Dyspnea

Name	Dyspnea
Diseasesdb	15892
Icd10
Icd9
Medlineplus	003075
Meshid	D004417

Dyspnea ( ; also dyspnoea; Latin: dyspnoea; Greek: dyspnoia from dyspnoos), shortness of breath (SOB), or air hunger, is the subjective symptom of breathlessness. Other definitions of dyspnea include "difficulty in breathing", "disordered or inadequate breathing", "uncomfortable awareness of breathing", Chronic breathlessness on the other hand comes on over weeks or months. Dyspnea is distinct from labored breathing, which is rather a common physical presentation of respiratory distress.

Differential diagnosis

While shortness of breath is generally caused by disorders of the cardiac or respiratory system other system such as neurological, DiagnosisPro, an online medical expert system, listed 497 distinct causes in October 2010. The most common cardiovascular causes are acute myocardial infarction and congestive heart failure while common pulmonary causes include chronic obstructive pulmonary disease, asthma, pneumothorax, and pneumonia.

Acute coronary syndrome

Acute coronary syndrome frequently presents with retrosternal chest discomfort and difficulty catching the breath. Cardiac tamponade presents with dyspnea, tachycardia, elevated jugular venous pressure, and pulsus paradoxus.

It is currently thought that there are three main components that contribute to dyspnea: afferent signals, efferent signals, and central information processing. It is believed that the central processing in the brain compares the afferent and efferent signals, and that a "mismatch" results in the sensation of dyspnea. In other words, dyspnea may result when the need for ventilation (afferent signaling) is not being met by the physical breathing that is occurring (efferent signaling). It may be subjectively rated on a scale from 1 to 10 with descriptors associated with the number (The Modified Borg Scale).

Blood tests

A number of labs maybe helpful in determining the cause of shortness of breath. D-dimer while useful to rule out a pulmonary embolism in those who are at low risk is not of much value if it is positive as it may be positive in a number of conditions that lead to shortness of breath.

Physiotherapy

Individuals can benefit from a variety of physical therapy interventions. Persons with neurological/neuromuscular abnormalities may have breathing difficulties due to weak or paralyzed intercostal, abdominal and/or other muscles needed for ventilation. Some physical therapy interventions for this population include active assisted cough techniques, volume augmentation such as breath stacking, education about body position and ventilation patterns and movement strategies to facilitate breathing. There is a lack of evidence to recommend midazolam, nebulised opioids, the use of gas mixtures, or cognitive-behavioral therapy.

Epidemiology

Shortness of breath is the primary reason 3.5% of people present to the emergency department in the United States. Of these approximately 51% are admitted to hospital and 13% are dead within a year. Some studies have suggested that up to 27% of people suffer from dyspnea, while in dying patients 75% will experience it. Acute shortness of breath is the most common reason people who are palliative visit an emergency department.

Etymology

Dyspnea ( ; from Latin dyspnoea, from Greek dyspnoia from dyspnoos) literally means disordered breathing.

See also

List of terms of lung size and activity

References

External links

Category:Abnormal respiration Category:Pulmonology Category:Symptoms and signs: Circulatory and respiratory systems