reference of pathology by inam danish all about treatment pathogensis drugs investigation methods

1. Dyspnea

2. Dyspnea
• Dyspnea or shortness of breath is an abnormal awareness of respiration
• Dyspnea in heart disease is precipitated or exacerbated by exertion but may
occur at rest
• It results from elevated left atrial and pulmonary venous pressure
• Hypoxia
• Result of left ventricular systolic or diastolic dysfunction
• Valvular obstruction

3. Grading of dyspnea by (NYH)
Grade 1 No breathlessness
Grade 2 Breathlessness on severe exertion
Grade 3 Breathlessness on mild exertion
Grade 4 Breathlessness at rest

4. Types of cardiac dyspnea
• There are three type of cardiac dyspnea
• Acute pulmonary edema
• Angina equivalent
• Chronic heart failular

5. Acute pulmonary edema
• Develops from
• Acute myocardial infarction (in previously healthy heart)
• Atrial fibrillation (in previously heart disease)
• Symptoms
Suddenly develop shortness of breath Distress
Agitation Cyanosis with coughing
Wheezing Sputum may profuse
Frothy of blood-streaked or pink Heart auscultation reveals crepitation and
rhonchi

6. Angina equivalent
• When shortness of breath is the dominant or sole feature of myocardial
ischemia instead of chest pain this is called angina equivalent
• In old people present ischemia with shortness of breath without feature of
pulmonary edema
• ECG show st change
• Treatment of angina relieves shortness of breath even without diuretics

7. Shortness of breath (dyspnea)
System Acute dyspnea at rest Chronic exertional dyspnea
Cardiovascular Acute pulmonary edema
Myocardia ischemia (angina may
present just with dyspnea and this
presentation is called angina
equivalent)
Chronic heart failure
Myocardial ischemia (angina may
present jut dystaca and this
presentation is called angina
equivalent)

8. Chronic heart failure
• Orthopnea
is dyspnea that occur during supine position (recumbency) as a
result from increase venous return
Paroxysmal Nocturnal dyspnea (PND)
is the shortness of breath that occurs abruptly 30 min to 2
hours after going to bed and is relieved by sitting up or standing up