home Audience 3 What is orthopnea? Dyspnea. The causes of shortness of breath are cardiac, pulmonary, and anemia. Diagnosis and treatment of causes of shortness of breath What is orthopnea position

What is orthopnea? Dyspnea. The causes of shortness of breath are cardiac, pulmonary, and anemia. Diagnosis and treatment of causes of shortness of breath What is orthopnea position

Dyspnea is difficulty breathing, accompanied by a feeling of lack of air and manifested by an increase in the frequency of respiratory movements. Clinically, shortness of breath is manifested by a feeling of lack of air, a feeling of difficulty in inhaling or exhaling, and discomfort in the chest. Breathing becomes shallow and frequent. Often the frequency of respiratory movements increases 2-3 times or more. Accessory muscles are involved in the act of breathing - a pathological increase in the work of the respiratory muscles, which is associated with an obstacle to exhalation or inhalation. With physical exertion, shortness of breath increases significantly. To determine the degree of shortness of breath, it is necessary to count the number of respiratory movements in 1 minute and attacks of suffocation. Normally, the respiratory rate of an adult per minute is 16-20 respiratory movements; for children, depending on age, it ranges from 20 to 35-40 per minute. Respiratory movements are counted by counting the number of movements of the chest or abdominal wall unnoticed by the patient.

The act of breathing occurs when the receptors of the respiratory muscles, tracheobronchial tree, lung tissue and vessels of the pulmonary circulation are irritated. At its core, shortness of breath is a protective reaction of the body that occurs in response to a lack of oxygen and excess carbon dioxide.

The accumulation of excess carbon dioxide in the blood leads to activation of the respiratory center located in the brain. To remove carbon dioxide from the body, compensatory hyperventilation occurs - the frequency and depth of respiratory movements increases. Thus, the physiologically necessary balance between the concentrations of oxygen and carbon dioxide is normalized.

Dyspnea is the main clinical sign of respiratory failure, i.e. a condition in which the human respiratory system does not provide the proper gas composition of the blood or in the event that this composition is maintained only due to the excessive work of the entire external respiration system.

In healthy people, shortness of breath may occur during physical activity or during overheating, when the body needs an increased supply of oxygen, as well as when the partial pressure of oxygen decreases or the partial pressure of carbon dioxide increases in the environment, for example, when climbing to a height.

Causes

1. Pathology of the respiratory system. Most often, pulmonary dyspnea develops in patients with pneumonia, bronchial asthma, tuberculosis, pleurisy, pulmonary emphysema, pulmonary embolism, as a result of chest trauma.

2. Pathology of the cardiovascular system. Shortness of breath appears in the event of the development of heart failure, and if at first it appears only during physical activity, then over time it also occurs at rest. In severe cases of bronchial asthma, advanced sclerotic changes in the pulmonary artery and hemodynamic disturbances, cardiopulmonary dyspnea develops.

3. Damage to the central nervous system. As a rule, cerebral dyspnea develops as a result of irritation of the respiratory center due to brain lesions. This can be neurosis, traumatic brain injury, brain tumors, hemorrhages. With shortness of breath caused by neurosis or hysteria, as well as in people feigning shortness of breath, breathing occurs without effort, and when the patient is distracted, the respiratory rate normalizes.

4. Disturbance of biochemical blood homeostasis. Hematogenous dyspnea often develops with poisoning, renal or liver failure, as a result of the accumulation of toxic substances in the blood that bind hemoglobin and, therefore, reduce the amount of oxygen in the blood, as well as with anemia, accompanied by a direct decrease in the number of red blood cells and hemoglobin.

Pulmonary dyspnea is of three types: inspiratory, expiratory and mixed.

Inspiratory dyspnea is manifested by difficulty breathing when breathing mechanics are disrupted.

usually occurs when the upper respiratory tract (larynx, trachea and large bronchi) is affected. Inspiratory dyspnea is accompanied by increased work of the respiratory muscles, which is aimed at overcoming excess resistance to inhaled air due to rigidity of the lung tissue or chest. It occurs with pressure from a tumor, a foreign body, reflex spasm of the glottis or inflammation of the mucous membrane of the upper respiratory tract, fibrosing alveolitis, sarcoidosis, valvular pneumothorax, pleurisy, hydrothorax, diaphragmatic paralysis, laryngeal stenosis.

Clinical manifestations of inspiratory dyspnea include prolongation of inhalation time and increased frequency of respiratory movements. Inspiratory dyspnea is often characterized by stridor breathing, which is clinically manifested by inhalation, audible at a distance, tension of the respiratory muscles and retraction of the intercostal spaces.

Expiratory shortness of breath is characterized by the appearance of difficulty in exhalation, and therefore an increase in expiration time is recorded. It occurs as a result of increased resistance to air movement in the lower parts of the respiratory tract (medium and small bronchi, alveoli). Disruption of air flow occurs when the lumen of the small bronchi and bronchioles narrows as a result of changes in their walls and deformation of the small and medium bronchi, for example, with pneumosclerosis, inflammatory or allergic edema, spasm of the airways (bronchospasm), as well as blockage of their lumen with sputum or a foreign body.

As air passes into the lungs, intrathoracic pressure increases due to the active work of the respiratory muscles. Changes in intrathoracic pressure are manifested by swelling of the jugular veins, retraction of the jugular fossa, supraclavicular and subclavian fossae, intercostal spaces and epigastric region during inspiration. Accessory muscles are involved in the act of breathing. Often shortness of breath is accompanied by chest pain. There is pallor and even cyanosis of the nasolabial triangle, moisture and even marbling of the skin. In severe respiratory failure, the skin is pale, with a grayish tint. Difficulty in exhalation leads to the accumulation of air in the lungs, which is clinically manifested by a boxy sound during percussion of the chest, drooping of the lower borders of the lungs, as well as a decrease in their mobility. Often there is noisy breathing, respiratory crepitus, audible at a distance.

Patients with severe bronchial asthma during an exacerbation take a forced sitting position to facilitate breathing.

In obstructive pulmonary diseases, along with the appearance of shortness of breath, a cough occurs, which is characterized by the release of mucous or mucopurulent sputum.

Expiratory shortness of breath is a manifestation of diseases such as bronchial asthma and chronic obstructive bronchitis.

Mixed shortness of breath appears as difficulty in both inhalation and exhalation. It occurs in pathological conditions accompanied by a decrease in the respiratory surface of the lungs, resulting from atelectasis or compression of the lung tissue by effusion (hemothorax, pyothorax, pneumothorax).

Cardiac dyspnea is the most common symptom of acute and chronic left ventricular or left atrial heart failure, which can develop in patients with congenital and acquired heart defects, cardiosclerosis, myocardial dystrophy, cardiomyopathy, myocardial infarction, myocarditis. Breathing in cardiovascular pathology becomes not only frequent, but also deep, i.e. polypnea occurs. Cardiac dyspnea increases in the supine position, as the venous return of blood to the heart increases, during physical exertion, neuropsychic stress and other conditions accompanied by an increase in the volume of circulating blood.

A patient with cardiac dyspnea takes a forced position - orthopnea - sitting, resting his hands on his hips, or standing. Improvement in well-being is associated with a decrease in lung congestion. A typical sign of heart failure is the appearance of acrocyanosis. There is a bluish coloration of the skin and visible mucous membranes, and coldness of the extremities. When auscultating the lungs in patients with cardiac dyspnea, a large number of scattered moist fine rales are heard.

To clarify the nature of shortness of breath, it is necessary to conduct an X-ray examination of the chest organs, electrocardiography, echocardiography, determine the gas composition of the blood (oxygen and carbon dioxide indicators), and examine the function of external respiration (peak flowmetry and spirography).

Treatment of shortness of breath should be aimed at eliminating the disease that led to its occurrence, as well as improving the general well-being of the sick person.

If the patient develops an attack of shortness of breath, he must be seated in a chair or given an elevated position on the bed with the help of pillows. It is important to reassure the patient, as stress leads to an increase in heart rate and the need for tissues and cells for oxygen. It is necessary to ensure access of fresh air to the room where the patient is located, and therefore a vent, window or door should be opened. In addition to a sufficient amount of oxygen in the air, it is necessary that it has sufficient humidity, for which you turn on the kettle, pour water into the bath, and hang wet sheets. Inhalation of humidified oxygen has a good effect.

It is necessary to make the breathing process as easy as possible for a person with shortness of breath by freeing him from restrictive clothing: a tie, tight belts, etc.

Treatment

1. 1 liter of honey, squeeze 10 lemons, peel 10 heads of garlic (whole heads) and grind the garlic into a paste. Mix all this together and leave it in a closed jar for a week. Drink 4 teaspoons every day, once a day. 4 spoons, but do not swallow immediately, and do not rush, slowly consume one spoon after another. Don't miss a day. This amount should be enough for 2 months.

This recipe often cures decrepit old people who cannot walk 50 steps without stopping to rest.

2. Grind 350 g of garlic, squeeze the juice from 24 lemons. Pour crushed garlic and lemon juice into a wide-necked jar, leave the jar for 24 hours and tie a light, transparent cloth on top. Shake when taking.

Take 1 time per day before bedtime. 1 teaspoon of this mixture in half a glass of water, stir and drink. After 10-14 days, a person will feel the elixir of youth and lack of fatigue in this remedy, and the person using this wonderful remedy will be rewarded with good sleep.

This is a remedy for shortness of breath to rejuvenate the blood, especially in obese people with a sluggish, decrepit body, and almost an elixir of youth.

medn.ru

Shortness of breath concept

Shortness of breath (dyspnea) is not an independent disease, but its appearance indicates a progressive disease in the body, where shortness of breath is just a symptom. The external manifestation of the symptom is noticeable to people around and palpable to the patient himself. Dyspnea is characterized by 3 morphological manifestations:

A feeling of lack of air for breathing, problems with respiratory movements observed with asphyxia.
Rapid breathing with increased chest excursion.
Respiratory movements are accompanied by extraneous sounds from the respiratory tract (hoarseness, wheezing, whistling, etc.).

A specialist will tell you more about what shortness of breath is in the video below:

Its varieties

The classification of difficulty breathing is based on two factors.

Respiratory rate

The first classification is based on the frequency of respiratory movements.

If there is an increase in the frequency of respiratory acts, shortness of breath is usually called tachypnea. An increase in the number of respiratory movements over 20 is usually referred to as tachypnea. The nature of the motor reactions of breathing is superficial. A similar symptom accompanies hematological diseases, anemia, and various types of fever.
If the respiratory rate reaches 50-70 times per minute or higher, pronounced tachycapnea is popularly called "Breath of a hunted beast". A similar morphophysiological state is observed in a hysterical state of the body.
The decrease in the number of respiratory acts is called bradycapnea. The state of reduced breathing is a great threat to life, as it is detected during a diabetic coma, severe diabetes mellitus, inflammation of the meninges and damage to the neural structure of the brain.

Phases of the respiratory act

The second classification of dyspnea is based on the occurrence of dyspnea in one or another phase of the respiratory act. Based on this sign, it is customary to distinguish 3 types of pathological signs:

Dyspnea during inspiration is the inspiratory type.
Expiratory type of dyspnea that occurs during exhalation.
Dyspnea is observed both during inhalation and at the exhalation stage - mixed type.

Identifying a symptom in yourself

The patient finds difficulty in breathing, a feeling of lack of air after performing physical activity and eating.

Due to insufficient activity of the heart, shortness of breath occurs along with swelling of the legs. A person feels discomfort and pain in the chest cavity. The limbs of a sick person become cold.

The moment of onset of dyspnea determines the degree of development of the pathology.

In the first degree of severity, breathing difficulties are detected only during vigorous physical activity (running, long brisk walking, climbing stairs, etc.).
The second degree of severity occurs when walking at a slightly accelerated rhythm, and the person begins to slow down the rhythm compared to a person feeling normal.
When the patient stops in order to restore normal breathing rhythm, shortness of breath becomes the third degree of severity.
The most severe, fourth degree, is typical for patients who suffocate while walking slowly or at rest.
If dyspnea occurs during prolonged intense physical activity, then its degree is considered to be zero.

We will talk further about the causes of severe shortness of breath in children, adults, and elderly people.

This video will tell you how to timely diagnose an illness indicated by shortness of breath:

What ailments does this sign indicate?

Dyspnea is not a pathology listed in the International Classification of Diseases as an independent disease. There are several systemic disorders in the body when shortness of breath accompanies a series of diseases of the functional system.

The cardiovascular system

Other body systems

In addition to cardiovascular pathologies, shortness of breath can be pulmonary in nature.

Thus, the symptomatic picture for bronchitis, edematous state of the lungs, obstructive phenomena in the bronchi and lungs, pulmonary inflammation, bronchial asthma includes, among the emerging signs, immediate shortness of breath.
In case of serious disturbances in the functioning of the lungs of a chronic and acute nature, dyspnea is observed as a secondary symptom against the background of acutely manifested other symptoms. For example, pulmonary tuberculosis, emphysema, pneumothorax, ankylosing spondylitis of the thoracic vertebrae, etc.

There are a number of pathologies that are not related to disorders of the respiratory and cardiovascular systems, but have difficulty breathing as a concomitant symptom. Anemia, obesity, thyrotoxicosis, diabetes mellitus are an incomplete list of pathologies manifested by shortness of breath.

Among physiological conditions not related to pathologies, there are factors that contribute to the initiation of shortness of breath: pregnancy, overeating and others.

Symptom treatment

The above diseases, which do not exist without manifested shortness of breath, are difficult to differentiate based on only one sign. Therefore, it is impossible to cope with shortness of breath without the participation of a doctor. A cardiologist or therapist, infectious disease specialist or endocrinologist will help to correctly recognize the pathology concomitant with dyspnea and, only after a detailed examination, create the correct treatment method.

It is not recommended to independently attempt to treat shortness of breath with folk remedies or medications for heart failure and other ailments until a diagnostic examination results in a diagnosis.

This video will tell you more about the treatment of shortness of breath:

gidmed.com

Main causes of shortness of breath

As a rule, shortness of breath appears in various pathological conditions in which the respiratory rhythm is disturbed, even at rest. This creates a lot of problems, and in addition, a serious threat to life. Therefore, the doctors’ recommendation in this case is to immediately go to the hospital, because this is a rather serious symptom.

All the main pathologies that can cause difficulty breathing can be divided into groups and arranged depending on the root causes. They were the ones who contributed to the occurrence of shortness of breath:

Heart disease is the most common cause of difficulty breathing, especially in older people. In case of disorders of the heart muscle, the work of the blood flow decreases, which means that blood stops flowing to the internal organs to the required extent, first of all this concerns the brain.
Ailments associated with the respiratory system, lungs and bronchi. When the bronchi narrow, the structure of the lung tissue changes, the blood does not receive enough oxygen, and the system switches to an increased, intense rhythm of work.
Anemia. The lack of red blood cells and hemoglobin makes the blood passive and unable to transport oxygen molecules to the tissues.

What is shortness of breath?

For doctors, difficult breathing has the same signs, the differences are only in symptoms and causes, so there are three types:

Inspiratory view - when inhaling.
Expiratory observed during exhalation
Mixed occurs when inhalation and exhalation are difficult.

Among the main types, the main one is cardiac, caused by diseases of the cardiovascular system.

Heart failure. This term refers to disorders and diseases of the system. It is this concept that characterizes shortness of breath when walking and various physical activities. As the disease worsens, breathing becomes more difficult and sometimes even sleep is accompanied by this problem.
High blood pressure and hypertension. Since hypertension increases the stress on the heart, functional impairment occurs.
Myocardial infarction. A disease that requires special attention, since with the loss of one of the sections of the muscle tissue of the heart, its functionality and condition, for this reason, a problem with oxygen starvation of the tissues again arises. In the acute period of a heart attack, shortness of breath becomes more severe and noticeable.
The causes of shortness of breath can be a variety of diseases associated with thrombophlebia, pulmonary edema, bronchitis, chronic obstructive pulmonary disease, pneumonia and bronchial asthma, tumors in the respiratory tract.
Shortness of breath occurs with the appearance of pathologies such as diabetes and obesity, thyrotoxicosis.
Children's difficulty breathing is primarily associated with laryngitis and false croup, congenital heart defects, anemia, which you can read about here.

How can you cure shortness of breath?

Based on the fact that problems with normal breathing can be caused by many reasons and
various diseases, the spectrum of which is quite wide, treatment is strictly individual. The correct therapy or set of measures is selected based on a number of diagnostic definitions.

The speed and effectiveness of treatment depends on how accurately the disease and its consequences in the form of shortness of breath are determined.

Conservative and medicinal treatment

It is proposed to consider the most typical types of shortness of breath and methods of dealing with them.

If shortness of breath is caused by a foreign body, it is immediately removed. This is done using the Heimlich maneuver; in particularly acute and dangerous situations, the method of surgical intervention is used.
If bronchial asthma is the cause, Salbutamol or Eufillin is prescribed intravenously.
In case of heart failure, treatment is prescribed with narcotic analgesics, diuretics, Nitroglycerin, as a venous vesodilator.
For unknown reasons, and in cases where differential diagnosis is impossible, if the patient has severe shortness of breath, Lasix is prescribed.
Neurogenic shortness of breath is treated with breathing exercises and intravenous administration of Diazepam.
For obstructions, there are several methods: direct oxygen supply, treatment with anxiolytics, surgical reduction method and other effective and quick methods.

Folk remedies to combat shortness of breath

To help yourself reduce attacks, increase their frequency and reduce their intensity, you can use the experience of traditional medicine and carry out the following activities:

Drink hot goat milk three times a day on an empty stomach, adding a glass of milk and a large spoonful of honey. The duration of the course of treatment is one week.
A garlic-honey mixture with lemons helps with shortness of breath. For five lemons, take five heads of garlic and half a liter of honey. Lemons and garlic are ground in a meat grinder and honey is added. The mixture should brew and after a week you can start taking it, a teaspoon in the morning on an empty stomach for exactly two months.
Dry dill mixture - two small spoons, brewed with boiling water. This infusion is best drunk warm for 14 days, half a glass.
Turnip is also an effective folk remedy against shortness of breath. For two glasses of water, take a medium-sized finely chopped turnip. Cook it for 15 minutes. Strain and drink 200 grams at night.
Celandine, fresh or dried, will serve you as an excellent helper. You will need a pinch of celandine, half a liter of white grape wine and a spoon of honey. Boil all ingredients until reduced from the original volume to one-fourth. Take two times a day in portions before meals.

Prevention

The first thing to do is to eliminate all risk factors, such as obesity, smoking, alcohol, lack of physical activity, hazardous production and others.
Review your food basket and remove those foods that contribute to weight gain, accumulation of cholesterol and harmful substances in the body.
Constantly monitor your health and do not forget to conduct an annual examination to prevent chronic pathologies.
Spend more time in the fresh air, using parks, forests, and the sea coast for walks.
Use sanatorium and resort services, special health courses and offers as treatment.

Shortness of breath can leave you once and for all if you lead a healthy lifestyle and provide timely assistance to your body.

You can also learn about shortness of breath from this video:

domalekar.ru

Shortness of breath shortness of breath - discord

Yes, indeed, the general name does not determine the identical nature of this disorder, therefore, clarifying the individual “symptoms” of shortness of breath in most cases helps to clarify its origin in the first stages of the search. Thus, the following types of shortness of breath have emerged in clinical practice:

If breathing disorder is expressed in its increased frequency, then they speak of tachypnea. This type is widely known and familiar to many due to the fact that it is a constant companion of febrile conditions in any infectious processes and hematological diseases. Frequent and deep breathing is denoted by the terms hyperpnea and polypnea;
Rare breathing movements are called bradypnea, which may indicate brain damage and hypoxia as a consequence of these lesions. Rare shallow breathing is called oligopnea;
Apnea(respiratory cessation) can be recorded by observing a sleeping person who has a change in the functional properties of the respiratory system due to various acquired diseases, mainly age-related (COPD - chronic obstructive pulmonary disease). This is why snoring is not considered so harmless, since it is the culprit behind apnea in the first place. People suffering from heart disease do not tolerate a strictly horizontal position; some time after falling asleep they experience orthopnea(lying down makes it difficult to inhale), so many people prefer to sleep half-sitting on high pillows.

A factor such as difficulty inhaling or exhaling underlies the division of dyspnea into:

Inspiratory dyspnea, characterized difficulty breathing. It is characteristic of heart failure (cardiac dyspnea) and lesions of the respiratory system (upper respiratory tract, trachea, large bronchi, pleura, diaphragm) and indicates their poor patency, which can be caused by:

bronchospasm,
swelling of the mucous membrane of the respiratory tract,
foreign body
accumulation of pathological secretion,
developmental anomalies,
tumors compressing the airways,
abscesses, etc.

Expiratory dyspnea, indicating obstacles that impede the passage of small bronchi and are caused by bronchospasm caused by narrowing of the bronchioles, accumulation of secretions in them and swelling of the mucous membrane. Expiratory shortness of breath accompanies diseases such as bronchial asthma, bronchiolitis;

Mixed type of shortness of breath is a characteristic sign of parenchymal acute respiratory failure (ARF).

Obviously, the most common cause of shortness of breath is bronchopulmonary pathology, ranging from childhood laryngospasm to acute respiratory failure and pulmonary edema. Of course, this list will include other diseases (bronchitis, bronchial asthma, pneumosclerosis), leading to COPD and, accordingly, to chronic respiratory failure.

Treatment of each type of dyspnea should be aimed at eliminating or reducing the negative impact of the underlying disease, the symptom of which is shortness of breath.

Why is there not enough air if everything is normal with the heart?

Dyspnea in heart failure is very common and is associated mainly with organic damage to the organs of the cardiovascular system; it is predominantly inspiratory nature, that is, it manifests itself on inspiration. Cardiac dyspnea, in general, is the prerogative of old age, although not only with severe congenital heart defects, but also with mitral valve prolapse, it can easily be present in a child. Especially if the child is vagotonic, who is susceptible to the influence of psycho-vegetative crises or panic attacks.

In addition, the causes of shortness of breath may be hidden behind many other pathological conditions that give symptoms of suffocation and lack of air, but are not associated with cardiac dysfunction. For example, a fairly common childhood disease - laryngeal stenosis (laryngospasm) causes significant respiratory distress (inspiratory dyspnea), which can quickly lead to death if medical assistance does not arrive in time. However, everything is in order.

Psychogenic and physiological factors that provoke shortness of breath

Shortness of breath is often caused by psychogenic factors or physiological:

Physiological conditions such as pregnancy, sports or overeating soon pass one way or another, but with psychophysiological factors everything is a little more complicated, since there is a possibility that such a condition can lead to psychosomatic diseases, which are often diseases of the cardiovascular system.

Heart disease and shortness of breath

Cardiac dyspnea can have a different mechanism of occurrence.

The first way changes occur, initially associated with pathology of the respiratory organs and later involvement of the circulatory system. Increasing hypoxia promotes the deposition of collagen in the lung tissue and the development of pneumosclerosis, which, in turn, leads to even greater hypoxia, aggravating it. The vicious circle closes with the formation of irreversible processes.

Under such conditions, it becomes incredibly difficult for the right ventricle to push blood into the pulmonary circle. First, the right ventricle of the heart hypertrophies in order to somehow cope and compensate for blood circulation. However, since the cardiac and respiratory systems are inseparable, over time the right section expands. As a consequence of such changes, the stage of decompensation of cardiac activity begins with the development cardiopulmonary (right ventricular) insufficiency, called the “pulmonary heart”. This condition often provokes rhythm disturbances with the development of tachycardia and flickering arrhythmias.

Second way the formation of dyspnea is directly related to diseases of the cardiovascular system. And so that the reader understands the mechanism, it can be displayed in a diagram:

Heart damage or valves (defects, myocarditis, myocardial infarction, chronic cardiac aneurysm, etc.)

Difficulty in returning blood from the lungs to the left atrium

Increased pressure in the small circle and development of pulmonary hypertension

Circulatory disorder in the lungs, which leads to stagnation of fluid, disruption of ventilation and, consequently, respiratory activity ( left ventricular failure).

The cause of shortness of breath is heart problems

Almost all pathology of the cardiovascular system, leading to heart failure, is accompanied by inspiratory shortness of breath, and then mixed type:

Arterial hypertension (AH) and coronary heart disease (CHD) in older people, giving “minor” signs of congestive heart failure in the form of lack of air and suffocation. And since there is a clear correlation between hypertension and excess weight, in obese patients with constantly high blood pressure, shortness of breath occurs not only when walking and physical activity, but quite often appears at rest and at night. Such people sleep anxiously, and their sleep is continually interrupted by apnea;
The asthmatic variant of myocardial infarction (and MI itself), as a rule, has all the manifestations of left ventricular failure and occurs with noisy breathing, coughing, shortness of breath and suffocation;
Valve defects, myocarditis, cardiomyopathies, chronic cardiac aneurysm and other heart lesions complicated left ventricular failure, accompanies dyspnea (paroxysmal nocturnal dyspnea);
Cardiac asthma, causing the patient a lot of suffering;
Pulmonary edema. Unfortunately, it often leads to death and therefore requires emergency resuscitation measures;
PE (pulmonary embolism) is a most dangerous condition that cannot even exist without symptoms such as lack of air and suffocation, since it leads to the development acute respiratory failure, developing as a result bronchospasm.

How to treat shortness of breath?

Before you start fighting shortness of breath, you should not run to the pharmacy and buy the pills that your neighbor recommended. To get started you need:

Quit the bad habit of smoking if you smoke;
Lose weight if you have excess weight;
Adjust blood pressure if it is present in abnormal numbers.

To determine the cause of respiratory impairment, you will also need to undergo an examination, which includes:

Biochemical blood test;
R-graph of the chest;
Ultrasound of the heart;
Analysis of external respiration function.

Unfortunately, not every type of shortness of breath can be cured; basically, it all depends on the reasons that gave rise to it. Of course, rapid shallow breathing at high temperatures (flu, ARVI) will go away when the condition returns to normal, although it is known that a common complication of influenza infection is bronchitis, which also impairs respiratory function and requires quite long-term treatment measures.

To treat childhood laryngospasms, which the child usually “outgrows” by the age of 4, distractive therapy (mustard plasters), antispasmodics (nosh-pa), anticholinergics (platifillin), antihistamines (claritin, fenistil, pipolfen) and glucocorticoids are used. The latter are used in emergency cases when the attack has gone too far.

Medicines that dilate the bronchi, expectorate and reduce the load on the heart help relieve shortness of breath during respiratory failure:

β-adrenergic agonists (salbutamol, clenbuterol, berotec);
M-anticholinergics (atrovent, berodual);
Long-acting methylxanthines (aminophylline, theophylline) (teopec, theotard);
Inhaled glucocorticoids, which are used primarily to treat severe shortness of breath in the case of bronchial asthma;
Medicines that thin sputum and promote its evacuation (bromhexine, mucaltin, ACC, ambraxol);
Peripheral vasodilators (calcium antagonists - nifedipine, nitrates - nitrosorbitol, ACE inhibitors, which are especially effective for pulmonary hypertension - captopril, enalapril);
Diuretics (furosemide, veroshpiron, diacarb, hypothiazide), reducing congestion;
Antispasmodics (nosh-pa, papaverine).

In addition to drug treatment, oxygen therapy with humidified oxygen, physiotherapy, and breathing exercises are successfully used to regulate respiratory function.

The above-mentioned schemes are also applied to shortness of breath when walking, indicating COPD, the treatment of which is very difficult due to the irreversible changes that have occurred.

Treatment of cardiac dyspnea with folk remedies is very common among patients, since breathing problems last for years, cause a lot of trouble, are painful and significantly reduce a person’s quality of life. Help with shortness of breath is provided by medicines growing in forests, vegetable gardens and meadows. The principle of action of medicinal herbs is similar to the effect of synthetic drugs (bronchodilators and expectorants), however, as is known, they are mostly harmless and do not have as many side effects. In addition, many pharmaceutical preparations are based on the healing properties of plants. So why not try to make a medicine at home that, at least temporarily (at first!) will help get rid of shortness of breath, so obsessive and unpleasant?

The roots of cyanosis, licorice, lovage, peppermint and yarrow herbs, and bean pods are great for making medicine yourself.
A little-known recipe of aloe leaves (you can take them on the windowsill) infused with vodka for 10 days relieves any cough and shortness of breath. To do this, a teaspoon of the infusion taken is flavored with a tablespoon of honey, a pause of 10 minutes is maintained and washed down with a glass of hot tea.

It is better to ask your doctor about the use of garlic with honey and lemon for the treatment of cardiac shortness of breath, but if he gives his go-ahead, you can try the following recipes:

Make a paste of 10 squeezed lemons (use the juice) and 10 heads of garlic, add this mixture to a liter jar of honey, close and forget for a week. Take 4 teaspoons, savoring and swallowing slowly. They say that in 2 months you can achieve good results.
What if you take the juice of 24 lemons, add garlic pulp (350 g), leave for a day and drink a teaspoon, having first dissolved it in ½ glass of water? People who have tried the medicine on themselves claim that after 2 weeks you can run and dance, feeling a second youth.

Sadly, folk remedies for cardiac shortness of breath will help for the time being, so you should not rely on them completely. The cause of shortness of breath still remains, the disease progresses and it will still have to be treated. And in such a matter it will not be possible to do without the help of a doctor.

1. Position of the patient.

The “orthopnea” position in patients with severe left ventricular failure is a forced position in which shortness of breath decreases. The patient sits with his legs down, his head slightly thrown back and supported by a high headboard or pillows, his mouth slightly open, shortness of breath at rest. In this position, the venous return of blood to the heart is reduced, the pulmonary circulation is unloaded, and shortness of breath is reduced.

Forced position of patients with severe vascular insufficiency (collapse, shock). The patient occupies a strictly horizontal position, sometimes with the head end lowered and legs raised. In this position, blood circulation in the brain improves, dizziness and weakness decrease.

With effusion pericarditis, the patient sits leaning forward, with his legs bent at the knee joints and pulled towards the body. In this position, the exudate in the pericardial cavity puts less pressure on the heart, shortness of breath decreases, and the patient feels better.

2. Facial expression. The most typical:

Mitral face (facies mitralis) – in patients suffering from mitral stenosis: against the background of pallor, cyanosis of the lips, cheeks, tip of the nose, earlobes is clearly visible;

Corvisar's face (facies Corvisari) – in patients with severe heart failure: a thin, pale cyanotic face with a jaundiced tint, the mouth is open, severe shortness of breath at rest, orthopnea.

3. Examination of the skin and mucous membranes. First of all, we evaluate their color. The most typical:

Cyanosis. It can be pronounced diffuse (with “blue” congenital heart defects, pulmonary artery sclerosis (Aerz disease)), cor pulmonale.

Peripheral cyanosis (acrocyanosis) is most typical for the initial stage of heart failure. In this case, mainly the most distant parts of the body are cyanotic - hands, feet, fingertips, lips, tip of the nose. This is due to impaired microcirculation and blood stasis in the periphery. Gas exchange is disrupted here, and there is an accumulation of reduced hemoglobin, which causes a bluish discoloration of the peripheral areas. The limbs are cold.

Mixed cyanosis - has features of central and peripheral cyanosis. In cardiac patients, this happens with heart failure of the total type.

Local cyanosis is most characteristic of local impairment of venous outflow, in particular with thrombophlebitis of the lower and upper extremities, and with compression of the veins by tumors.

Isolated cyanosis of the head and neck is extremely characteristic of compression of the superior vena cava by a tumor of the mediastinum, a package of lymph nodes in the mediastinum with lymphogranulomatosis, lymphosarcoma. In this case, the venous outflow from the upper part of the body is disrupted, the face and neck become cyanotic, and at the same time swelling of the face and neck is noted (“Stokes collar”, “superior vena cava syndrome”).

Paleness of the skin and mucous membranes. It is noted in aortic heart defects, rheumatic carditis, fainting, collapse.

“Coffee-au-lait color” is a peculiar pallor with a icteric tint in infective endocarditis due to intoxication and accelerated hemolysis of red blood cells (anemia). At the same time, these patients may develop petechial rashes on the skin and mucous membranes.

A visual sign of heart failure is swelling. According to the mechanism of occurrence, they are hydrostatic due to venous stagnation. The main diagnostic signs of cardiac edema are:

a) localization on the lower extremities;

b) appear at the end of the day, disappear or decrease during the night;

With various diseases, a person, in order to alleviate his suffering, often puts his body in a forced position. By observing him, we can obtain very important information, including determining the location of pain. Here are some examples:
“fetal position”– can often be seen with pancreatitis. The patient lies on his side with his legs pulled towards his stomach.

the patient is bent towards the side of pain– for renal and periumbilical abscess.

frozen position– with peritonitis (any movement increases pain), angina pectoris.

expressed concern– intestinal obstruction, myocardial infarction.

the patient lies on his back with the leg bent at the knee and the hip abducted (symptom of the psoas muscle)– observed in the case of local damage to the area located near the iliopsoas muscle. This can be due to a local inflammatory process near the iliopsoas muscle (in the appendix, terminal ileum in Crohn's disease, as well as intestinal diverticulum), as well as if the muscle itself is inflamed. Until recently, the psoas muscle could be observed with a “cold” tuberculous abscess of the spine, which spread down the course of this muscle and proceeded without fever or other signs of inflammation. Nowadays, damage to the iliopsoas muscle can be found with an intramuscular hematoma, which can be provoked by anticoagulant therapy.

“Muslim praying pose”(sitting in bed, leaning forward) – observed with pericardial effusion (especially with cardiac tamponade). In this case, you can often see significantly swollen neck veins.

Positional changes in respiratory disorders.

Platypnea– difficulty breathing that occurs in an upright position. The patient feels better in the supine position. Often combined with orthodeoxy– a condition in which deterioration of hemoglobin oxygen saturation occurs in a vertical position.

Platypnea can occur with:

recurrent pulmonary embolism(gravity provokes damage mainly to the basal parts of the lungs)

pleural effusion, bilateral lower lobe pneumonia(fluid accumulates in the lower parts of the lungs, which provokes the appearance of bilateral lower lobe atelectasis).

liver cirrhosis(with bilateral lower lobe arteriovenous shunting)

atrial septal defect(for this, there must also be an increase in pressure in the pulmonary vessels (for example, during lobectomy, pneumonectomy) or pleural effusion must appear)

Orthopnea– a condition in which difficulty breathing appears or worsens when lying down, disappearing when sitting. In 95% of cases, it is caused by heart disease. The fact is that when a person sits, there is a redistribution of blood to the underlying areas. This leads to a decrease in venous return, and the preload on the ventricles of the heart is reduced. Thus, orthopnea is a fairly effective and rapid mechanism for eliminating blood stagnation in the pulmonary circulation (PCC). But we must remember that long-term left ventricular failure can be complicated by the fact that right ventricular failure will also join it. In this case, if the left ventricle is unloaded and congestion in the ICC decreases, it will become easier for the patient to breathe while lying down than standing or sitting.

Orthopnea in lung disease. Causes:

bilateral damage to the apexes of the lungs, especially with the formation of bullae. At the same time, in a sitting position, perfusion of the lower parts of the lungs improves, which leads to a decrease in shortness of breath.

COPD. By occupying the orthopneic position, the patient provides himself with not only improved gas exchange, but also respiratory mechanics, because stretching of the additional respiratory muscles is observed. The patient unconsciously chooses a position in which he rests his forearms, fixes his shoulders and neck muscles, facilitating the work of the respiratory muscles (his arms clasp the edge of the bed or rest on his hips - S. Dahl).

for bronchial asthma, orthopnea helps assess its severity. It is considered an unfavorable prognostic sign. And if the patient cannot take a horizontal position, this, along with sweating, indicates a deterioration in lung function and is an indication for hospitalization.

The same forced position can be occupied by a patient with laryngeal stenosis.

Trepnea– a condition in which the patient prefers lying on his side to lying on his side or sitting.

Lying position on the “healthy side”– observed in diseases affecting one lung:

unilateral lung collapse with bronchial obstruction; massive pleural effusion, which compresses the lung from the outside.

dry pleurisy– shifting to the affected side leads to a sharp increase in pain.

But in some situations the position on the “healthy side” can be very dangerous . For example, if we are talking about unilateral pneumonia or hemorrhagic lung damage, because there is a danger of pus/blood flowing from the affected lung to the healthy one. In such cases, the patient should lie on the “sick side”.

Position on the “sick side”.

abscess or gangrene of the lung, pulmonary tuberculosis, effusion and dry pleurisy– in this case, the unaffected lung is more fully used in the act of breathing and coughing is less bothersome.

attack of appendicitis.

Other poses

knee-elbow– can be observed during exacerbation of peptic ulcer disease, effusion pericarditis.

“cocked hammer” – (the patient is on his side. The legs are brought to the stomach, the head is thrown back) – with inflammation in the membranes of the spinal cord and brain.

sitting, leaning forward (mostly on a pillow)– you can suspect effusion pericarditis, aortic aneurysm, pancreatic cancer with damage to the solar plexus.

· Dyspnea– one of the earliest symptoms of heart failure. Initially, shortness of breath occurs only during physical activity and goes away after it stops. As the disease progresses, shortness of breath begins to appear with less and less exertion, and then at rest. Clinical variants of shortness of breath are orthopnea and cardiac asthma.

· Orthopnea- shortness of breath that occurs when the patient is lying down with a low headboard and disappears in an upright position. Often such patients go to bed, put several pillows under their heads and spend the whole night in this semi-sitting position.

· Cardiac asthma (paroxysmal nocturnal dyspnea) is an attack of intense shortness of breath that turns into suffocation, usually occurs at night and is accompanied by a dry cough, agitation, and the patient’s fear for his life.

· Cough is non-productive often accompanies shortness of breath, appearing either in a horizontal position or after physical exertion.

· Heartbeat. The sensation of palpitations may be associated with sinus tachycardia, an increase in pulse blood pressure, and the presence of various heart rhythm disturbances. Palpitations first appear during physical activity, and then at rest.

· Swelling in the legs in the early stages, insufficiency is localized in the area of the feet and ankles, appears in patients in the evening, and can disappear by the morning. As heart failure progresses, swelling spreads to the legs and thighs, persisting throughout the day. Edema is usually symmetrical, combined with acrocyanosis and coldness of the extremities; with prolonged existence of edema, trophic changes in the skin appear - thinning, hyperpigmentation, trophic ulcers.

· Peripheral edema can be located in the sacrum, buttocks, and back of the thighs during prolonged bed rest.

· Abdominal edema– ascites, hydrothorax, hydropericardium appear in the late stages of heart failure.

· Anasarca– widespread swelling of the subcutaneous tissue, internal organs and cavities is observed in total (biventricular) heart failure.

· Nocturia (increased diuresis at night) appears already in the early stages of the development of heart failure. As the condition progresses, there is a significant decrease in daily diuresis - oliguria.

· Severe muscle weakness, rapid fatigue, heaviness in the lower extremities against the background of light physical activity - a typical and disabling sign caused by changes in skeletal muscles due to metabolic disorders.

· Pain, feeling of heaviness in the right hypochondrium associated with liver enlargement.

· Orthopnea position– a forced sitting or semi-sitting position in bed, usually with legs down, is typical for patients with severe left ventricular failure.

· Cyanosis most pronounced on the lips, tip of the nose, ears, fingers of the upper and lower extremities and is called acrocyanosis, usually combined with cold skin.

· Swelling of neck veins is an important clinical sign of blood stagnation in the systemic circulation.

For chronic left ventricular heart failure, accompanied by stagnation of blood in the pulmonary circulation are characterized by:

Dyspnea (tachypnea, orthopnea),

Dry non-productive cough, which occurs mainly in a horizontal position,

Dyspnoea (cardiac asta, pulmonary edema)

Orthopnea position

· Moist rales in the lungs.

For chronic right ventricular heart failure, accompanied by stagnation of blood in the systemic circulation are characterized by:

· Acrocyanosis,

· Swelling of the veins of the neck,

"The Face of Corvisar"

Swelling of the knees, feet,

Enlarged liver

· Hydrothorax,

· Oliguria,

· Nocturia.

Appearance of a patient with total (biventricular) CHF in severe cases, it is very characteristic: usually there is a position of orthopnea with legs down, pronounced swelling of the lower extremities, acrocyanosis, swelling of the veins of the neck, a noticeable increase in the volume of the abdomen due to ascites. Often the face is puffy, the skin is yellowish-pale with significant cyanosis of the lips, tip of the nose, ears, the mouth is half open, the eyes are dull (Corvisar's face).

Classification of chronic heart failure by stages,

Stage	Characteristic
Stage I (initial)	Hemodynamics are not impaired. There are no complaints or appear only during physical activity - shortness of breath, tachycardia, fatigue. At rest, clinical signs disappear, hemodynamics normalize.
Stage II period A period B	Hemodynamic disturbances in the form of blood stagnation in the pulmonary and/or systemic circulation persist at rest. Signs of heart failure at rest are moderate. Hemodynamics are disturbed in only one of the blood circulation circles. Pronounced signs of heart failure in the systemic and pulmonary circulation.
Stage III period A period B	Severe hemodynamic disturbances and signs of venous stagnation in both circulation circles, dystrophic changes in organs and tissues. Severe hemodynamic disturbances and signs of venous stagnation in both circulation circles; with active complex treatment, signs of stagnation are reduced, hemodynamics are stabilized, and the functions of vital organs are partially restored. The final dystrophic stage with severe widespread hemodynamic disorders.

Functional classification of chronic heart failure is based on an assessment of the patient’s physical (functional) capabilities, which can be identified through a careful, targeted history taking, without the use of complex diagnostic equipment.

Functional class (FC)	Limitation of physical activity and clinical manifestations
I FC	There are no restrictions on physical activity. Normal physical activity does not cause significant fatigue, weakness, shortness of breath or palpitations.
II FC	Moderate limitation of physical activity. At rest there are no symptoms. Ordinary physical activity causes weakness, fatigue, shortness of breath, palpitations, etc.
III FC	Marked limitation of physical activity. Patients feel comfortable only at rest; the slightest physical exertion leads to weakness, shortness of breath, palpitations, pain in the heart area, etc.
IV FC	Inability to perform any exercise without discomfort. Symptoms of heart failure are present at rest and worsen with any physical activity.

The patient's functional class can be determined by the distance of a 6-minute walk, determined in meters.

)

shortness of breath, forcing the patient to remain in a sitting or standing position due to its sharp increase in the horizontal position of the body; characteristic of left atrial and left ventricular heart failure - see Shortness of breath.

II Orthopnea (orthopnō; Ortho- + Greek pnoē breathing)

a forced sitting position taken by the patient to facilitate breathing with severe shortness of breath.

1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M.: Soviet Encyclopedia. - 1982-1984.

Synonyms:

See what “Orthopnea” is in other dictionaries:

Noun, number of synonyms: 1 shortness of breath (10) ASIS Dictionary of Synonyms. V.N. Trishin. 2013… Synonym dictionary

- (orthopnoe; ortho + Greek. breathing) a forced sitting position taken by the patient to facilitate breathing with severe shortness of breath ... Large medical dictionary

ORTHOPNEA- (from the Greek orthos direct and pnoo breathing), the highest degree of shortness of breath that occurs with circulatory failure ... Veterinary encyclopedic dictionary

ORTHOPNEA- (orthopnoea) difficulty breathing when lying down, forcing a person to sleep in a semi-sitting position in bed or sitting on a chair. Orthopnoeic… Explanatory dictionary of medicine

Difficulty breathing when lying down, forcing a person to sleep in a semi-sitting position in bed or sitting on a chair. Orthopnoeic. Source: Medical Dictionary... Medical terms

I Shortness of breath (dyspnoe) is a disturbance in the frequency, depth or rhythm of breathing or a pathological increase in the work of the respiratory muscles due to an obstacle to exhalation or inhalation, accompanied, as a rule, by subjectively painful sensations of lack of air,... ... Medical encyclopedia

Various inhalers used for bronchial asthma ... Wikipedia

I Myocarditis Myocarditis (myocarditis; Greek + myos muscle + kardia heart + itis) is a term that unites a large group of different etiologies and pathogenesis of myocardial lesions, the basis and leading characteristic of which is inflammation. Secondary... ... Medical encyclopedia

Vascular crises in patients with hypertension, most often developing in the form of acute disorders of cerebral hemodynamics or acute heart failure against the background of a pathological increase in blood pressure. There are several... ... Medical encyclopedia

I Heart failure is a pathological condition caused by the inability of the heart to provide adequate blood supply to organs and tissues during exercise, and in more severe cases, at rest. In the classification adopted at the XII Congress... ... Medical encyclopedia