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Understanding Dyspnea: Causes and Assessment

Dyspnea, or shortness of breath, refers to an uncomfortable awareness of breathing that can vary in intensity. It is a common symptom with many potential causes. After taking a thorough history and physical exam, objective tests may be used to determine the underlying system or disease process. Spirometry, peak flow meters, blood gas analysis, imaging like x-rays or CT scans, and other tests can help evaluate patients for conditions affecting the lungs, heart, chest wall, muscles, or metabolism that could be causing dyspnea. Proper diagnosis is important to guide treatment of the underlying cause of a patient's shortness of breath.

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496 views29 pages

Understanding Dyspnea: Causes and Assessment

Dyspnea, or shortness of breath, refers to an uncomfortable awareness of breathing that can vary in intensity. It is a common symptom with many potential causes. After taking a thorough history and physical exam, objective tests may be used to determine the underlying system or disease process. Spirometry, peak flow meters, blood gas analysis, imaging like x-rays or CT scans, and other tests can help evaluate patients for conditions affecting the lungs, heart, chest wall, muscles, or metabolism that could be causing dyspnea. Proper diagnosis is important to guide treatment of the underlying cause of a patient's shortness of breath.

Uploaded by

BeNz Zodiazepin
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
  • Introduction to Dyspnea: The opening section introduces dyspnea with an illustrative diagram and introductory note.
  • Definition of Dyspnea: Defines dyspnea, its intensity, and compares normal and abnormal breathing rates.
  • Abnormal Breathing Patterns: Describes abnormal rhythm patterns such as Cheyne-Stokes and Kussmaul breathing.
  • Shortness of Breath Scale: Presents the American Thoracic Society scale for grading shortness of breath severity.
  • Causes of Dyspnea: Lists potential causes of dyspnea including physiological and psychological factors.
  • History Taking in Dyspnea: Guides on acquiring patient's history for assessment and diagnosis of dyspnea.
  • Lung Diseases Related to Dyspnea: Discusses lung diseases like airway obstruction and their contribution to dyspnea.
  • Heart Disease Impacting Breathing: Highlights how heart disease can lead to respiratory issues and dyspnea.
  • Evaluation and Testing for Dyspnea: Describes objective tests and evaluations required for diagnosing dyspnea.
  • Usage of Medical Devices: Provides instructions for using medical devices like inhalers and nebulizers for dyspnea management.

Dyspnea

Retno Ariza

Definition

Abnormally uncomfortable awarness of breathing


Intensity quantified Sensation

Normal breathing : respiratory rate about 14 20/mnt (adult), up to 44 (infant) Bradypnea : slow breathing (causes as coma,drug induced respiratory depression) Tachypnea : rapid shallow breathing (restrictive lung disease)

Abnormally of rhythm of breathing

Cheyne-Stokes breathing : periods of deep breathing alternate with periode apnea (brain damage) Kussmaul breathing : rapid deep breathing has causes metabolic acidosis Biots breathing : ataxic breathing is characterized by unpredictable irregularity. Breaths may be shallow or deep, and stop for short periods (respiratory depression and brain damage)

American Thoracic Society Shortness of Breath Scale


0 (none) no troubled by shortness of breath when hurrying on the level or walking up a slight hill 1(mild) troubled by shortness of breath when hurrying on the level or walking up a slight hill 2(moderate)walk slower than people of the same age on the level because of breathlessness or has to stop for breath when walking at own pace on the level

American Thoracic Society Shortness of Breath


3(severe) stop for breath after walking about 100 yard or after a few minutes on the level 4(very severe) too breathless to leave the house or breathless on dressing or undressiing

Cause

Chest wall Pleura Neuromuscular Lung disease Heart disease Metabolic system

Renal Hematology Rheumatohologic Psychiatric disorder Endocrine changes (pregnancy)

History taking of dyspnea


Acute (Asthma, MCI, pneumonia, CHF), chronic (respiratory distress from muscular dystrophy) Nocturnal dypnea : Asthma, CHF,gastroesophageal reflux,nasal congestion Supine position : pregnancy, acites,diaphragmatic paralysis Symptoms are intermittent (reversible disease) : asthma, CHF,COPD Symptoms appear with somethink induced (smoke,allergen) : asthma

Lung disease

Airway obstruction
Extrathoracic airways to lung periphery Upper airway obstructrion inspiratory stridor & retraction of supraclavicular fossae Intrathoracic obstruction asthma

Diffuse parenchymal lung disease Pulmonary embolism

Heart disease
pulmonary capillary pressure Fatigue of respiratory muscles Exertional breathlessness orthopnea paroxymal nocturnal dyspnea

Others

Disease of the chest wall or respiratory muscles


Severe kyphoscoliosis Spinal deformity Bilateral diaphragmatic paralysis

Other objective testing in the evaluation of dyspnea

After complete history & physical examination determine of the system


Respiratory system Cardiovascular system Metabolic disturbance, musculosceletal ect

Choice the objective testing

Respiratory infection : hematology (leucocyte,diff count), Blood gas analysis, x ray

Resiratory obstruction :Pulmonary Function Test (spirometry) Malignancy in respiratory system : broncoscopy, CT Scan CVS : EKG,ECHO Metabolic : Blood sugar, BGA, renal function test,ect

Peak flow meter

Spirometry

Bronchoscopy

Radiology

Radiology

Pleura Space

To use M D I

Nebulizer

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