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Dyspnea: Symptoms, Causes and Treatment

Dyspnea is a condition characterized by shortness of breath or difficult or labored breathing. The intensity of the condition varies from mild to severe, as does the number of episodes a person with dyspnea may experience. The condition can be extremely frightening for patients, though it is typically not life-threatening.

Dyspnea Symptoms

Symptoms of dyspnea can occur when a person is completely at rest as well as during periods of intense exercise. Although shortness of breath remains the primary symptom, the following symptoms may also accompany dyspnea:

difficult or labored breathing
feeling of suffocation or smothering
inability to get enough air
tightness in the chest.

With dyspnea, different symptoms often indicate different causes. For instance, tightness in the chest may indicate a ventilatory disorder, including asthma. A feeling of suffocation may indicate a pulmonary edema.

When discussing your symptoms with your health care provider, it is important to be as specific as possible. Also, if you are experiencing any symptoms that don't seem to be related to dyspnea, be sure to tell your doctor. These symptoms might help your doctor diagnose an underlying cause.

Dyspnea Causes

Dyspnea can be caused by a variety of pulmonary or cardiac conditions, cancer or a variety of illnesses and infections:

Cancerous Causes: Cancerous causes can include a tumor blocking the trachea or bronchus or a tumor that prevents the lungs from fully expanding to take in enough air. People with lung cancer commonly experience dyspnea.
Cardiac and Pulmonary Causes: Most causes of dyspnea have roots in a cardiac or pulmonary disorder. Cardiac or pulmonary causes include an accumulation of fluid in either the lung tissue (pleural effusion) or around the heart itself (pericardial effusion).
Non-Cancerous Illnesses and Infections: Many non-cancer-related illnesses or infections can also cause dyspnea, including:
- anemia
- anxiety
- asthma
- cardiomyopathy
- chronic bronchitis
- chronic obstructive pulmonary disease (COPD)
- congestive heart failure
- emphysema
- pneumonia
- pulmonary edema
- renal insufficiency
- ventricular dysfunction.

This list by no means covers all the possible causes, which is why it's important to discuss symptoms with your health care provider for a full diagnosis.

Dyspnea Diagnosis

There is no specific way to measure dyspnea, as the severity and symptoms can vary. However, in order to form a diagnosis, a health care provider will most likely begin by giving you a physical examination.

The exam may involve an assessment of the health of your cardiac, respiratory and renal systems. Your doctor might also check your musculoskeletal and skin status. This helps to identify possible causes of dyspnea.

Finally, some laboratory testing may be needed, including:

a complete blood count
an electrocardiogram (ECG)
an evaluation of the oxygen and carbon dioxide levels in the blood
chest X-rays.

Based on the test results, additional testing may be needed.

Immediate Dyspnea Treatment

Dyspnea treatment can be either pharmacologic or non-pharmacological, depending on the dyspnea cause. Both aim to relieve the patient's difficult breathing.

When trying to cope with symptoms of dyspnea, it is important for the patient to remain calm. Panic will only exacerbate the problem. Here are some useful tips for immediate relief of dyspnea:

Abdominal Breathing: Lie on your back and bend your knees (you can use a pillow if it's more comfortable), then place one hand on your upper chest and the other on your stomach under your breastbone. Exhale slowly while squeezing your abdominal muscles inward (pressing them toward the floor), then allow your abdomen to expand as you inhale.
Controlled Breathing: Purse your lips, take a normal breath through your nose while counting the seconds required to inhale, then exhale through your pursed lips for twice the number of seconds required for inhalation. Don't force the air out, release it slowly.
Relaxation: Ease your muscles and try to relieve any tension in them to decrease their demand for oxygen. Also try learning various relaxation techniques that can help you, such as visualization, and use them when dyspnea occurs.
Medication: For immediate relief of especially severe dyspnea, patients may need medication, such as anti-anxiety drugs.

Overall Dyspnea Treatment and Prognosis

Further dyspnea treatment depends greatly on the underlying cause of the dyspnea. For instance, if it arises from cancer or infection, the cancer or infection must be treated to relieve the dyspnea.

Dyspnea prognosis will also vary based on the underlying cause of dyspnea.

Fortunately there are many treatments available to deal with the symptoms of dyspnea and to help provide relief, even if the underlying cause turns out to be a complicated health issue.

Resources

Lung Cancer Alliance (n.d.). Symptom Management – Dyspnea. Retrieved July 27, 2007, from the Lung Cancer Alliance Web site: http://www.lungcanceralliance.org/facing/dyspnea.html.

Merck & Co., Inc. (November 2005). Dyspnea. Retrieved July 27, 2007, from the Merck Web site: http://www.merck.com/mmpe/sec05/ch045/ch045d.html.

Morgan, Walter C.; Hodge, Heidi L., (Feb. 15, 1998). Diagnostic Evaluation of Dyspnea. Retrieved July 27, 2007, from the American Academy of Family Physicians Web site: http://www.aafp.org/afp/980215ap/morgan.html.

Oncology Nursing Society (2006). Dyspnea. Retrieved July 27, 2007, from the CancerSymptoms.org Web site: http://www.cancersymptoms.org/dyspnea/index.shtml.

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