Dyspnea: Shortness of breath – Causes, diagnosis, and treatment
Dyspnea is a subjective feeling of lack of air, difficulty breathing or shortness of breath.
It depends on many coexisting physiological, environmental, psychological and social factors. In healthy people, dyspnea may appear during intense physical exertion, while in patients it occurs with little effort or at rest. It is often accompanied by anxiety.
The severity of dyspnea can be assessed using various scales, e.g. using the Modified Medical Research Council (mMRC) scale.
| MMRC scale | |
|---|---|
| 0 | shortness of breath only occurs with strenuous physical exertion |
| 1 | shortness of breath occurs when walking briskly across flat terrain or when climbing a slight hill |
| 2 | due to breathlessness, the patient walks slower than his peers or, walking at his own pace on flat ground, must stop to breathe |
| 3 | after walking about 100 meters or after a few minutes of walking on flat ground, the patient must stop to catch breath |
| 4 | breathlessness prevents the patient from leaving the house or occurs when putting on or undressing |
Classification of dyspnea:
- resting and exercise
- paroxysmal (acute) and chronic
- depends on the position of the body (the most common is orthopnoea, i.e. breathlessness that occurs when lying down and resolves in a sitting or standing position).
In this article, Niketrainers.com.co will tell you:
Causes of shortness of breath
Dyspnoea can cause most lung disease, heart disease, and some other organ disease or poisoning.
The causes of paroxysmal dyspnea include:
- acute bronchitis
- pneumonia
- bronchial asthma attack
- exacerbation of chronic obstructive pulmonary disease (COPD)
- pneumothorax
- pulmonary embolism
- exacerbation of circulatory failure
- heart attack .
Causes of chronic breathlessness include:
- pulmonary fibrosis and other interstitial lung diseases
- chronic obstructive pulmonary disease (COPD)
- circulatory failure
- neurological diseases (e.g. myasthenia gravis , amyotrophic lateral sclerosis).
The division of dyspnea depending on the mechanism of its formation (in many diseases, dyspnea is the result of various mechanisms):
- reducing the supply of oxygen to tissues:
- diseases that reduce the amount of active lung parenchyma (e.g. pneumonia, pulmonary fibrosis, emphysema)
- Heart failure (decreased cardiac output – heart failure )
- anemia (decrease in hemoglobin in the blood, reducing the delivery of oxygen to the tissues)
- impaired binding of hemoglobin with oxygen in the course of poisoning with carbon monoxide or substances causing methaemoglobinaemia
- enhancement of the central respiratory drive necessary to obtain sufficient ventilation (and hyperventilation):
- narrowing of the bronchi – asthma and COPD, bronchial tumors
- lesions affecting the lung parenchyma, pleura or chest wall (reducing lung compliance) – heart failure, pneumonia, interstitial lung diseases, pleural diseases, chest deformities
- non-respiratory acidosis (metabolic changes in the course of e.g. decompensated diabetes)
- weakness of the respiratory muscles and disturbances in nerve conduction and neuromuscular disorders (myasthenic crisis), resulting in impaired respiratory muscle function
- stimulation of the respiratory center by toxins (e.g. salicylates)
- overactive thyroid gland
- pain, anxiety
- strenuous physical exertion in healthy people.
Symptoms accompanying shortness of breath
Dyspnoea rarely occurs without the other symptoms of lung disease. In patients with asthma, attacks of breathlessness are often accompanied by a cough , sometimes wheezing heard while breathing, and a tight feeling in the chest. Bronchitis and pneumonia usually include fever and cough with purulent (yellow or green) sputum. Patients with bronchiectasis usually expectorate a lot of purulent discharge. In many interstitial lung diseases, shortness of breath is accompanied by a dry cough. Pulmonary embolism presents as rapid dyspnea often accompanied by chest pain and haemoptysis. When a heart attack is the cause of the sudden breathlessness, patients usually complain of severe pain behind the breastbone or the front of the chest, which may radiate to the left hand, left shoulder, between the shoulder blades, or the lower jaw.
When should you contact your doctor?
Dyspnoea in most cases requires medical attention. If breathlessness is so severe that it is difficult to speak, or is accompanied by chest pain, hemoptysis, or severe weakness, an ambulance should be called urgently.
