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Dyspnea
Dyspnea, also known as shortness of breath, is the feeling that one cannot breathe well enough. It is normally felt during heavy exertion but can become pathological during light exertion or unexpected situations. The causes of dyspnea are often asthma, pneumonia, heart failure, lung disease, or anxiety disorders. The initial evaluation of dyspnea involves assessing breathing, circulation, and getting a medical history and physical exam. Imaging tests like chest x-rays or CT scans may help identify specific causes like pneumonia or pulmonary embolism. Treatment focuses on the underlying cause, with oxygen therapy and pulmonary rehabilitation also being effective options.
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Dyspnea
- 1. DYSPNEA Mr. Aby Thankachan,M.Sc N, PGDSH Senior Nursing Tutor KMCH CoN , CBE
- 2. DEFINITION • Shortness ofbreath, also known as dyspnea, is the feeling that one cannot breathe well enough. • The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of the distinct sensations, the degree of distress involved, and its burden or impact on activities of daily living. • Distinct sensations include effort/work, chest tightness, and air hunger (the feeling of not enough oxygen).
- 3. CAUSES • Dyspnea isa normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations or light exertion. • In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, chronic obstructive pulmonary disease, or psychogenic causes,such as panic disorder and anxiety.
- 4. DAIGNOSTIC EVALUATION • Theinitial approach to evaluation begins by assessment of the airway, breathing, and circulation followed by a medical history and physical examination.
- 5. • Signs thatrepresent significant severity include hypotension, hypoxemia, tracheal deviation, altered mental status, unstable dysrhythmia, stridor, intercostal indrawing, cyanosis, tripod positioning, pronounced use of accessory muscles (sternocleidomastoid, scalenes) and absent breath sounds.
- 6. • A numberof scales may be used to quantify the degree of shortness of breath. • It may be subjectively rated on a scale from 1 to 10 with descriptors associated with the number (The Modified Borg Scale). • Alternatively a scale such as the MRC breathlessness scale might be used – it suggests five grades of dyspnea based on the circumstances in which it arises.
- 9. Imaging • A chestx-ray is useful to confirm or rule out a pneumothorax, pulmonary edema, or pneumonia. Spiral computed tomography with intravenous radiocontrast is the imaging study of choice to evaluate for pulmonary embolism.
- 11. • The primarytreatment of shortness of breath is directed at its underlying cause. • Extra oxygen is effective in those with hypoxia; however, this has no effect in those with normal blood oxygen saturations • Physiotherapy and Pulmonary Rehabilitation