Causes of shortness of breath: advice of a therapist
May 26, 2018
Shortness of breath or dyspnea is one of the most frequent complaints that patients make.This subjective feeling is often one of the symptoms of a serious disease of the respiratory system or cardiovascular system.It also occurs with obesity and anemia.The emerging feeling of lack of oxygen can be the reason for an urgent call for help to a doctor.In some cases, a patient with shortness of breath needs urgent hospitalization and urgent measures to maintain life functions.Table of contents:
Classification of dyspnea
Dispnoe is acute, subacute and chronic.When shortness of breath, a person feels tight in the chest.Objectively, it increases the depth of inspiration, and the frequency of respiratory movements( BHD) increases to 18 or more per minute.
Normally a person never pays attention to how he breathes.Against the backdrop of more or less significant physical activity, the BHP and the depth of breaths usually increase, as the body's need for oxygen increases, but this does not involve discomfort.In this case we are talking about physiological dyspnea.After the termination of loading the breath of the healthy person is normalized for some minutes.If the feeling of lack of air arises when performing ordinary actions or at rest, then this is no longer the norm.In such cases, it is customary to talk about pathological dyspnea, indicating that the patient has a certain disease.
There are three types of dyspnea:
The inspiratory species is characterized by a labored inhalation.It develops against the background of a narrowing of the lumen of the respiratory system - the trachea and bronchi.Such dyspnea is detected in certain chronic diseases( asthma), as well as in acute inflammation of the pleura and injuries leading to compression of the bronchi.
When expiratory dyspnea patient on the contrary it is difficult to exhale.The cause of the problem is the narrowing of the lumen of the small bronchi.Dyspnoea of this type is characteristic for emphysema and chronic obstructive pulmonary disease.
Among the most common causes in the clinical practice of development of dyspnea of mixed type are advanced lung pathologies, as well as heart failure.
Based on patient complaints, the degree of dyspnea on the MRC scale is determined.
It is accepted to distinguish 5 degrees:
- 0 degree - dyspnea develops only with considerable physical exertion, i.e.There is no question of abnormal dyspnea;
- 1 degree - mild dyspnoea.Disturbance of breathing occurs when lifting up or walking at a rapid pace;
- 2 - medium degree.Dyspnea occurs with normal walking, and the patient has to stop for breathing to return to normal;
- 3 degree of dyspnea - severe dyspnea.The person at walking is forced to make stops every 2-3 minutes;
- 4 degree - very heavy dyspnea.Breathing is difficult against a background of minimal load and even in a state of rest.
Causes of development of dyspnea
Four main causes of dyspnea development can be identified:
- heart failure;
- respiratory failure;
- metabolic disorders;
- hyperventilation syndrome.
Please note: respiratory failure may be due to problems from the pulmonary vessels, diffuse lesions of the lung tissue, reduced bronchial patency, and pathology of the respiratory musculature.
Syndrome of hyperventilation manifests itself in some varieties of neuroses and against a background of neurocirculatory dystonia.
Cardiovascular pathologies as causes of dyspnea
The cause of dyspnea in heart disease is usually the increase in pressure in vessels supplying the myocardium.
Dyspnoea in heart pathologies increases with the progression of the disease.In the early stages, it develops under load, and when the process is started, it appears even in a state of rest.
Note: with severe heart lesions is often noted at night paroxysmal dyspnoea, which is a sudden onset of a breathless asthma attack.Pathology is also known as cardiac asthma;Its cause is stagnation of fluid in the lungs.
Respiratory failure leading to dyspnea
Shortness of breath for respiratory problems is often chronic.It can be noted in the patient for months and years.This kind of dyspnea is typical for chronic obstructive pulmonary disease, when the airway lumen narrows and sputum accumulates in it.In this case, the patient has a short, rapid inhalation followed by a difficult exhalation accompanied by noise.In parallel with expiratory dyspnea, cough and the passage of a secret of a viscous consistency are often noted.After using an inhaler with a bronchodilator, breathing usually returns to normal.If you can not stop an attack with conventional medications, the patient's condition deteriorates very quickly.Lack of oxygen leads to loss of consciousness.In such cases, urgent medical attention is required.
In diseases of infectious genesis( acute bronchitis and pneumonia), the severity of dyspnea directly depends on the severity of the pathological process.With adequate therapy, the symptomatology is stopped within a few days.Severe pneumonia can cause heart failure.Shortness of breath while increasing.This condition is an indication for the urgent hospitalization of the patient.
Gradually increasing constant dyspnea may indicate the presence of neoplasms in the lungs.The severity of the symptom increases with the growth of the tumor.In addition to dyspnea, the patient has a superficial, unproductive cough, often hemoptysis, general weakness and cachexia( significant weight loss).
Important: The most dangerous pathology of the respiratory system, in which dyspnea occurs, are pulmonary edema, pulmonary embolism( PE) and local airway obstruction.
With thromboembolism, there is a blockage of the pulmonary artery branches with blood clots.As a consequence, a part of the organ ceases to participate in the act of breathing.Dispnoea in this situation develops suddenly, worries with minimal load and even at rest.The patient complains of the tightness and pain in the chest, which resembles the symptoms of an attack of angina pectoris.In some cases, hemoptysis is noted.
Airway obstruction may be due to aspiration of a foreign object, compression of the bronchi or trachea from the outside( with goiter, aortic aneurysm and tumors), cicatricial narrowing of the lumen or chronic inflammation in autoimmune diseases.When obstructed, shortness of breath is of an inspiratory nature.The patient's breathing is loud with hissing noise.Violation of the patency of the airways is accompanied by suffocation and an excruciating cough, which is aggravated by a change in the position of the body.Bronchodilators in such cases are ineffective;It is necessary to mechanically restore the patency of the trachea and bronchi and measures aimed at treating the underlying disease.
The reason for dyspnea may be a toxic edema that develops as a result of inhalation of aggressive substances or against the background of an infectious respiratory infection with pronounced intoxication of the body.The patient has increased dyspnea, which, as the process progresses, is replaced by suffocation.Breathing sounds are well audible.In this situation, urgent medical assistance is required, involving the maintenance of respiratory function and detoxification of the body.
Respiratory failure develops in such an acute condition as pneumothorax.With the penetrating injury of the chest, air enters the pleural cavity and presses on the lung, preventing it from breaking down on inhalation.The patient needs an emergency operation.
Shortness of breath is one of the symptoms of tuberculosis, actinomycosis, and emphysema.
Important: dyspnea can develop with severe scoliosis.The cause of shortness of breath and shortness of breath in this case is the deformation of the chest.
To determine the factors leading to the development of respiratory failure, additional( instrumental) methods of investigation are needed: X-rays( fluorography), spirometry, ECG, tomography, angiography and bronchoscopy.
One of the causes of shortness of breath is anemia.When anemia in the blood decreases the number of red blood cells or decreases the hemoglobin content in red blood cells.Since hemoglobin is responsible for the transfer of oxygen to all cells, with its deficiency, hypoxia develops.The organism reflexively tries to compensate for the lack of oxygen, so the frequency of breathing increases, and the person takes a deeper breath.The causes of anemia may be congenital metabolic disorders, insufficient intake of iron by alimentary tract, chronic blood loss, severe illnesses transferred, blood cancer, etc.
Patients with anemia complain of general weakness, headaches, memory impairment, decreased ability to concentrate, loss of appetite and sleep disorders.The skin of such patients is pale or icteric.The disease is easily diagnosed on the basis of laboratory blood test data.The type of anemia is specified when conducting additional studies.Treatment is carried out by a specialist-hematologist.
Dispensary often accompanies endocrine pathologies such as diabetes mellitus, thyrotoxicosis( thyroid disease) and obesity.With thyrotoxicosis, metabolism is accelerated, as a result of which the body's need for oxygen increases.Increasing the level of thyroid hormones increases the frequency of contractions of the myocardium, and the heart can not pump the blood to other tissues in the right amount.As a consequence, hypoxia develops, which causes a person to breathe more often and deeper.
Obesity significantly complicates the work of the lungs, heart and respiratory muscles, which also leads to oxygen deficiency.
Diabetes mellitus as it progresses affects the blood vessels, so all body tissues begin to suffer from a lack of oxygen.Diabetic nephropathy leads to anemia, which additionally increases hypoxia and causes dyspnea.
Shortness of breath for nervous disorders
75% of patients with psychiatrists and neurologists complain of a more or less pronounced dyspnea from time to time.Such patients are concerned about the feeling of lack of air, which is often accompanied by the fear of dying from suffocation.Patients with psychogenic dyspnea are mostly hypochondriacs with unstable psyche and a tendency to hypochondria.Dyspnoea can develop in them with stress or even for no apparent reason.In some cases, so-called.Attacks of false asthma.
A specific feature of dyspnea with neurotic conditions is its "noise formulation" by the patient.He loudly and often breathes, moans and groans, trying to attract attention.
Dyspnea in pregnant women
During pregnancy, the total volume of circulating blood rises.The respiratory system of a woman must supply oxygen at once to two organisms - a future mother and a developing fetus.As the uterus increases considerably in size, it presses against the diaphragm, somewhat reducing the respiratory excursion.These changes cause shortness of breath in many pregnant women.The frequency of breathing increases to 22-24 breaths per minute and additionally increases with emotional or physical exertion.Dispno can progress as the fetus grows;In addition, it is aggravated by anemia, which is often noted in expectant mothers.If the respiratory rate exceeds the above values, this is an occasion to show increased alertness and to consult a doctor of the female consultation leading the pregnancy.
Dyspnea in children
In children, the respiratory rate is different;She gradually cuts down as she grows up.
It is possible to suspect abnormal dyspnea in a child if the frequency of breaths per minute exceeds the following:
- 0-6 months - 60;
- 6 months - 1 year - 50;
- 1 year -5 years - 40;
- 5-10 years - 25;
- 10-14 years - 20.
It is recommended to determine FHD while the child is sleeping.In this case, the measurement error will be minimal.During feeding, as well as physical activity or emotional excitement, the frequency of the baby's breathing always increases, but this is not a deviation.It is worthwhile to worry if the breathing rate does not return to normal numbers at rest in the next few minutes.
Among the causes of dyspnea and dyspnoea in children are:
- respiratory distress syndrome( in newborns);
- false croup( acute inflammation of the larynx and trachea with stenosis);
- congenital heart disease;
- infectious diseases of the respiratory system;
- allergy attacks.
If the child has shortness of breath, it should be urgently shown to the district pediatrician.Severe respiratory insufficiency requires the calling of an ambulance brigade, since it is life-threatening condition.
For more information on dyspnoea, its causes and methods of diagnosing comorbid pathologies, you will receive in the video review:
Plisov Vladimir, medical reviewer