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Respiration; International Review of... 2021Breathlessness, also known as dyspnoea, is a debilitating and frequent symptom. Several reports have highlighted the lack of dyspnoea in a subgroup of patients suffering... (Review)
Review
Breathlessness, also known as dyspnoea, is a debilitating and frequent symptom. Several reports have highlighted the lack of dyspnoea in a subgroup of patients suffering from COVID-19, sometimes referred to as "silent" or "happy hyp-oxaemia." Reports have also mentioned the absence of a clear relationship between the clinical severity of the disease and levels of breathlessness reported by patients. The cerebral complications of COVID-19 have been largely demonstrated with a high prevalence of an acute encephalopathy that could possibly affect the processing of afferent signals or top-down modulation of breathlessness signals. In this review, we aim to highlight the mechanisms involved in breathlessness and summarize the pathophysiology of COVID-19 and its known effects on the brain-lung interaction. We then offer hypotheses for the alteration of breathlessness perception in COVID-19 patients and suggest ways of further researching this phenomenon.
Topics: Brain; COVID-19; Dyspnea; Humans; SARS-CoV-2
PubMed: 34333497
DOI: 10.1159/000517400 -
Revue Medicale de Liege Sep 2011Dyspnea is an extremely common symptom in medicine and in cardio-pulmonary medicine in particular. In most of the cases dyspnea reflects an unbalance between the...
Dyspnea is an extremely common symptom in medicine and in cardio-pulmonary medicine in particular. In most of the cases dyspnea reflects an unbalance between the ventilatory demand and the possibility of the thoracic and lung mechanics. Through to a simple clinical case describing an early stage of lung fibrosis we review the main causes and the differential diagnoses of dyspnea, and provide means of grading it through validated assessment scales.
Topics: Diagnosis, Differential; Dyspnea; Humans; Severity of Illness Index
PubMed: 21995241
DOI: No ID Found -
BMJ Case Reports Nov 2017A 32-year-old woman suffering from systemic lupus erythematosus presented with a 6-week history of progressive dyspnoea and pleuritic chest pain. Examination was normal...
A 32-year-old woman suffering from systemic lupus erythematosus presented with a 6-week history of progressive dyspnoea and pleuritic chest pain. Examination was normal apart from reduced air entry at the lung bases.Arterial blood gases showed hypoxaemia and chest X-ray revealed raised hemidiaphragms without any pleural effusions. Lung function showed a restrictive pathology while high-resolution chest CT and CT pulmonary angiogram were negative. Echocardiography showed normal ventricular diameters and no pericardial effusion. Reduced lung volumes and a positive fluoroscopic sniff test lead to a diagnosis of shrinking lung syndrome. Symptoms improved following treatment with glucocorticoids and non-invasive ventilation, but there was no change in lung function.A year later, our patient presented again with worsening dyspnoea. This time echocardiography revealed severe mitral stenosis with pulmonary hypertension. Mitral valve replacement was performed and dyspnoea resolved. Histology showed Libman-Sachs endocarditis.
Topics: Adult; Diagnosis, Differential; Dyspnea; Echocardiography; Familial Primary Pulmonary Hypertension; Female; Humans; Lung; Lupus Erythematosus, Systemic; Mitral Valve Stenosis; Rare Diseases; Respiratory Function Tests; Treatment Outcome
PubMed: 29122894
DOI: 10.1136/bcr-2017-220162 -
Heart & Lung : the Journal of Critical... 2023Besides dyspnoea and cough, patients with idiopathic pulmonary fibrosis (IPF) or sarcoidosis may experience distressing non-respiratory symptoms, such as fatigue or...
INTRODUCTION
Besides dyspnoea and cough, patients with idiopathic pulmonary fibrosis (IPF) or sarcoidosis may experience distressing non-respiratory symptoms, such as fatigue or muscle weakness. However, whether and to what extent symptom burden differs between patients with IPF or sarcoidosis and individuals without respiratory disease remains currently unknown.
OBJECTIVES
To study the respiratory and non-respiratory burden of multiple symptoms in patients with IPF or sarcoidosis and to compare the symptom burden with individuals without impaired spirometric values, FVC and FEV1 (controls).
METHODS
Demographics and symptoms were assessed in 59 patients with IPF, 60 patients with sarcoidosis and 118 controls (age ≥18 years). Patients with either condition were matched to controls by sex and age. Severity of 14 symptoms was assessed using a Visual Analogue Scale.
RESULTS
44 patients with IPF (77.3% male; age 70.6±5.5 years) and 44 matched controls, and 45 patients with sarcoidosis (48.9% male; age 58.1±8.6 year) and 45 matched controls were analyzed. Patients with IPF scored higher on 11 symptoms compared to controls (p<0.05), with the largest differences for dyspnoea, cough, fatigue, muscle weakness and insomnia. Patients with sarcoidosis scored higher on all 14 symptoms (p<0.05), with the largest differences for dyspnoea, fatigue, cough, muscle weakness, insomnia, pain, itch, thirst, micturition (night, day).
CONCLUSIONS
Generally, respiratory and non-respiratory symptom burden is significantly higher in patients with IPF or sarcoidosis compared to controls. This emphasizes the importance of awareness for respiratory and non-respiratory symptom burden in IPF or sarcoidosis and the need for additional research to study the underlying mechanisms and subsequent interventions.
Topics: Humans; Male; Adolescent; Aged; Middle Aged; Female; Cough; Sleep Initiation and Maintenance Disorders; Idiopathic Pulmonary Fibrosis; Sarcoidosis; Dyspnea; Fatigue; Muscle Weakness
PubMed: 37269615
DOI: 10.1016/j.hrtlng.2023.05.013 -
Lakartidningen Jan 2017Persons with COPD should be recommended training Persons with chronic obstructive pulmonary disease (COPD) should be recommended aerobic and resistance training to be... (Review)
Review
Persons with COPD should be recommended training Persons with chronic obstructive pulmonary disease (COPD) should be recommended aerobic and resistance training to be able to improve quality of life and physical capacity, and to decrease dyspnoea, anxiety and depression (moderately strong scientific evidence - quality of evidence grade 3). Subjects with an exacerbation should be recommended training at a low intensity in direct connection with the exacerbation to improve quality of life and physical capacity (moderately strong scientific evidence - quality of evidence grade 3), and to lower the risk of mortality and hospitalization (limited scientific evidence - quality of evidence grade 2). Prescription of exercise should be based on assessment of physical capacity. Aerobic exercise can be performed as interval or continuous training. Special attention is needed regarding oxygen saturation, heart rate, blood pressure and subjective rating of dyspnea and leg fatigue.
Topics: Disease Progression; Dyspnea; Exercise; Humans; Prescriptions; Pulmonary Disease, Chronic Obstructive; Quality of Life; Resistance Training; Walk Test
PubMed: 28140421
DOI: No ID Found -
Chronic Respiratory Disease 2012Dyspnea is a complex physiologic and psychosocial symptom that is difficult to characterize and measure, but essential to treat, as it has a significant effect on... (Review)
Review
Dyspnea is a complex physiologic and psychosocial symptom that is difficult to characterize and measure, but essential to treat, as it has a significant effect on quality of life. Although palliation of dyspnea in the child with chronic illness is an under-researched area, children and their families cannot wait for the research to catch up with their current needs. This article addresses several aspects of dyspnea in pediatrics palliative care, with an eye toward practical suggestions for evaluation and management.
Topics: Child; Dyspnea; Humans; Palliative Care
PubMed: 22872362
DOI: 10.1177/1479972312452439 -
British Medical Journal (Clinical... Jul 1983
Topics: Dyspnea; Humans
PubMed: 6409235
DOI: 10.1136/bmj.287.6386.160 -
Ugeskrift For Laeger Jul 2021Patients with emphysema often have limited treatment options. Lung volume reduction is an effective treatment to carefully selected patients with emphysema. Most... (Review)
Review
Patients with emphysema often have limited treatment options. Lung volume reduction is an effective treatment to carefully selected patients with emphysema. Most importantly, the primary care physician should refer patients with COPD and refractory dyspnoea and/or with emphysema to departments specialised in respiratory medicine for further treatment and assessment, which is discussed in this review.
Topics: Dyspnea; Emphysema; Humans; Pneumonectomy; Pulmonary Disease, Chronic Obstructive; Pulmonary Emphysema; Treatment Outcome
PubMed: 34356024
DOI: No ID Found -
NPJ Primary Care Respiratory Medicine Mar 2022Dyspnoea or breathlessness is a common presenting symptom among patients attending primary care services. This review aimed to determine whether there are clinical tools... (Review)
Review
Dyspnoea or breathlessness is a common presenting symptom among patients attending primary care services. This review aimed to determine whether there are clinical tools that can be incorporated into a clinical decision support system for primary care for efficient and accurate diagnosis of causes of chronic dyspnoea. We searched MEDLINE, EMBASE and Google Scholar for all literature published between 1946 and 2020. Studies that evaluated a clinical algorithm for assessment of chronic dyspnoea in patients of any age group presenting to physicians with chronic dyspnoea were included. We identified 326 abstracts, 55 papers were reviewed, and eight included. A total 2026 patients aged between 20-80 years were included, 60% were women. The duration of dyspnoea was three weeks to 25 years. All studies undertook a stepwise or algorithmic approach to the assessment of dyspnoea. The results indicate that following history taking and physical examination, the first stage should include simply performed tests such as pulse oximetry, spirometry, and electrocardiography. If the patient remains undiagnosed, the second stage includes investigations such as chest x-ray, thyroid function tests, full blood count and NT-proBNP. In the third stage patients are referred for more advanced tests such as echocardiogram and thoracic CT. If dyspnoea remains unexplained, the fourth stage of assessment will require secondary care referral for more advanced diagnostic testing such as exercise tests. Utilising this proposed stepwise approach is expected to ascertain a cause for dyspnoea for 35% of the patients in stage 1, 83% by stage 3 and >90% of patients by stage 4.
Topics: Adult; Aged; Aged, 80 and over; Decision Support Systems, Clinical; Dyspnea; Female; Humans; Middle Aged; Spirometry; Young Adult
PubMed: 35260575
DOI: 10.1038/s41533-022-00271-1 -
Internal Medicine (Tokyo, Japan) Oct 1998
Topics: Arm; Dyspnea; Humans; Lung Diseases, Obstructive; Respiratory Muscles; Sensation; Vibration; Weight Lifting
PubMed: 9840697
DOI: 10.2169/internalmedicine.37.799