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    DYSPNEA (Shortness of Breath)

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    Martin Clyde
    Dyspnea, or shortness of breath, can result from abnormalities in gas exchange in the lungs, increased work of breathing, or anxiety. It is caused by various conditions that decrease oxygen levels, impair ventilation, or obstruct the airways or lungs. Dyspnea may be paroxysmal (occurring in sudden attacks), orthopnea (when lying flat), or platypnea (when standing). Paroxysmal dyspnea often improves with sitting or walking temporarily. Orthopnea requires the patient to sleep elevated, and platypnea is associated with liver disease and improved by sitting or lying down.

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    DYSPNEA (Shortness of Breath)

    Uploaded by

    Martin Clyde
    40 views3 pages
    Dyspnea, or shortness of breath, can result from abnormalities in gas exchange in the lungs, increased work of breathing, or anxiety. It is caused by various conditions that decrease oxygen levels, impair ventilation, or obstruct the airways or lungs. Dyspnea may be paroxysmal (occurring in sudden attacks), orthopnea (when lying flat), or platypnea (when standing). Paroxysmal dyspnea often improves with sitting or walking temporarily. Orthopnea requires the patient to sleep elevated, and platypnea is associated with liver disease and improved by sitting or lying down.

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    Dyspnea

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    Dyspnea, or shortness of breath, can result from abnormalities in gas exchange in the lungs, increased work of breathing, or anxiety. It is caused by various conditions that decrease oxygen levels, impair ventilation, or obstruct the airways or lungs. Dyspnea may be paroxysmal (occurring in sudden attacks), orthopnea (when lying flat), or platypnea (when standing). Paroxysmal dyspnea often improves with sitting or walking temporarily. Orthopnea requires the patient to sleep elevated, and platypnea is associated with liver disease and improved by sitting or lying down.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    40 views3 pages

    DYSPNEA (Shortness of Breath)

    Uploaded by

    Martin Clyde
    Dyspnea, or shortness of breath, can result from abnormalities in gas exchange in the lungs, increased work of breathing, or anxiety. It is caused by various conditions that decrease oxygen levels, impair ventilation, or obstruct the airways or lungs. Dyspnea may be paroxysmal (occurring in sudden attacks), orthopnea (when lying flat), or platypnea (when standing). Paroxysmal dyspnea often improves with sitting or walking temporarily. Orthopnea requires the patient to sleep elevated, and platypnea is associated with liver disease and improved by sitting or lying down.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    DYSPNEA (Shortness of breath)

    Dyspnea results from abnormalities of gas exchange (decreased oxygenation, hypoventilation, hyperventilation), and
    increased work of breathing because of changes in respiratory mechanics and/or anxiety

    Clinical occurrence

    1. Decreased Fraction of Inspired Oxygen


    a. High altitudes
    2. Airway Obstruction
    a. Larynx and Trachea infections
    i. Laryngeal diphtheria
    ii. Acute Laryngitis
    iii. Epiglottitis
    iv. Ludwig angina
    b. Angioedema
    c. Trauma
    i. Hematoma
    ii. Laryngeal edema
    d. Neuropathic: Abductor paralysis of vocal cords
    e. Foreign bodies
    f. Tumors of the neck
    i. Goiter
    ii. Carcinoma
    iii. Lymphoma
    iv. Aortic aneurysm
    g. Ankylosis of the cricoarytenoid joints
    3. Bronchi and Bronchioles
    a. Acute and chronic bronchitis
    b. Asthma
    c. Retrosternal goiter
    d. Aspirated foreign bodies
    e. Extensive bronchiectasis
    f. Bronchial stenosis
    4. Abnormal alveoli
    a. Alveolar filling
    i. Pulmonary edema
    ii. Pulmonary infiltration
    1. Infectious and aspiration pneumonia
    2. Carcinoma
    3. Sarcoidosis
    4. Pneumoconioses
    iii. Pulmonary hemorrhage
    iv. Pulmonary alveolar proteinosis
    b. Alveolar Destruction
    i. Pulmonary emphysema
    ii. Pulmonary fibrosis
    iii. Cystic diseases of the lungs
    c. Compression of the alveoli
    i. Atelectasis
    ii. Pneumothorax
    iii. Hydrothorax
    iv. Abdominal distention
    5. Restrictive Chest and Lung diseases
    a. Paralysis of the respiratory muscles (esp. the intercostals and diaphragm)
    b. Myasthenia gravis
    c. Thoracic deformities
    i. Kyphoscoliosis
    ii. Thoracoplasty
    d. Scleroderma or burns of the thoracic wall
    e. Pulmonary fibrosis
    6. Abnormal Pulmonary Circulation
    a. Pericardial tamponade
    b. Pulmonary artery stenosis
    c. Arteriovenous shunts in heart and lungs
    d. Pulmonary thromboembolism and infarction
    e. Other emboli (fat, ari, amniotic fluid)
    f. Arteriolar stenosis (Primary pulmonary hypertension, irradiation)
    7. Oxyhemoglobin deficiency
    a. Anemia
    b. Carbon monoxide poisoning (carboyhemoglobinemia)
    c. Methemoglobinemia
    d. Sulfhemoglobinema
    e. Cyanide and cobalt poisoning
    8. Abnormal Respiratory stimuli
    a. Pain from respiratory movement
    b. Exaggerated consciousness of respiration (effort syndrome)
    c. Hyperventilation syndrome
    d. Secondary respiratory alkalosis (increased intracranial pressure, metabolic acidosis)

    Paroxysmal dyspnea.

    A transient increase in pulmonary capillary pressure is caused by redistribution of fluid from edematous extremities to the
    lungs with recumbency, or ischemia-induced transient decreases in LV performance. Sudden paroxysms of breathlessness
    often occur with recumbency or exertion. When sleep is interrupted, it is termed paroxysmal nocturnal dyspnea which
    may be accompanied by orthopnea and coughing. The patient often finds that sitting or walking for a few minutes relieves
    the dyspnea permitting sleep to resume.

    Shortness of breath when lying down—orthopnea.

    Redistribution of extracellular fluid from the periphery to the lungs, elevation of the diaphragm from obesity or ascites,
    and muscular weakness all contribute to dyspnea when lying flat. The patient assumes a resting position with the head
    and chest elevated; the severity is estimated by the number of pillows required to achieve a comfortable sleeping position.
    Many patients awaken from sleep in the supine position severely short of breath (paroxysmal nocturnal dyspnea).
    Orthopnea may be overlooked if not specifically ask about or if the patient is not observed for some time while supine.

    Shortness of breath when standing up—platypnea.

    Enlargement of pulmonary arteriovenous shunts leads to increased right to left shunting with standing. The results are
    decreased oxygen saturation on standing (orthodeoxia) and shortness of breath. This is part of the hepatopulmonary
    syndrome seen in patients with advanced liver disease. Patients complain of shortness of breath and weakness on
    standing, relieved by sitting or lying. They have stigmata of advanced liver disease including cutaneous spiders and ascites
    caused by portal hypertension.

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