BSN Notes: Common Signs And Symptoms: Dyspnea

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Dyspnea -  difficulty in breathing
Mechanisms of Dyspnea
·         Respiratory sensations are the consequence of efferent and afferent input from receptors throughout the body.
·         A given disease state may lead to dyspnea by one or more mechanisms.
            Motor Efferents:
·         Disorders of the ventilatory pump are associated with increased work of breathing or a sense of an increased effort to breathe.
·         When the muscles are weak or fatigued, greater effort is required, even though the mechanics of the system are normal.
            Sensory Afferents:
·         Chemoreceptors in the carotid bodies and medulla are activated by hypoxemia, acute hypercapnia, and academia.
·         Leads to increase in ventilation, produce a sensation of air hunger.
Occurs in -
·         Chest tightness or constriction -  in Bronchoconstriction, asthma, myocardial ischemia
·         Increased work or effort of breathing - Airway obstruction, neuromuscular disease, kyphoscoliosis
·         Air hunger, need to breathe- Increased drive to breathe (CHF, pulmonary embolism, moderate to severe airflow obstruction.
Common causes
Respiratory System Dyspnea
·         Disorders of the airways (e.g., asthma, emphysema, chronic bronchitis, and bronchiectasis) lead to increased airway resistance and work of breathing. Hyperinflation further increases the work of breathing
·         Conditions that stiffen the chest wall, such as kyphoscoliosis, or that weaken ventilatory muscles, such as myasthenia gravis or the Guillain-Barre syndrome, are also associated with an increased effort to breathe.
·         Pneumonia, pulmonary edema, and aspiration all interfere with gas exchange.
·         Pulmonary vascular and interstitial lung disease and pulmonary vascular congestion may produce dyspnea by direct stimulation of pulmonary receptors.
Cardiovascular System Dyspnea
·         Mild to moderate anemia is associated with breathing discomfort during exercise
·         Hypertension, aortic stenosis, or hypertrophic cardiomyopathy- cause of exercise-induced breathlessness.  
·         Pericardial disease.
·         Diseases of the myocardium resulting from coronary artery disease and non-ischemic cardiomyopathies.
Management
·         Correct the underlying problem responsible for the symptom.  
·         Supplemental O2 administration -  oxygen mask , venture mask  
·         Propped up position.

·         Intubation and mechanical ventilation.

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notes.nursium.com: BSN Notes: Common Signs And Symptoms: Dyspnea
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