Shortness of breath (Dyspnea)

Important:

Dyspnea is a condition that makes you feel like the air you breathe is not enough. If you feel pressure and heaviness in your chest along with shortness of breath, if you have pain radiating to your arms, back, neck and jaw, you may be experiencing a heart problem. Call the emergency services immediately and seek help.

Sometimes you may be experiencing severe shortness of breath without chest pain. In this case, you may be experiencing a condition that causes damage to your lungs. In such a case, immediately call 112 emergency service and seek help.

What is dyspnea?

Dyspnea is a complaint of respiratory failure. There are many breathing problems that are perceived as dyspnea but not dyspnea. For example, the feeling of sighing or not being able to breathe deeply is not dyspnea. Excessive breathing is called hyperventilation. Frequent deep breathing is called hyperpnea. The shortness of breath that occurs when lying down and decreases when sitting upright is called orthopnea. An attack of shortness of breath that occurs at night and awakens from sleep is called paroxysmal nocturnal dyspnea.



Dyspnea can be grouped in two ways: acute dyspnea with sudden onset and chronic dyspnea that lasts for a long time.

What is acute dyspnea?

Patients experiencing acute dyspnea complain of sudden onset of shortness of breath. These patients may also experience increased heart rate, frequent breathing and fever. They should be evaluated urgently for further examination and treatment in a hospital setting.

The most common causes of acute dyspnea are:

• Pneumonia:
  • They are severe infections of the lungs. Viral, bacterial or fungal infections may be the cause. Due to infection, the passage of oxygen into the blood decreases and causes respiratory distress. Symptoms such as cough, sputum, chest pain, fever and chills may be seen in these patients along with dyspnea.
• Pulmonary embolism:
  • It is a vascular occlusion in the lung tissue. Since there will be no blood supply in the tissues following the veins, there will be tissue damage and decrease in oxygenation, and shortness of breath occurs with severe pain. It is seen in conditions such as prolonged immobility, recent surgery, congestive heart failure, recent trauma. In addition, the susceptibility is increased in patients with previous vascular occlusion or vascular inflammation. In addition, women using oral contraceptives and patients with sickle cell anemia or polycythemia have an increased susceptibility to pulmonary embolism. At the same time, the susceptibility to pulmonary embolism is increased in diseases in which the anticoagulation proteins in the blood are insufficient.
• Spontaneous pneumothorax:
  • It is the sudden accumulation of free air in the lung that should not normally occur. Since this air cannot be expelled, it can cause tension and damage to the surrounding tissues. This causes respiratory limitation. It is mostly seen in young, thin and tall people. In these patients, sudden onset chest pain occurs. It usually occurs after strenuous exercise, severe coughing, or air travel. Sometimes, some underlying diseases may facilitate this picture.
• Acute asthma attack:
  • An acute asthma attack can begin at any age against a seasonal or specific stimulus. It is often difficult to exhale and it becomes difficult to expel the inhaled air. The patient coughs frequently and has shortness of breath.
• Foreign body aspiration:
  • Foreign body escaping into the lungs makes it difficult to breathe and dyspnea occurs. Children, unconscious or intoxicated patients may not remember the event.
• Conditions that cause pulmonary edema:
  • ARDS (Adult Respiratory Distress Syndrome): ARDS may occur after septic shock caused by systemic infection or excessive blood loss, usually caused by hemorrhagic shock for any reason. Sometimes ARDS may develop after acute pancreatitis, multiple trauma, choking hazard or severe pneumonia. In these patients, dyspnea may occur within a few days.
  • Shortness of breath may also occur with inhalation of harmful gases.
  • Height; Pulmonary edema develops and dyspnea develops in young adults, who usually go to high areas in a short time and engage in heavy activity before they get used to the air pressure of the rate.
  • Pulmonary edema caused by neurogenic causes also causes dyspnea. For example, it can be seen in patients with epilepsy or in patients with increased intracranial pressure for any reason.
  • Heart diseases can also be an important underlying cause of acute dyspnea. Congestive heart failure, mitral valve stenosis or acute myocardial infarction can cause sudden onset of dyspnea.
• Hyperventilation: Dyspnea may develop as a result of frequent breathing for emotional reasons, usually in young people without any other reason. Usually a tingling sensation and spasm at the corner of the mouth can also be seen.

What is chronic dyspnea?

If you have shortness of breath for a few weeks to a few months, there can be many reasons. This condition can sometimes be seen together with cough. Chronic dyspnea can also occur from pulmonary or extrapulmonary causes. Let’s look briefly at the causes of chronic dyspnea:

• Causes of chronic dyspnea originating from the lungs
  • Chronic obstructive pulmonary diseases
    • Emphysema; these patients have long-standing dyspnea that gets progressively worse.
    • Chronic bronchitis; These patients have a cough with sputum for nearly 2 years. There may also be a long history of smoking, a history of recurrent pneumonia.
    • Chronic asthma
  • restrictive lung diseases
    • Interstitial lung diseases (sarcoidosis, rheumatoid lung, scleroderma, pneumoconiosis, histiocytosis x, lymphangitic carcinomatosis, idiopathic fibrosing alveolitis etc.)
    • Chest wall deformities (kyphoscoliosis, thoracoplasty)
    • pleural fibrosis; In these patients, hardening of the outer membrane of the lung occurs due to previous tuberculosis, trauma, a history of frequent bacterial pneumonia or asbestosis, and breathing became difficult because the lungs could not expand.
    • Alveolar filling diseases (alveolar proteinosis, alveolar cell carcinoma, desquamative interstitial pneumonia, alveolar microlithiasis)
    • Neuromuscular diseases (myasthenia gravis, amyotrophic lateral sclerosis)
  • Causes of chronic dyspnea of extrapulmonary origin
    • Heart diseases
    • Anemia
    • Hyperthyroidism
    • Diseases of the upper respiratory tract
    • Obesity
    • Neurotic causes

Dyspnea is a health problem that should be treated by investigating its causes. If you think you have such a health problem, consult your doctor immediately.