terms, that blood passes through our lungs, where they remove carbon dioxide from it and add oxygen to it. 

Through the force of our heart’s pumps, that oxygen-rich blood circulates to our brain and the rest of the body’s organs and cells. 

When a significant medical event disrupts that system, agonal breathing may be the first symptom you can see. 

Along with the sight of a person gasping for air and their skin possibly turning blue, you may hear them struggling to breathe as well. It might sound like they are moaning or snorting, as they are laboring to get air in and out of their lungs. 

What Medical Issues Cause Agonal Breathing?

Certain medical conditions can disrupt the flow of adequate oxygenated blood to the brain. 

Cardiac Arrest 

When a person’s heart has stopped beating effectively, they are in cardiac arrest. 

Electrical impulses regulate the beat of the human heart, and sometimes, those pulses become disorganized. A person who is experiencing irregular heartbeats is said to be experiencing an arrhythmia. 


If left untreated, that arrhythmia can result in A-fibrillation, which needs immediate medical attention. A fibrillating heart beats so erratically that it quivers without adequately moving the blood throughout the body. 

Persons experiencing severe arrhythmias may go into cardiac arrest, depriving their brain of the oxygen it needs to survive and causing the physiological reaction of gasping for air. 

Stroke 

A stroke is an ischemic event or a reduction in blood flow to the brain. In this case, the pump at the center of the system (the heart) is still working, but there is a problem in the blood vessels of the body that is depriving the brain of oxygen. 

Sometimes, a clot causes a stroke by working its way into a small blood vessel in the brain, partially or even completely blocking blood flow. Or, in other cases, the stroke may be hemorrhagic in nature, meaning that a blood vessel has ruptured, causing a disruption in the flow of blood to the brain.

Hypoxia

Hypoxia is a generic term for an insufficient oxygen supply. Cerebral hypoxia is incredibly dangerous, as the brain is quite likely to suffer permanent damage if it does not receive adequate oxygen for even a brief time. 

What to Do

If you see someone who is gasping for air, ask them what’s wrong. If they can answer you, speaking in a full sentence, they are not in agonal breathing. But if they are cyanotic (turning blue) and cannot answer, they are experiencing a true medical emergency. 

Cardiopulmonary resuscitation (CPR) protocols vary. But if you know how to perform CPR, you should prioritize activating the emergency services system and initiating the chain of survival. Your intervention is needed and may potentially save a life!

When you speak to the emergency control dispatcher, explain what you are witnessing. If they ask if the person is breathing, don’t just say yes. Explain what you see and hear, as any signs of agonal breathing will result in a high-priority dispatch for first responders. 

This early warning will also help the EMTs and paramedics prepare to initiate their care once they arrive on the scene. 

Review: Agonal Breathing and Gasping for Air

Agonal breathing indicates that the individual is experiencing a medical emergency. There has likely been a disruption in the oxygen supply to their brain and its essential cells. 

The underlying cause of the emergency is probably unknown, but you should immediately take action. 

Activate the emergency services system, provide any help you can, and consider performing CPR if trained to do so. 

agonal breathing what it is and how to stop it
Spotting if someone is agonal breathing
Charlie Penwarden

Former mental health nurse turned consultant with a critical focus on human behaviour research analysis and the optimisation of mental health management to prevent illness and promote life harmony.