Dyspnoea |Shortness of Breath|Respiratory Physiology

                                                                     Dyspnoea 

This article discusses different causes of dyspnoea, stages of dyspnoea, and more.

Keywords:

Psychometric |5-point Likert Scale (5PLS) |MRC breathlessness scale| COPD|

 Table of contents

1.	Introduction
2.	Causes
3.	Stages and severity
4.	Treatment
5.	Prognosis

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Definition 

A patient with dyspnoea,Credit -Canva

Dyspnoea is the medical term commonly used for shortness of breath.'

According to the American Thoracic Society, "dyspnoea is a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity."

Difficulty in breathing is dyspnoea. A person becomes conscious of breathing.

We are unaware of our respiration, but in dyspnea, we become uncomfortably aware of breathing and experience breathlessness. We feel we cannot breathe well and feel 'air hunger.'

When pulmonary ventilation increases by more than double, it increases awareness of respiration. When it increases by three to four times, it causes uncomfortable breathing, i.e., a person becomes dyspneic.

[ Average pulmonary ventilation is six liters per minute.]

It is known as a dyspneic point when pulmonary ventilation becomes three to four times that of normal pulmonary ventilation and produces dyspnoea or uncomfortable breathing.

Causes:

1. Cardiovascular system- common cardiovascular causes are myocardial infarction and heart failure.

2. Respiratory system   COPD (chronic obstructive pulmonary disease), asthma, pneumonia, emphysema, and pulmonary edema.

3. Neurological causes: Multiple sclerosis, phrenic nerve, and spinal cord injury.

4. Musculoskeletal: Muscular dystrophy, respiratory muscle, and bone injury.

5.Endocrinal-metabolic acidosis.

6.Hematological -anemia.

7. Psychiatric causes: anxiety.

8. Environmental causes: sudden environmental changes, chemicals, and pollution.

https://youtube.com/shorts/h4zLOXsfPcg

Special types of dyspnea-

1. Cardiac dyspnea is due to heart failure, which produces stagnant hypoxia. A patient suffering from heart failure becomes dyspneic on lying down.

2. Orthopnoea – dyspnea in the lying down position.

3. Platypnea-dyspnea in sitting or standing position.

3. Bendopnea- dyspnea on bending over.

On a pathophysiological basis, causes can be divided into:

1. Increased awareness of normal breathing, for example, during anxiety.

2. Increased work on breathing, and

3. Abnormality in the respiratory system.

Three main components contribute to the development of dyspnea;

1. Afferent signals

2. Central processing in the brain

3. Efferent signaling.

Severity of dyspnea :

MRC breathlessness scale

(1) Grade 1 -no dyspnea except with strenuous exercise.

(2) Grade 2- dyspnea when walking up an incline or hurrying on the level.

(3) Grade 3- walk on the level or stop after 15 minutes of walking on the level

(4) Grade 4 stops after a few minutes of walking on the level

(5) Grade 5- too dyspneic to leave the house.

5-point Likert Scale (5PLS) for dyspnoea is a psychometric instrument for the measurement or grading of dyspnoea

Scale 1.no dyspnea

Scale 2 mild shortness of breath

Scale 3 moderate shortness of breath

Scale 4 severe shortness of breath

Scale 5 worst possible shortness of breath

Treatment

Dyspnea is treated by addressing the underlying disease or condition.

Prognosis

The prognosis depends on the underlying disease and proper treatment.

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