Dyspnea

Basics

DESCRIPTION

A subjective experience of breathing discomfort that consists of qualitatively distinct sensations that varies in intensity

PATHOPHYSIOLOGY

Abnormality in one of the following elements:

  • Respiratory controller (breathing rate, depth)
  • Ventilatory pump (chest wall, pleura, airways)
  • Gas exchanger (alveoli, capillaries)
  • Cardiovascular derangements (cardiac output)

ETIOLOGY

  • Respiratory
    • Upper airway
      • Infection (croup, tracheitis, peritonsillar abscess, epiglottitis)
      • Foreign body
      • Anaphylaxis
      • Anatomic abnormalities
      • Vocal cord dysfunction (VCD)/paradoxical vocal fold movement (PVFM)
    • Lower airway
      • Asthma
      • Aspiration
      • Airway malacia
      • Hemorrhage
      • Internal/external fixed compression (tumor, cyst, vascular)
    • Parenchymal lung disease
      • Infection (viral, bacterial, fungal)
      • Interstitial lung disease (ILD)
      • Atelectasis
      • Chronic lung disease (chronic obstructive pulmonary disease [COPD], cystic fibrosis)
    • Chest wall disorder
      • Neuromuscular weakness (Duchenne muscular dystrophy [DMD], spinal muscular atrophy [SMA])
      • Scoliosis
      • Pectus excavatum
    • Pleural
      • Pleural effusion
      • Pneumothorax
  • Cardiovascular
    • Cardiac
      • Elevated pulmonary venous pressure
      • Congestive heart failure (CHF)
    • Vascular
      • Pulmonary hypertension (PH)
      • Pulmonary embolism (PE)
  • Toxic/metabolic
    • Metabolic acidosis (diabetic ketoacidosis [DKA], salicylate intoxication, renal tubular acidosis [RTA])
    • Renal failure causing fluid overload
  • Other
    • Anemia
    • Deconditioning
    • Obesity
    • Panic attack
    • Pregnancy
    • Trauma
    • Gastroesophageal reflux disease (GERD)

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