Shortness of breath (dyspnea) is a violation of the function of external respiration, accompanied by both objective symptoms and a subjective feeling of lack of air. The development of dyspnea is caused by pathologies of the respiratory and cardiovascular systems, anemia. The symptom may occur due to organic lesions of the central nervous system, neurotic disorders, metabolic disorders. To identify the cause of shortness of breath, spirometry, radiography, ECG, ultrasound, and laboratory tests are performed. To reduce symptoms, non-drug methods are used, the underlying disease is corrected.
Shortness of breath is perceived by patients as a subjective feeling of lack of air, inefficiency of respiratory movements, tightness in the chest. The symptom is accompanied by characteristic objective signs: increased or slowed down inhalations-exhalations, blanching or cyanosis of the nasolabial triangle, convulsive loud inhalation, suffocation. Often, to alleviate the condition, a person with dyspnea stops moving, takes a forced position - sits on a chair or bed, leans forward slightly, leaning on straight arms.
Most often, the appearance of shortness of breath is associated with physical exertion, and at the beginning of the disease, the disorder is provoked only by significant activity, and with progression, patients feel short of breath after normal activities. In addition to respiratory disorders, pathological symptoms are possible: pain and discomfort in the chest, headache, dizziness, decreased performance. If shortness of breath is noted during the performance of habitual work or at rest, it is necessary to seek the advice of a specialist.
Shortness of breath is caused by many complex reflex mechanisms that involve higher nervous structures, so there are several theories of its development. The direct cause of the violation of the frequency and quality of breathing, many doctors call a change in the content of oxygen and carbon dioxide in the blood. An increase in carbon dioxide concentration, leading to a decrease in pH, has a significant stimulating effect on the bulbar centers, peripheral chemoreceptor zones of the arteries and central receptors located in the medulla oblongata.
At the same time, protective mechanisms are activated, the respiratory center of the brain stem sends activating impulses to the bronchopulmonary system, causing pathological rapid breathing. The appearance of shortness of breath is associated with impulses from the spindle-shaped nerve endings of the respiratory tract, which are activated due to various pathological processes. Sometimes an increased work of the respiratory center is observed with descending cortical influences caused by hysterical or neurotic states.
The connection of the symptom with the temperature of the internal environment of the body has been proved. With hyperthermia, the sensitive zones of the respiratory center are washed with warmer blood, which causes their activation - the so-called thermal shortness of breath occurs. A decrease in body temperature, on the contrary, leads to a decrease in respiratory movements. The development of dyspnea is affected by the amount of muscle load and the level of metabolism. Most researchers believe that this mechanism is due to two types of reactions - slow humoral and fast neurogenic.
Subjective sensations in the form of lack of air and suffocation are primarily associated with the spread of excessive excitation from the centers of the medulla oblongata to the limbic structures and the cerebral cortex. This causes the appearance of negative emotional reactions of fear and anxiety in patients with shortness of breath. Sometimes unpleasant symptoms develop due to a mismatch between the body's needs for ventilation and the functionality of the respiratory apparatus to provide it.
Shortness of breath can manifest itself in many diseases and pathological conditions, therefore, to facilitate the diagnostic search, it is necessary to accurately determine its type. The classification of a symptom is based on the mechanism of development, the degree of change in respiratory function, the ratio of inhalation-exhalation phases. There are physiological shortness of breath, when the frequency of inhalations and exhalations changes in proportion to physical activity, and pathological. Most often, the symptom is classified in relation to the respiratory phases:
Taking into account changes in respiratory function, several types of shortness of breath are distinguished: tachypnea - an increase in the frequency of breaths more than 4 per minute, bradypnea - a decrease in respiratory movements less than 12 per minute, apnea - a sudden stoppage of breathing. There is a classification of the symptom according to the main mechanism of development: central dyspnea is observed with organic or functional changes in the work of the respiratory center in the medulla oblongata, the neurogenic variant is associated with a weakening of inhibitory influences in the cerebral cortex, the hemic form develops with anemia.
A subjective feeling of difficulty in breathing can be observed in healthy people after intense physical exertion, in pregnant women. Pathological causes of the symptom are various disorders in the work of the respiratory and other body systems. Lack of air is caused by:
Expiratory dyspnea with convulsive short inhalation and prolonged exhalation is often a sign of various diseases of the bronchopulmonary system. The symptom is often accompanied by a feeling of tightness in the chest. Difficulty exhaling manifests the following pathological conditions:
Patients with complaints of lack of air or difficulty exhaling seek help from a specialist pulmonologist or local therapist. Diagnostic search involves laboratory and instrumental studies of the respiratory system, functional tests. The most informative to clarify the cause of shortness of breath are:
To identify the etiological factor of shortness of breath, allergy tests are performed, the results of an extended immunogram are informative. If suspicious lesions are found on radiographs, a transbronchial lung biopsy is performed. For the diagnosis of rare congenital malformations, as a possible cause of dyspnea, specialized specialists are involved.
Inhaled bronchodilators are used to quickly relieve shortness of breath
With a sharp onset of an attack of shortness of breath, the patient must be reassured, seated on a chair or bed so that the body is in an elevated position. To facilitate breathing, it is advisable to remove tight clothing, belt, unbutton the shirt collar. It is necessary to ensure the flow of fresh air into the room - open a window or door. Allowed to take herbal sedatives. The frequent occurrence of breathing difficulties indicates the development of the disease or the progression of existing diseases. In such a situation, it is necessary to consult a doctor as soon as possible.
The treatment regimen is selected individually, taking into account the cause of dyspnea. An important place in the treatment of chronic conditions accompanied by shortness of breath is occupied by lifestyle correction: smoking cessation, regular performance of a special set of physical exercises. With hypoxemia, sessions of oxygen therapy are performed. Shown etiotropic, pathogenetic and symptomatic drug therapy with drugs of the following groups: