Dyspnea is difficulty breathing or an uncomfortable awareness
of breathing. It is one of the cardinal symptoms of cardiac (heart)
If you experience
dyspnea, you may have difficulty getting enough air into your
lungs. You may feel claustrophobic or you may sigh a lot. Sometimes
shortness of breath can be relieved by taking a few deep breaths
or by resting.
are the noncardiac causes of dyspnea?
Dyspnea is a relatively common occurrence. It does not always
indicate illness. Strenuous activity or anxiety may produce shortness
of breath. Dyspnea may be caused by obesity or may develop as
part of an allergic reaction.
occurs as a symptom of a variety of illnesses. These include neuromuscular,
pulmonary (lung), cardiac (heart), and other diseases.. Some of
the pulmonary illnesses which have shortness of breath as a symptom
include: emphysema, obstructive airway disease, pulmonary embolism,
bronchitis, and asthma.
What are the cardiac causes
A major cardiac cause of dyspnea is heart failure - in particular,
failure of the left lower heart chamber (left ventricle). In addition
to shortness of breath, you may experience upper abdominal pain,
and excessive night time urination (nocturia). Usually the shortness
of breath worsens on exertion, and is partially or completely
relieved by rest. If you have left ventricular heart failure,
you may avoid dyspnea in bed by sleeping with two or more pillows.
If you have heart failure, you
may experience dyspnea when you are sleeping. This is known as
"paroxysmal nocturnal dyspnea.". Shortness of breath usually occurs
two to four hours after falling asleep. You will awaken with dyspnea,
sweating, coughing and perhaps wheezing. Your symptoms may be
relieved by getting out of bed or by sitting on the side of the
bed. The relief comes gradually, and may take ten to twenty minutes.
Dyspnea on exertion may signify
another cardiac illness called, "coronary artery disease." If
you have coronary artery disease, dyspnea may be accompanied by
chest discomfort or pain (angina). Dyspnea which is also accompanied
by chest pain, may indicate an acute myocardial infarction(heart
If you have a history of mitral
valve disease (deformity of one of the heart's valves), the sudden
onset of dyspnea may mean that you have developed a specific arrhythmia
(irregular heart rhythm). This arrhythmia is called, "atrial fibrillation",
and is rarely life threatening.
The onset of dyspnea in cardiac
disease is a serious occurrence. It may indicate a worsening of
your condition. If you have a history of heart disease and you
suddenly have episodes of shortness of breath, call you health
How are the underlying diseases diagnosed?
Your doctor will take a complete medical history and perform a
physical examination to determine the cause(s) of your shortness
of breath. He will be particularly interested in hearing your
account of the intensity, severity, and frequency of the dyspnea.
He will also question you as to the quality of the dyspnea and
your reactions and feelings about the episodes.
If a cough accompanies your dyspnea, your
physician will want to know if it occurs before or after the shortness
Your doctor may order include blood tests,
x-rays and electrocardiograms .
How is dyspnea treated?
Therapy for dyspnea usually consists of treating the underlying
illness(es). Depending on the cause, treatment may range from
instruction as to what to do when you experience shortness of
breath, to medications, to hospitalization.