What Is Dyspnea: Causes, Diagnosis, And Treatment

• which is subjectively felt as ” hunger / need for air ” and inadequacy of breathing
• involves increased effort to breathe,

resulting in non-spontaneous muscular effort to inhale and exhale.

Types Of Dyspnea

Dyspnea can be:

• Accessional : when it arises suddenly, without a precise regularity, as can happen in asthma , in closure of the glottis (throat), in pulmonary edema (presence of liquid in the small airways);
• Exertional : when it occurs during more or less intense physical activity and resolves with rest. This occurs for example in some heart diseases or in anemia ;
• Continuous : present constantly. It can be caused by heart failure or severe respiratory failure.

Depending on the phase of breathing in which dyspnea occurs, it can be inspiratory, expiratory or mixed.

Causes Of Dyspnea

Diseases of the respiratory centers : breathing is regulated by groups of neurons that function independently of the control of the subject’s will and which are located in a structure of the brain called the brainstem , under the cerebral hemispheres .

It can happen, for various reasons, that these neurons become ill, and therefore breathing is compromised with the appearance of dyspnea. The causes that can damage the respiratory centers are: inflammation , infections, trauma (especially due to road accidents), tumors, toxic substances (medicines or drugs based on opium , barbiturates ), hypoxia (when little oxygen passes into the blood), hypercapnia ( accumulation of carbon dioxide in the blood).

Impairment of the nervous pathways that carry information from the respiratory centers to the effector muscles for :

• multiple sclerosis (disease of the neurons of the central nervous system that destroys myelin , a protein that surrounds them);
• amyotrophic lateral sclerosis (which slowly destroys all neurons, both in the central and peripheral nervous system).

Respiratory Muscle Diseases :

• myasthenia gravis (chronic inflammatory disease that causes weakness of all muscles, including the chest wall).

Rigidity of the chest , which does not allow it to expand well, due to:

• scleroderma (chronic inflammatory disease that affects the internal organs and also the skin , making it hard and not very elastic);
• severe pain due to broken rib (which limits breathing movements).

Increased Abdominal Volume For:

• pregnancy (the growing baby compresses the diaphragm , which is located above the uterus and is the main breathing muscle);
• meteorism (abdomen filled with gas);
• ascites (fluid that forms due to liver diseases such as cirrhosis and hepatitis and which accumulates in the peritoneum , the membrane that surrounds the abdominal viscera ).

Obstructive lung diseases , i.e. obstructed passage of air in the airways:

• foreign bodies (especially in children who ingest small objects);
• diphtheria (infectious disease that causes inflammation and spasms of the larynx );
• asthma attacks (in which bronchial spasms and excessive mucus production occur );
• chronic bronchitis ;
• tumors ;
• pulmonary emphysema (disease in which the septa that separate the alveoli break and form large sacs filled with air, which thus remains trapped and struggles to exit the respiratory system);
• pulmonary edema (presence of liquid that hinders the diffusion of oxygen from the lung to the blood).

Restrictive Lung Diseases , i.e. due to a compromise of all lung tissue, such as:

• pulmonary fibrosis (replacement of the alveoli with fibrous tissue, not very elastic, therefore not inclined to expand during breathing), mostly due to substances of various kinds inhaled for years in work environments (asbestos, gas, etc.) or as a result of severe pneumonia , or radiation ;
• pleural effusion (fluid in the pleura);
• pneumothorax (air in the pleura);
• hemothorax (blood in the pleura).

Chest Wall Diseases :

• fibrosis;
• fat accumulation (obese people);
• chest wall deformity (from spinal abnormalities such as scoliosis , kyphosis , and lordosis ).

Heart disease : They are responsible for what is called cardiogenic dyspnea. The difficulty in breathing in those suffering from the heart is due to the fact that this organ, when severely compromised by various diseases such as heart attacks, valve alterations, cardiac decompensation or dilation, pumps less blood into the aorta because it has lost its “strength” .

As a result, blood accumulates upstream of the left heart, in the pulmonary veins . If this accumulation is large, a great pressure is created in the veins themselves which can cause the liquid to escape from the vessels. This compresses the small airways and can, in the most serious cases, also enter the alveoli, giving what is called pulmonary edema, a very serious condition which prevents the passage of oxygen and carbon dioxide from the alveolus to the blood and vice versa. , and which must be treated urgently because it can lead to death in a very short time. There are different degrees of cardiogenic dyspnea:

• class I: when the patient is not “hungry for air” but has a documented heart disease that could soon cause it;
• class II: when he has no symptoms at rest but they appear when performing high intensity efforts;
• class III: when dyspnea appears due to mild intensity efforts;
• class IV: when dyspnea is present even at rest.

Blood Diseases , which alter its composition:

Psychological And Psychiatric Causes

in patients suffering from neurosis , anxiety , anguish , depression .