What is Dyspnea?
Dyspnea is a type of labored breathing
- which is subjectively perceived as "hunger / need for" air "and inadequacy of breath
is that
- involves increasing the effort to breathe,
with the consequence of a non-spontaneous muscular effort to perform inhalations and exhalations.
Types of Dyspnea
Dyspnea can be:
- Accessory: when it arises suddenly, without a precise regularity, as can happen in asthma, in the closure of the glottis (throat), in pulmonary edema (presence of fluid in the small respiratory tract);
- From effort: when it occurs during a more or less intense physical activity and is resolved with rest. This occurs for example in some heart diseases or in anemia;
- Continues: present constantly. It can be caused by heart failure or by severe respiratory failure.
Depending on the phase of the breath in which dyspnea occurs, it can be inspiratory, expiratory or mixed.
Causes of dyspnea
Diseases of the respiratory centers: breathing is regulated by groups of neurons which function independently of the control of the subject's will and which are located in a structure of the brain called the brainstem, under the cerebral hemispheres.
It can happen, for various reasons, that these neurons get sick, and therefore breathing is compromised with the appearance of dyspnea. The causes that can damage the respiratory centers are: inflammation, infections, trauma (especially in road accidents), tumors, toxic substances (drugs or opium-based drugs, barbiturates), hypoxia (when little oxygen passes into the blood), hypercapnia ( accumulation of carbon dioxide in the blood).
Impairment of the nerve pathways that carry information from the respiratory centers to the effector muscles for:
- multiple sclerosis (a disease of neurons in the central nervous system that destroys myelin, a protein that surrounds them);
- amyotrophic lateral sclerosis (which slowly destroys all neurons, both in the central and peripheral nervous systems).
Diseases of the respiratory muscles:
- myasthenia gravis (chronic inflammatory disease causing weakness of all muscles, including the chest wall).
Stiffness in the chest, which does not allow it to expand well, for:
- scleroderma (chronic inflammatory disease that affects internal organs and also the skin, making it hard and inelastic);
- severe pain from a broken rib (which restricts breathing movements).
Increase in abdominal volume for:
- pregnancy (the growing baby compresses the diaphragm, which is located above the uterus and which is the main breathing muscle);
- bloating (gas-filled abdomen);
- ascites (fluid that forms due to liver diseases such as cirrhosis and hepatitis and which accumulates in the peritoneum, the membrane that surrounds the abdominal viscera).
Obstructive pulmonary diseases, i.e. from obstructed passage of air in the airways:
- foreign bodies (especially in children who ingest small objects);
- diphtheria (infectious disease causing inflammation and spasms of the larynx);
- asthma attacks (in which bronchial spasms and excessive mucus production occur);
- chronic bronchitis;
- tumors;
- pulmonary emphysema (disease in which the septa separating the alveoli break and if they form large pockets filled with air, which thus remains incarcerated and has difficulty in getting out of the respiratory system);
- pulmonary edema (presence of fluid that hinders the diffusion of oxygen from the lung to the blood).
Restrictive lung diseases, i.e. due to an impairment of all lung tissue, such as:
- pulmonary fibrosis (replacement of the alveoli with fibrous tissue, not very elastic, therefore not very inclined to expand during breathing), mainly due to substances of various kinds inhaled for years in the workplace (asbestos, gas, etc.) or as a result severe pneumonia, or radiation;
- pleural effusion (fluid in the pleura);
- pneumothorax (air in the pleura);
- hemothorax (blood in the pleura).
Chest wall diseases:
- fibrosis;
- accumulation of fat (obese people);
- chest wall deformity (from spinal abnormalities such as scoliosis, kyphosis and lordosis).
Heart disease: they are responsible for what is called cardiogenic dyspnea. The difficulty in breathing in heart sufferers is due to the fact that this organ, when severely compromised by various diseases such as heart attacks, valve changes, heart failure or cardiac dilations, pumps less blood into the aorta because it has lost its "strength" .
As a result, blood accumulates upstream of the left heart, in the pulmonary veins. If this buildup is large, great pressure is created in the same veins which can cause fluid to escape from the vessels. This compresses the small respiratory tract and can, in severe cases, also enter the alveoli, giving what is called pulmonary edema, a very serious condition that prevents the passage of oxygen and carbon dioxide from the alveolus to the blood and vice versa. , and which must be treated urgently because it can lead to death in a very short time. There are different degrees of cardiogenic dyspnea:
- class I: when the patient is not "air hungry" but has documented heart disease that could soon cause it;
- class II: when he has no symptoms at rest but they appear when making high intensity efforts;
- class III: when dyspnea appears due to efforts of mild intensity;
- class IV: when dyspnea is present even at rest.
Diseases of the blood, which alter its composition:
Psychological and psychiatric causes in patients suffering from neurosis, anxiety, anguish, depression.
Treatment of Dyspnea "
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