Lack of air (inspiratory dyspnea) is difficulty breathing while inhaling with a feeling of insufficient oxygen supply. May be accompanied by noisy, wheezing breathing. Occurs during pregnancy, diseases of the larynx, lungs, pleura, heart disease, emergency conditions, injuries, neuroses. To establish the causes of the disorder, chest x-ray, spirometry, ECG, laryngoscopy, and blood tests are prescribed. Prior to the diagnosis, to reduce severe shortness of breath, the patient is provided with rest, access to fresh air, and sedative herbal remedies are used.
When determining the degree of inspiratory dyspnea, the relationship between respiratory disorders and motor activity is taken into account. Normally, in a calm state, a person makes no more than 14-2 respiratory movements per minute, and the feeling of insufficient inhalation of air worries only after heavy exertion. There are 4 degrees of shortness of breath, indicating the likely presence of the disease:
Difficulty breathing in healthy people is caused by a mismatch between the amount of air inhaled and the need for oxygen. Such shortness of breath worries when doing hard work, during intense training, climbing mountains, in stressful situations. The appearance of a feeling of lack of oxygen contributes to the wearing of tight clothing, belts and corsets that prevent normal breathing. In older people, as a result of age-related changes in blood vessels and the heart, shortness of breath may occur with minimal exertion. The feeling of lack of air also manifests a number of conditions and diseases.
Shortness of breath with a feeling of insufficient inspiration occurs mainly in the 2nd half of the gestational period. With an increase in the uterus, the diaphragm is pressed up, which limits the depth of breathing. The longer the gestation period, the more often there is a lack of oxygen even with calm walking and slight exertion. At the same time, the frequency of respiratory movements at rest increases to 22-25 breaths per minute. When shortness of breath, a pregnant woman is usually disturbed by slight dizziness, sometimes flickering of “flies” and darkening in the eyes.
The symptom is more often manifested and more pronounced in patients who bear a large fetus, multiple pregnancy, suffer from polyhydramnios. An aggravating factor is the syndrome of the inferior vena cava during pregnancy. With aorto-caval compression, in addition to shortness of breath, due to the limitation of the mobility of the diaphragm, the woman experiences difficulty in breathing and lack of air in the supine position. Respiratory distress is combined with sudden weakness, severe dizziness up to fainting.
Increasing shortness of breath with difficulty breathing is a characteristic sign of inflammation of the pleura. Respiratory disorders are caused by intense pain during dry pleurisy, accumulation of fluid in the pleural cavity - with exudative, purulent, hemorrhagic process. Lack of air is the result of shallow, sparing breathing: in order to reduce acute stabbing or dull pulling pain over the affected areas, the patient limits the volume of respiratory movements. Often shortness of breath is accompanied by a painful dry cough, fever, chills.
With inflammatory and diffuse damage to the lung tissue, the feeling of lack of inhaled air is associated with the exclusion of part of the lung from the respiratory process, limiting its mobility and elasticity. Patients complain not of incomplete inspiration, weakness, fatigue, dizziness. With signs of pulmonary dyspnea, as a rule, proceed:
Most often, inhalation difficulties are caused by diseases in which, as a result of damage to the mucous membrane and vocal cords, obstacles are formed in the path of the movement of air masses. Shortness of breath of laryngeal origin is often characterized by a feeling of limited airflow into the airways, wheezing noisy breathing (stridor). The symptom is observed in the following pathological conditions:
When foreign objects enter the respiratory tract, there is difficulty in breathing up to the complete impossibility of inhalation. Lack of air feels like suffocation. The patient shows anxiety, takes a forced position, breathes often and superficially (“sobs”). A distinctive feature is the suddenness of the development of the symptom after accidental inhalation of food, small objects. Almost immediately, a paroxysmal cough begins with lacrimation, profuse salivation, increased formation of nasal mucus. The face becomes purplish-bluish.
If a foreign body remains in the airways, not completely blocking their lumen, third-party sounds may occur during breathing. Balloting objects in the lumen of the trachea is accompanied by hissing, buzzing, whistling. For partial obstruction of the bronchus, a remotely audible whistle is characteristic. At the same time, the intensity of the cough decreases, it is possible to expectorate mucous sputum with particles of a foreign body. Shortness of breath becomes less frequent, but pain in the neck and chest increases. Subsequently, inflammatory processes join.
Features of inspiratory dyspnea in malignant neoplasia depend on the localization of the oncological process. However, in any case, respiratory disorders precede or supplement the specific symptoms of the disease and general manifestations in the form of rapid fatigue, loss of appetite, and progressive weight loss. The feeling of inadequate breathing can disturb patients who develop:
Complaints about the lack of oxygen are one of the characteristic signs of cardiac shortness of breath, which is detected in cardiac diseases that occur with rhythm disturbance (tachycardia, extrasystole, WPW syndrome) or insufficient blood supply to the myocardium (angina pectoris, unstable angina pectoris, other forms of coronary heart disease). The severity of the symptom usually directly depends on the degree and form of heart failure. In mild cases, lack of air is felt after moderate physical exertion, with strong emotional experiences.
Pathological changes in the respiratory process in chronic heart failure are manifested by a feeling of lack of air and an increase in respiratory movements during simple physical exercises, daily work, fast, and then normal walking, at rest. Patients describe their sensation as a desire to inhale more air "full chest", note that they are "out of breath". Typical cyanosis (cyanosis) of the nasolabial triangle, nails, swelling of the lower extremities, severe fatigue, complaints of discomfort, heaviness, chest pain.
Shortness of breath with a feeling of acute air deficiency is a harbinger or symptom of a number of disorders requiring emergency medical attention. Together with dizziness, fog and “flies” before the eyes, “lightheadedness”, it indicates an approaching faint (syncope). Severe respiratory failure and severe difficulty in inhaling is observed in such acute conditions as:
Respiratory disorders in thoracic injuries can be both short-term and increasing. So, with bruised ribs, transient difficulty in breathing is secondary and is associated with restriction of respiratory movements due to chest pain with deep inhalation of air. With closed traumatic or spontaneous pneumothorax, complaints of insufficient oxygen supply, frequent breathing, blue lips, along with sharp stabbing chest pains radiating to the arm and neck, cold sweat, pressure drop, subcutaneous emphysema become leading in the clinical picture.
Up to 75% of patients of neurologists and psychiatrists complain of frequent or constant lack of air, a feeling of a "damper" or other obstruction in the chest, which makes it difficult to fully breathe. Often, patients have associated emotional disorders - anxiety, hypochondria, phobias, in particular, the fear of death from suffocation. The key features of neurotic shortness of breath are the appearance or intensification after psychotraumatic situations, vivid, figurative descriptions of experiences, characteristic noise design (groans, groans, sighs). Shortness of breath is especially acute during a panic attack.
With cardioneurosis, somatoform dysfunction of the autonomic nervous system, vegetovascular dystonia, a combination of difficulty in breathing with constant or paroxysmal palpitations, headaches, tingling in the precordial region, chilliness, sweating, a tendency to turn pale or reddened is typical. A subjectively felt lack of incoming air (“empty breath”), forcing the patient to breathe often, deeply and noisily in the absence of somatic prerequisites, is one of the options for respiratory dysfunction in hyperventilation syndrome.
At the initial stages of the diagnostic search, patients with complaints of lack of air are managed by a local therapist or family doctor, who, taking into account the anamnesis and research results, appoint consultations of specialized specialists. For a quick comprehensive screening of pathologies accompanied by difficulty in breathing, the following are prescribed:
Possible inflammatory changes (increased ESR, leukocytosis), signs of anemia are determined by a general blood test. At further stages of the examination, tomographic methods are used (CT, MRI of the chest cavity), ultrasound of the heart, bronchoscopy, pleuroscopy, transbronchial lung biopsy, followed by a histological study of the material obtained. If heart disease is suspected, stress tests (veloergometry, treadmill test, etc.) are recommended.
Physiological difficulty in breathing goes away on its own after rest. In the event of a sudden lack of air, the patient must be reassured, seated on a chair, armchair, bed (with an elevated position and back support on the pillows). To facilitate breathing, it is necessary to remove tight clothing, a tight belt, unbutton the top buttons of a shirt or blouse. It is important to ensure the flow of oxygen into the room - open the window, open the window or door. In order to humidify the air, you can turn on the kettle, hang a damp sheet next to the bed, and fill the bath with water.
Self-administration of herbal sedatives is allowed. In heart or lung disease, another known cause of shortness of breath, the patient is advised to drink the drugs that he takes constantly. If within 10-15 minutes the condition does not improve, you should call an ambulance. With repeated attacks of lack of oxygen that pass on their own, a constant or periodic feeling of difficulty when inhaling, you should consult a doctor to find out the causes of the respiratory disorder.