2. TYPES OF DYSPNEA.pptx
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This document discusses different types of dyspnea, which is shortness of breath. It describes exertional dyspnea, orthopnea, paroxysmal nocturnal dyspnea, platypnea, and trepopnea. For each type, it provides examples of conditions that can cause it and explains the physiological mechanisms involved. Orthopnea occurs when lying down and is relieved by sitting up, due to redistribution of blood volume. Paroxysmal nocturnal dyspnea happens at night due to fluid redistribution. Platypnea occurs when upright and is relieved by lying down, due to changes in lung perfusion. Trepopnea involves shortness of breath on one side when lying on
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Dyspnea derives from Greek for “ “ shortness of breath hard breathing ”. It is often also described as ”. This is a subjective sensation of breathing, from mild discomfort to feelings of suffocation. It is a sign of a variety of disorders and is primarily an indication of ventilation or of inadequate insufficient amounts of oxygen in the circulating blood .
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- 1. Abdullah Bin Mohd Subri Credited to : Syahirah Coronavirus Issue
- 2. TYPES OF DYSPNEA EXERTIONAL DYSPNEA ORTHOPNEA PAROXYSMAL NOCTURNAL DYSPNEA PLATYPNEA TREPOPNEA
- 3. EXERTIONAL DYSPNEA Shortness of breath when exercise and improves with rest GRADING FOR DYSPNEA
- 4. ORTHOPNEA • Shortness of breath when lying down (recumbent position) • Relieved by sitting up or elevation of head with pillows • Occurs within 1-2 minutes after lying down • Examples : Congestive cardiac failure (CCF), asthma, bilateral paralysis of diaphragm MECHANISM OF ORTHOPNEA Lying down / Horizontal position ↓ Redistribution of blood volume from lower extremities to the heart ( increased venous return ) ↓ In left ventricular failure, not able to pump out extra volume of blood ↓ Backflow of blood to the lung ↓ Pulmonary congestion ↓ Dyspnea Diaphragm paralysis or lung collapse ↓ Elevated diaphragm ↓ ↓ vital capacity
- 5. PAROXYSMAL NOCTURNAL DYSPNEA • Shortness of breath which occur at night and makes the patient wake up from sleep • Occur usually 1-2 hours after sleep • Shorter duration of dyspnea (10-30 min) • Example : Left sided failure / Cardiac asthma MECHANISM OF PND Due to gradual reabsorption of lower extremity interstitial edema into the circulation ↓ ↑ intravascular blood volume ↓ ↑ venous return to the heart and lung ↓ Pulmonary congestion ↓ Dyspnea
- 6. PLATYPNEA • Shortness of breath occurs when in upright position (sitting/standing) • Relieved by supine position • Examples : Pulmonary AV malformation, hepatopulmonary syndrome MECHANISM OF PLATYPNEA Upright (Sitting position) ↓ Gravitational force causes more blood goes to lower zone of lung ↓ ↑ perfusion and ↓ ventilation ↓ V/Q mismatch ↓ Dyspnea
- 7. TREPOPNEA Shortness of breath when lying on one side (lateral recumbent position) Relieved by lying on opposite side Causes : Unilateral lung disease, CHF MECHANISM OF TREPOPNEA Patient lies on affected side ↓ Gravitational force causes more blood goes to lower zone of lung ↓ ↑ perfusion and ↓ ventilation in diseased organ ↓ V/Q mismatch ( increased shunting ) ↓ hypoxemia ↓ Worsen dyspnea
- 9. In Ralston, S. H., In Penman, I. D., In Strachan, M. W. J., & In Hobson, R. P. (2018). Davidson's principles and practice of medicine. P. J. Mehta (2018). Common Medical Symptoms. Mukerji V. Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 11. Available from: https://www.ncbi.nlm.nih.gov/books/NBK213/ REFERENCES