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Dyspnea

Dyspnea or difficulty breathing is the sensation when a person cannot inhale enough air into their lungs, often accompanied by shortness of breath and tightness in the chest. Dyspnea can range from mild to severe. If this condition is chronic, it can significantly limit activity and negatively impact quality of life. Dyspnea can be a result of pulmonary, cardiac, vascular, neuromuscular, and metabolic diseases. Research shows that approximately one in four people seeking medical help report dyspnea. Treatment options include medication, breathing techniques, relaxation, and exercise.

An extreme sense of dyspnea is a condition in which a person is almost completely out of breath (hunger for air).

If you suddenly experience difficulty breathing, shortness of breath, along with other symptoms such as nausea, chest pain, or if your skin, lips, or nails turn blue, seek medical attention urgently!

What is dyspnea – shortness of breath?

Dyspnea is a condition where there is difficulty in inhaling enough air, leading to labored breathing. It may be accompanied by chest tightness. Dyspnea represents a mismatch between lung ventilation and the body’s need for air.

The importance of understanding and resolving difficulty breathing

Shortness of breath can be caused by many different diseases and conditions. It can be a frightening and disturbing symptom that can negatively impact all aspects of life. Breathing difficulties can trigger feelings of anxiety and panic that are difficult to control and can further worsen breathing. The causes of shortness of breath can be numerous, so it is important to determine the underlying cause in order to determine the most appropriate medical treatment.

Who can experience dyspnea – shortness of breath?

– People with lung or heart disease
– Obese people or those with a sedentary lifestyle
– Smokers and people individuals exposed to harmful environmental influences

Dyspnea can affect specific groups of people in different ways:

-Pregnant women: Mild symptoms of dyspnea are common during pregnancy due to changes in respiratory capacity.
-Elderly individuals: Dyspnea or difficulty breathing is often present in older adults, especially when climbing uphill or stairs.
-Children: Upper respiratory tract illnesses that cause acute dyspnea are one of the most common causes of shortness of breath in infants.

Most common types of dyspnea

Acute dyspnea – Acute dyspnea can occur suddenly and does not last long (typically hours, sometimes days). Allergies, anxiety, exercise, and illnesses (such as common cold or flu) can cause acute dyspnea. More severe conditions, such as a heart attack, sudden airway constriction (anaphylaxis), or blood clot (pulmonary embolism), can also cause acute dyspnea.

Chronic dyspnea – Chronic dyspnea is shortness of breath that lasts for a long time (several weeks or more) or constantly returns. Asthma, heart failure, and COPD (chronic obstructive pulmonary disease) can cause chronic dyspnea.

Mechanism of occurrence and difference (connection) between dyspnea and shortness of breath

Dyspnea is an unpleasant feeling of lack of air. Shortness of breath occurs when the breathing rate increases to meet the increased oxygen demand of the body. Dyspnea is caused by a disruption in the normal breathing mechanism. When such a disruption occurs, oxygen distribution to the tissues is reduced, and carbon dioxide begins to accumulate in the body.

This hypoxic and hypercapnic environment (elevated partial pressure of carbon dioxide) stimulates the respiratory center in the brain to increase the breathing rate so that the necessary oxygen can be quickly taken in and unwanted carbon dioxide can be eliminated from the body, preventing it from reaching toxic levels. Shortness of breath can be seen as a continuation of dyspnea.

The key difference between dyspnea and shortness of breath is that dyspnea is the unpleasant sensation of the need to breathe, while shortness of breath occurs due to an increased breathing rate to meet the body’s oxygen demand.

Symptoms and causes of dyspnea

As there are many causes, shortness of breath and difficulty breathing are very common. The causes of dyspnea in healthy individuals can be:

-Intense or irregular exercise (lack of fitness)
-High altitude

However, dyspnea can be a sign of a serious health issue. If shortness of breath starts suddenly, it is considered an acute case of dyspnea.

Causes of acute dyspnea

  • asthma
  • anxiety
  • pneumonia
  • heart disease
  • allergic reactions
  • anemia
  • acute weakness such as iron deficiency
  • Exposure to dangerous levels of carbon monoxide
  • heart failure
  • hypotension (low blood pressure)
  • pulmonary embolism
  • multiple sclerosis
  • respiratory infection

 

Causes of chronic dyspnea

If a person has difficulty breathing for more than a month, the condition is called chronic dyspnea, and the causes can be:

  • asthma
  • Chronic obstructive pulmonary disease (COPD)
  • heart problems such as pericarditis or cardiomyopathy
  • obesity
  • pulmonary fibrosis that causes scarring on lung tissue
  • Traumatic lung injury, lung cancer, tuberculosis, pleurisy, inflammation of the tissues surrounding the lungs, pulmonary edema…

Symptoms of dyspnea

Symptoms of dyspnea can vary from person to person depending on the cause. They may include:

  • Chest tightness
  • Feeling the need to breathe deeply
  • Effort to take a deep breaths
  • Rapid breathing (tachypnea)
  • Rapid heartbeat (heart palpitations)
  • Wheezing or stridor in the lungs (noisy breathing)
  • Shallow breathing

Risks of dyspnea

Environmental pollutants can trigger episodes of dyspnea or increase the risk of its occurrence. Other triggers can include:

  • Smoking
  • Inhalation of chemicals and vapors
  • Work in dusty conditions
  • Living in a damp environment

Diagnosis and tests for dyspnea – shortness of breath

Physical examination and medical history – A doctor can usually diagnose dyspnea based on a detailed physical examination of the person, along with taking a thorough medical history. The doctor will listen to the lungs with a stethoscope and measure blood pressure. They may use a pulse oximeter to check the oxygen level in the blood. During the examination, the person will explain how and when the episodes of dyspnea started, how long they last, how often they occur, and how severe they are. Doctors may also include other diagnostic tests.

-X-ray examinations: Doctors can use chest X-rays to evaluate the health of the heart, lungs, and surrounding tissues.

-CT scanner: It can provide a more detailed image of the body than an X-ray imaging.

-Electrocardiogram (ECG): this diagnostic test may show signs of a heart attack or other heart problems.

– Spirometry tests: They measure the airflow and lung capacity of the patient. This can accurately determine the type and extent of breathing problems in an individual.

-Blood tests: They are used to determine the presence of anemia or some disease.

-Cardiopulmonary exercise testing (stress test): The patient runs or exercises on a treadmill or rides a stationary bike for this test. The test can show how much oxygen is taken in and how much carbon dioxide is released during exercise.

Treatment of dyspnea – shortness of breath

To treat dyspnea, it is crucial to identify its cause, i.e., the underlying disease. Proper therapy and exercises can significantly improve dyspnea symptoms.

Treatments that can improve breathing include:

Exercise: It can strengthen the heart and lungs, so that they do not have to work under significant stress.

Relaxation techniques: Relaxation techniques and breathing exercises can help with dyspnea, especially when it is caused by anxiety.

Medications: The doctor may prescribe one of the following medications, depending on the underlying cause of dyspnea: bronchodilators to open the airways (asthma, COPD), steroids to reduce swelling, and painkillers. Medications should be taken exactly as prescribed by the doctor.

Oxygen therapy: It is important if the oxygen level in the blood is too low.

Surgical treatment: Certain conditions, such as chronic blood clots in the lungs or structural heart diseases, can contribute to breathing difficulties. These causes of shortness of breath can often be addressed with highly specialized surgical interventions. In many cases, surgery not only helps alleviate symptoms but can also improve long-term survival, for example, in certain patients with chronic structural lung conditions such as emphysema (permanent enlargement of the airways).

Lifestyle changes, quitting smoking, weight loss: If the cause of dyspnea is obesity or smoking, weight loss or quitting smoking can significantly alleviate or eliminate difficulty breathing.

Prevention of dyspnea – shortness of breath

Individuals with dyspnea can alleviate symptoms and improve their overall health. This includes:

-Quitting smoking and avoiding passive smoking whenever possible.

-Avoiding chemical fumes and other environmental pollutants.

-Regular exercise that strengthens the cardiovascular and respiratory system.

-Maintaining an optimal body weight.

-Breathing exercise or relaxation technique

-Avoiding activities when it is extremely hot or cold or when humidity is high.

Prognosis / Perspective

Recovery from dyspnea is primarily influenced by its cause, followed by age, living conditions, environmental pollution. Most people occasionally experience dyspnea that disappears with the removal of its cause. However, episodes of dyspnea can recur in people with some diseases (heart, lungs). The intensity of dyspnea is higher in patients with cardio-respiratory disorders and weak respiratory muscles because it takes more effort for their initiation. These conditions are more common in the elderly.

In eliminating dyspnea, it is crucial to follow the doctor’s advice on treatment, as well as regular check-ups and lifestyle changes that facilitate prolonged ease of breathing.

Tips for self-help in managing dyspnea

To prevent worsening of chronic dyspnea, it is important for individuals to adhere to the following:

  • Quit smoking: Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Quitting smoking can slow down the progression of COPD and prevent complications.
  • Avoid exposure to pollutants: Minimize exposure to environmental pollutants that can worsen respiratory symptoms.
  • Avoid extreme temperatures: Engaging in activities in very hot and humid or extremely cold conditions can increase dyspnea associated with chronic lung diseases.
  • Follow the doctor’s advice on what to do if symptoms worsen
  • Adhere to medication and treatment recommendations: Take prescribed medications and follow the recommended treatment plan for the underlying condition causing dyspnea. Skipping medications for chronic lung and heart diseases can lead to poorer control of dyspnea.
  • Be mindful of high altitudes: Higher altitudes require time for adjustment, so it is advisable to avoid strenuous activities during this period.
  • Check equipment: if additional oxygen is required, it is necessary to provide supplies.
  • Breathing exercises: Two helpful breathing exercises include abdominal breathing (focus on filling the lungs with oxygen during inhalation and emptying the lungs during exhalation) and pursed-lip breathing (inhaling through the nose and exhaling slowly through pursed lips).


When to seek additional medical attention or control examinations?

Seek additional medical help or schedule follow-up appointments if you experience severe difficulty breathing or if shortness of breath impairs your daily activities. If you frequently experience distressing breathlessness, consult with your doctor about additional treatments that can help improve your breathing.

Emergency dyspnea symptoms or warning signs

Sometimes dyspnea can be a sign of a life-threatening condition. Go to the nearest health care facility if you have:

  • sudden shortness of breath
  • inability to catch your breath
  • shortness of breath that persists even after resting for 30 minutes
  • blue skin, lips, or nails (cyanosis)
  • pain or heaviness in the chest
  • rapid or irregular heartbeat (palpitations)
  • high fever
  • stridor (sound of high tone) or whistling when breathing
  • swollen ankles or feet
  • nausea

Strategies for coping with chronic shortness of breath

If you’re living with chronic dyspnea caused by a medical condition, talk to your doctor about ways to manage your symptoms. You may not be able to completely eliminate the symptoms, but sometimes even small changes can make a big difference in your quality of life.

There are six main strategies for coping with episodes of shortness of breath:

  • reduce physical exertion
  • use cognitive and psychological strategies such as mental calming and relaxation techniques and focus on your breathing.
  • Practice breathing techniques and positions.
  • Seek fresh air and consider using supplemental oxygen if prescribed by your doctor.
  • Take prescribed medications and use medical devices as directed.
  • Avoid harmful environmental triggers and irritants.

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