Dyspnea: Difference between revisions
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* [[Amphotericin B]] | * [[Amphotericin B]] | ||
* [[Amyl nitrite]] | * [[Amyl nitrite]] | ||
* [[Amyotrophic Lateral Sclerosis]] (ALS) | * [[Amyotrophic Lateral Sclerosis]] ([[ALS]]) | ||
* [[Anaphylactoid reactions]] | * [[Anaphylactoid reactions]] | ||
* [[Anaphylaxis]] | * [[Anaphylaxis]] | ||
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* [[Bird breeder's lung]] | * [[Bird breeder's lung]] | ||
* [[Bird fancier's lung]] | * [[Bird fancier's lung]] | ||
* Biventricular heart failure | * Biventricular [[heart failure]] | ||
* [[Bland-White-Garland Syndrome]] | * [[Bland-White-Garland Syndrome]] | ||
* [[Bleomycin]] in [[ABVD]] | |||
* [[Blood transfusion]] | * [[Blood transfusion]] | ||
* Brain stem infarction | * [[Brain stem infarction]] | ||
* [[Bronchial asthma]] | * [[Bronchial asthma]] | ||
* Bronchial tumors | * [[Bronchial tumors]] | ||
* [[Bronchiolitis]] | * [[Bronchiolitis]] | ||
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* [[Congestive Heart Failure]] | * [[Congestive Heart Failure]] | ||
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* Decreased thoracic or | * Decreased thoracic or [[diaphragm]]atic excursion | ||
* [[Diabetic coma]] | * [[Diabetic coma]] | ||
* [[Diffuse panbronchiolitis]] | * [[Diffuse panbronchiolitis]] | ||
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* [[Erdheim-Chester disease]] | * [[Erdheim-Chester disease]] | ||
* [[Esophageal cancer]] | * [[Esophageal cancer]] | ||
* Esophageal diseases with | * Esophageal diseases with [[trachea]]l compression | ||
* [[Exercise-induced asthma]] | * [[Exercise-induced asthma]] | ||
* [[Extrinsic allergic alveolitis]] | * [[Extrinsic allergic alveolitis]] | ||
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* [[Goodpasture syndrome]] | * [[Goodpasture syndrome]] | ||
* [[Grain handler's lung]] | * [[Grain handler's lung]] | ||
* Gram-negative sepsis | * Gram-negative [[sepsis]] | ||
* [[Guillain-Barre Syndrome]] | * [[Guillain-Barre Syndrome]] | ||
* [[Heart failure]] | * [[Heart failure]] | ||
* | * [[Hemochlyothorax]] | ||
* [[Hemothorax]] | * [[Hemothorax]] | ||
* [[Histiocytosis X]] | * [[Histiocytosis X]] | ||
* [[Hoose (disease)]] | * [[Hoose (disease)]] | ||
* [[Humidifier lung]] | * [[Humidifier lung]] | ||
* Hydrochlyothorax | * [[Hydrochlyothorax]] | ||
* [[Hypersensitivity Pneumonitis]] | * [[Hypersensitivity Pneumonitis]] | ||
* [[Hypertension]] | * [[Hypertension]] | ||
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* [[Inappropriate sinus tachycardia]] | * [[Inappropriate sinus tachycardia]] | ||
* [[Interstitial lung disease]] | * [[Interstitial lung disease]] | ||
* [[Intoxication]] ([[carbon monoxide]], [[cyanide]]) | * [[Intoxication]] ([[carbon monoxide]], [[cyanide]]) | ||
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* [[Loeffler's Endocarditis]] | * [[Loeffler's Endocarditis]] | ||
* [[Lung cancer]] | * [[Lung cancer]] | ||
* Lymphangitic metastases | * [[Lymphangitic metastases]] | ||
* [[Lymphocytic interstitial pneumonia]] | * [[Lymphocytic interstitial pneumonia]] | ||
* [[Lymphoma]] | * [[Lymphoma]] | ||
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* [[Mucor stolonifer]] | * [[Mucor stolonifer]] | ||
* Multiple rib fractures | * Multiple [[rib fractures]] | ||
* [[Myasthenia Gravis]] | * [[Myasthenia Gravis]] | ||
* [[Myocardial infarction]] | * [[Myocardial infarction]] | ||
* [[Myxoma]] | * [[Myxoma]] | ||
* [[STEMI]] | * [[STEMI]] | ||
* Neuromuscular | * [[Neuromuscular disease]] | ||
* [[Obesity]] | * [[Obesity]] | ||
* [[Patent Ductus Arteriosus]] | * [[Patent Ductus Arteriosus]] | ||
* [[Pericardial effusion]]/[[pericardial constriction]] | * [[Pericardial effusion]]/[[pericardial constriction]] | ||
* [[Perimyocarditis]] | * [[Perimyocarditis]] | ||
* Phrenic nerve | * [[Phrenic nerve paralysis]] | ||
* Pleural callosity | * Pleural callosity | ||
* [[Pneumoconiosis]] | * [[Pneumoconiosis]] | ||
* [[Pneumonia]] | * [[Pneumonia]] | ||
* Pneumochlyothorax | * [[Pneumochlyothorax]] | ||
* [[Pneumothorax]] | * [[Pneumothorax]] | ||
* [[Pleural Effusion]] | * [[Pleural Effusion]] | ||
* Pleural fibrosis | * Pleural fibrosis | ||
* [[Polyradiculitis]] | * [[Polyradiculitis]] | ||
* Pulmonary arteriovenous malformation | * Pulmonary [[arteriovenous malformation]] | ||
* [[Pulmonary Edema]] | * [[Pulmonary Edema]] | ||
* [[Pulmonary Embolism]] | * [[Pulmonary Embolism]] | ||
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* [[Pulmonary stenosis]] | * [[Pulmonary stenosis]] | ||
* [[Quincke's Edema]] | * [[Quincke's Edema]] | ||
* Radiation pneumonitis | * [[Radiation]] pneumonitis | ||
* [[Respiratory tract infection]] | * [[Respiratory tract infection]] | ||
* [[Right ventricular failure]] | * [[Right ventricular failure]] | ||
* [[Sarcoidosis]] | * [[Sarcoidosis]] | ||
* [[Shock]] | * [[Shock]] | ||
* Shock lung | * [[Shock lung]] | ||
* [[Sleep Apnea Syndrome]] | * [[Sleep Apnea Syndrome]] | ||
* [[Tetralogy of Fallot]] | * [[Tetralogy of Fallot]] | ||
* [[Trauma]] | * [[Trauma]] | ||
* [[Tracheal stenosis]] | * [[Tracheal stenosis]] | ||
* Tracheal tumors | * [[Tracheal tumors]] | ||
* [[Tracheomalacia]] | * [[Tracheomalacia]] | ||
* Tracheobronchial collapse | * [[Tracheobronchial collapse]] | ||
* [[Tricuspid stenosis]] | * [[Tricuspid stenosis]] | ||
* Tumors of the myocardium | * [[Tumors of the myocardium]] | ||
* [[Uremia]] | * [[Uremia]] | ||
* [[Valvular heart disease]] | * [[Valvular heart disease]] | ||
Revision as of 14:08, 16 February 2009
| Dyspnea | ||
| ICD-10 | R06.8 | |
|---|---|---|
| ICD-9 | 786.0 | |
| DiseasesDB | 15892 | |
| MedlinePlus | 003075 | |
| MeSH | C08.618.326 | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Synonyms or related key words: Breathlessness, DIB, difficulty breathing, dyspnoea, respiration difficult, respiratory distress, shortness of breath, SOB.
Overview
Dyspnea or dyspnoea (pronounced disp-nee-ah, IPA /dɪsp'niə/), from Latin dyspnoea, from Greek dyspnoia from dyspnoos, shortness of breath) or shortness of breath (SOB) is perceived to be difficulty of breathing or painful breathing. It is a common symptom of numerous medical disorders.
Dyspnea on exertion (DOE or exertional dyspnea) indicates dyspnea that occurs (or worsens) during physical activity.
Conditions That Dyspnea Should be Distinguished From
- Air hunger the sensation of an urgent need to breathe, sensation that you cannot take in a full breath
- Tachypnea breathing rapidly
- Bradypnea breathing slowly
- Eupnea normal unlabored breathing
- Orthopnea dyspnea that occurs with lying flat
- Trepopnea an abnormal awareness of one's own breathing that is seen in one lateral position but not in the other
- Paroxysmal nocturnal dyspnea sudden, severe shortness of breath at night that awakens a person from sleep, often with coughing and wheezing.
Life Threatening Causes of Dyspnea Requiring Urgent Evaluation and Management
- Acute heart failure
- Acute papillary muscle rupture
- Cardiac tamponade
- Foreign body aspiration
- Spontaneous pneumothorax
- H. influenza epiglottitis
- Bronchospasm
- Pulmonary edema
Complete Differential Diagnosis of Causes of Dyspnea
In alphabetical order. [1] [2]
- Abdominal masses
- Acute bronchitis
- Acute Chest Syndrome
- Acute Coronary Syndromes
- Acute myeloid leukemia
- Acute promyelocytic leukemia
- Acute tracheobronchitis
- AIDS
- Air pollution
- Air-conditioner lung
- Allergy
- Alpha 1-antitrypsin deficiency
- Altitude sickness
- Amniotic fluid embolism
- Amphotericin B
- Amyl nitrite
- Amyotrophic Lateral Sclerosis (ALS)
- Anaphylactoid reactions
- Anaphylaxis
- Anemia
- Angina Pectoris
- Anthrax
- Anxiety
- Aortic Arch Anomalies
- Aortic regurgitation
- Aortic stenosis
- Arrhythmia
- Asbestosis
- Aspergillus clavatus
- Aspiration
- Asthma
- Atelectasis
- Atrial Fibrillation
- Atrioseptal defect
- Atypical pneumonia
- Barium
- Beriberi Heart Disease
- Beta-blockers
- Betazole
- Bird breeder's lung
- Bird fancier's lung
- Biventricular heart failure
- Bland-White-Garland Syndrome
- Bleomycin in ABVD
- Blood transfusion
- Brain stem infarction
- Bronchial asthma
- Bronchial tumors
- Bronchiolitis
- Bronchiolitis obliterans
- Bronchiolitis obliterans organizing pneumonia
- Bronchitis
- Bronchogenic carcinoma
- Bronchoscopy
- Cardiac Disease in Pregnancy
- Cardiac failure
- Cardiomegaly
- Cardiomyopathy
- Caspofungin
- Cheese worker's lung
- Chemical worker's lung
- Chest trauma
- Chest tube
- Cholesterol pericarditis
- Chronic bronchitis
- Chronic fatigue syndrome
- Chronic Obstructive Pulmonary Disease (COPD)
- Chylothorax
- Cirrhosis
- Cladosporium
- CMV Pneumonitis
- Community-acquired pneumonia
- Congenital heart disease
- Congestive Heart Failure
- Continuous murmur
- Cor Pulmonae
- Coronary Artery Disease
- Coronary Artery Fistula
- Croup
- Cystic Fibrosis
- Daptomycin
- Decompression sickness
- Decreased thoracic or diaphragmatic excursion
- Diabetic coma
- Diffuse panbronchiolitis
- Diverticulosis
- Drugs
- Ebstein's Anomaly of the Tricuspid Valve
- Ehrlichiosis (canine)
- Empty nose syndrome
- Empyema, pleural
- Encephalitis
- Endocarditis
- Endomyocardial fibrosis
- Eosinophilic pneumonia
- Ephedrine
- Epidemic dropsy
- Erdheim-Chester disease
- Esophageal cancer
- Esophageal diseases with tracheal compression
- Exercise-induced asthma
- Extrinsic allergic alveolitis
- Fat embolism
- Fibrosing alveolitis, cryptogenic
- Gamma-Hydroxybutyric acid
- Gastroesophageal reflux
- Gemeprost
- Glatiramer acetate
- Glottal edema
- Goiter
- Goodpasture syndrome
- Grain handler's lung
- Gram-negative sepsis
- Guillain-Barre Syndrome
- Heart failure
- Hemochlyothorax
- Hemothorax
- Histiocytosis X
- Hoose (disease)
- Humidifier lung
- Hydrochlyothorax
- Hypersensitivity Pneumonitis
- Hypertension
- Hypertensive heart disease
- Hyperthyroidism
- Hypertrophic cardiomyopathy
- Hypoxia
- Hysteria
- Idiopathic pulmonary fibrosis
- Iloprost
- Inappropriate sinus tachycardia
- Interstitial lung disease
- Intoxication (carbon monoxide, cyanide)
- Intrapulmonary receptor stimulation
- Intussusception (medical disorder)
- Iron deficiency anemia
- Irregular Heart Rhythms
- Ketorolac
- Kyphoscoliosis
- Laryngeal/bronchospasm
- Leukemia
- Levo-Transposition of the great arteries
- Loeffler's Endocarditis
- Lung cancer
- Lymphangitic metastases
- Lymphocytic interstitial pneumonia
- Lymphoma
- Malignant hypertension
- Malignant Mesothelioma
- Malt worker's lung
- Mediastinal tumors
- Megaloblastic Anemias
- Mercury (element)
- Metabolic acidosis
- Methyl isocyanate
- Micropolyspora faeni
- Miliary tuberculosis
- Mitral Regurgitation
- Mitral Stenosis
- Mollusk shell hypersensitivity
- Mucor stolonifer
- Multiple rib fractures
- Myasthenia Gravis
- Myocardial infarction
- Myxoma
- STEMI
- Neuromuscular disease
- Obesity
- Patent Ductus Arteriosus
- Pericardial effusion/pericardial constriction
- Perimyocarditis
- Phrenic nerve paralysis
- Pleural callosity
- Pneumoconiosis
- Pneumonia
- Pneumochlyothorax
- Pneumothorax
- Pleural Effusion
- Pleural fibrosis
- Polyradiculitis
- Pulmonary arteriovenous malformation
- Pulmonary Edema
- Pulmonary Embolism
- Pulmonary Emphysema
- Pulmonary fibrosis
- Pulmonary hypertension
- Pulmonary stenosis
- Quincke's Edema
- Radiation pneumonitis
- Respiratory tract infection
- Right ventricular failure
- Sarcoidosis
- Shock
- Shock lung
- Sleep Apnea Syndrome
- Tetralogy of Fallot
- Trauma
- Tracheal stenosis
- Tracheal tumors
- Tracheomalacia
- Tracheobronchial collapse
- Tricuspid stenosis
- Tumors of the myocardium
- Uremia
- Valvular heart disease
- Ventricular septal defect
Complete Differential Diagnosis of the Causes of Dyspnea
(By organ system)
| Cardiovascular | Aortic dissection, Cardiomyopathy, Congenital heart disease, Heart failure, Ischaemic heart disease, Malignant hypertension, Diseases of the pericardium such as Cardiac tamponade, Constrictive pericarditis or Pericardial effusion, Pulmonary edema, Pulmonary embolism, Valvular heart disease |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | No underlying causes |
| Ear Nose Throat | No underlying causes |
| Endocrine | Hypothyroidism |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | No underlying causes |
| Hematologic | Anemia, Leukemia |
| Iatrogenic | No underlying causes |
| Infectious Disease | Sepsis |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | Amyotrophic lateral sclerosis, Guillain-Barré syndrome, Multiple sclerosis, Myasthenia gravis, Parsonage-Turner syndrome, Eaton-Lambert syndrome |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | Lung cancer |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | Anxiety disorders and panic attacks |
| Pulmonary |
Obstructive lung diseases
Diseases of lung parenchyma and pleuraContagious
Non-contagious
Pulmonary vascular diseases
Obstruction of the airwayImmobilization of the diaphragm
Restriction of the chest volume |
| Renal / Electrolyte | Metabolic acidosis |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Diagnosic Evaluation
- History
- Physical examination: All patients should be evaluated for underlying diseases (especially heart and lung diseases). Detecting of following symptoms and signs are important:
- Complete blood count
- Thyroid function tests
- Chest x-ray
- Electrocardiography
- Echocardiography
- Spirometry
- Pulse oximetry
- Exercise stress test (Treadmill test)
- Arterial blood gases
- Pulmonary function tests
- Cardiopulmonary exercise testing
Treatment of the Patient with Dyspnea
Oxygen Supply
Oxygen supply is the essential part of acute dyspnea management.
Exercise Training
Controlled studies have shown that dyspnea upon exertion decreases and exercise tolerance improves in response to exercise training, even in patients with advanced disease. It is now well established that for patients with COPD who remain breathless despite optimal drug therapy, exercise training can confer significant symptomatic benefits.
Pharmacologic Therapy
Two types of medications have proven useful in alleviating dyspnea: opiates and drugs that reduce anxiety. A number of studies have shown that opiates acutely relieve dyspnea and improve exercise performance in patients with COPD.
The drugs to reduce anxiety have the potential to relieve ventilatory response related to the available amounts of oxygen in the blood, as well as by lowering the emotional response to dyspnea.
Fans
The movement of cool air with a fan has been observed to reduce dyspnea in pulmonary patients. A decrease in the temperature of the facial skin alters feedback to the brain and modifies the perception of dyspnea. Cool air has been shown in normal volunteers to reduce dyspnea in response to excess carbon dioxide in the blood.
Altered Breathing Patterns
Breathing retraining including diaphragmatic breathing and pursed lip breathing has been advocated to relieve dyspnea in COPD patients. During a breathing retraining period, many patients adopt slower, deeper breathing techniques; however, they often resort to spontaneous, fast, shallow breathing patterns when the training ends.
Continuous Positive Airway Pressure (CPAP)
In various studies, CPAP has been shown to relieve dyspnea during asthma attacks, when patients are being weaned from ventilators, and during exercise sessions for patients with advanced COPD.
Nutrition
Several investigators have shown improvement in respiratory muscle function in response to short-term use of nutritional repletion by an intravenous route.
Positioning
Patients with COPD often change body position to improve dyspnea. They tend to lean forward to improve overall respiratory muscle strength and to reduce their symptoms.
Steroids
Steroid use can be beneficial to pulmonary patients by reducing airway inflammation and by increasing vital capacity in chronic lung inflammation. However, steroids have adverse effects, including muscle wasting and weakness. These potential problems need to be balanced against possible gains in lung function associated with this drug.
Cognitive-behavioral Approaches In patients with different pain syndromes, distraction, relaxation, and education about symptoms have modified the intensity of pain, increased tolerance, and decreased distress. Improvements in dyspnea and anxiety have been shown to follow distractions such as music during exercise, although long-term effects have been minimal. However, exercise in a monitored, supportive environment has been shown to be a powerful method of overcoming apprehension, anxiety, and/or fear associated with exertional dyspnea.
See also
References
Additional Resources
- Julie K. Stegman, Stedman's Medical Dictionary, 28th Edition, pages=601, Lippincott Williams & Wilkins, Baltimore, Maryland ISBN 0781733901
External links
Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs
ca:Dispnea da:Åndenød de:Dyspnoe eu:Arnasestu it:Dispnea nl:Benauwdheid no:Dyspné nn:Andenød qu:Sasa samay sk:Dyspnoe sv:Dyspné uk:Задишка