1. DYSPNOEA
GRADES OF DYSPNOEA
 Dyspnoea is undue awareness of one’s own breathing; an awareness of increased drive to breathe.
 normal with strenuous physical exercise.
 pathological if occurs at a significantly lower threshold than expected.
 non specific symptom ; caused by cardiac/ respiratory/ neuromuscular / metabolic/ toxins/ anxiety.
CLASSIFICATION
• Classification based on cardiovascular system by THE NEW YORK HEART ASSOCIATION
GRADE DYSPNOEA
Grade 1 No limitations. Ordinary physical activity does not cause undue fatigue/ dyspnoea / palpitation
(asymptomatic left ventricular dysfunction).
Grade 2 Slight limitation of physical activity but comfortable at rest.
Ordinary physical activity results in fatigue/ palpitation/ dyspnoea or angina pectoris (symptomatically
'mild' heart failure).
Grade 3 Marked limitation of physical activity.
Less than ordinary physical activity will lead to symptoms
(symptomatically 'moderate' heart failure).
Grade 4 Symptoms of congestive heart failure present, even at rest.
any physical activity is uncomfortable (symptomatically 'severe' heart failure)
• Classification based on respiratory system
(a) THE MEDICAL RESEARCH COUNCIL
GRADE DYSPNOEA
Grade 1 Breathless when hurrying on the level or walking up a slight hill.
Grade 2 Breathless when walking with people of own age or on level ground.
Grade 3 Has to stop because of breathlessness when walking on level ground at own pace.
(b) SHERWOOD JONES CLASSIFICATION
GRADE DYSPNOEA
Grade 1 Able to do household work
a. with moderate difficulty.
b. With great difficulty.
Grade 2 Confined to chair or bed and
a. Able to get up with moderate difficulty.
b. Able to get up with great difficulty.
Grade 3 Totally confined to chair or bed.
Grade 4 Moribund.
Dr. MURALIKRISHNA BHARADHI.
2nd Year PG
emaiI: doctormkb@gmail.com
Dr. MURALIKRISHNA BHARADHI.
2nd Year PG
emaiI: doctormkb@gmail.com
REFERENCES:
1. MACLEOD’S CLINICAL EXAMINATION.
2. R. ALLAGAPAN MANUAL OF MEDICINE.