Dyspnea - Shortness of Breath

Dyspnea is an abnormally uncomfortable awareness of breathing – it involves both the perception of a sensation and the reaction to that perception.

Verbal expression includes:

  • “I cannot get enough air.”
  • “The air does not go down all the way.”
  • “I have a smothering feeling, a tightness or a tiredness in my chest.”
  • “I have a choking sensation.”

A meticulous history is needed to determine if the patient's symptoms match the description. Once this is determined, the physician needs to define the circumstances in which it occurs and to assess associated symptoms.


Types of Occurrences

  • Orthopnea – shortness of breath upon assuming the supine position – in congestive heart failure (CHF), chronic obstructive pulmonary disease, or asthma

  • Trepopnea – shortness of breath only in the lateral decubitus position – in heart disease

  • Platypnea – shortness of breath only in the upright position

  • Paroxysmal Nocturnal Dyspnea – shortness of breath occurring at night and awakening the patient from sleep – in Congestive Heart Failure (CHF) and pulmonary edema

  • Cheyne-Stokes respiration - a crescendo-decrescendo pattern of respiration followed by central apnea (lack of breathing) or hypopnea (shallow breathing).

    For more information on Shortness of Breath, be sure to see:

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