Dyspnea

• Dyspnea - Definition

  An abnormally uncomfortable awareness of breathing
• NYHA uses

  • Dyspnea
  • Palpitation
  • Fatigue
  • Angina
• NYHA Grades

  1. No symptoms with normal activity
  2. Symptoms with ordinary activity,Slight limitation of physical activity
  3. Symptoms with less than ordinary activity,Marked limitation of activity
  4. Symtoms with any physical activity and rest
• Cardiac causes of DYSPNOEA

  • Left heart failure
  • Congential heart diseases
  • Acquired vlvular Heart diseases
  • Hypertensive heart disease
  • Cardiomyopathies
• Respiratory causes of Dyspnea

  • Bronchial Asthma
  • Chronic Bronchitis
  • Emphysema
  • Pneumoconiosis
  • Interstitial Lung Disease
  • Pneumonias
  • Pulmonary neoplasm
  • Pulmonary embolism
  • Laryngea obstruction
• Extra parenchymal causes of Dyspnea

  • Mysthenia gravis
  • Guillain Barre Syndrome
  • Ankylosing Spondylitis
  • Kyphoscoliosis
  • obesity
• PND Full form

  Paroxysomal Nocturnal Dyspnoea
• Define PND

  Occurs 2 to 5 hours after the onset of sleep and takes 10 to 30 minutes for recovery after resuming the right posture
• PND Mechanism

  • Similar to orthopnea
  • Fall in PaO2
  • Decreased Sympthetic support to Left ventricular function during sleep
• PND Causes

  • Aortic Valve Disease
  • Hypertension
  • Cardiomyopthy
  • Atrial fibrillation
• Trepopnoea

  Dyspnoea occurs only in left or right Lateral Decubitus position
• Platypnoea


  Dyspnoea which occurs only in the upright position
• Platypnoea causes

  • Left Atrial thrombus
  • Left Atrial Tumours- Myxomas
  • Pulmonary Arterioveous Fistula