Download Section III Common Symptoms

Section III
Common Symptoms
(dyspnea)
Dr. Zhuoren Lu
First Hospital
Xian Jiaotong University
C. Dyspnea
1. Definition: shortness of breath. It is purely
subjective.
2. Causes of dyspnea
(1) pulmonary dyspnea
a) Obstructive disease of airways
 Large airway obstruction produces “inspiring
dyspnea”
 Obstruction of intrathoracic airways produces
“expiring dyspnea” -- asthmatic wheezing
b) Ephysema and Diffuse parenchymal lung
disease
c) Disease of chest wall and respiratory muscles
(2) Cardiac dyspnea: In left ventricular failure, the
hydrostatic pressure in the pulmonary capillaries
exceeds oncotic pressure of plasma, transudation
of fluid from capillaries to alveoli takes place.
(3)Miscellaneous causes of dyspnea
3. Some types of dyspnes
(1) Exertional dyspnes: Dyspnea during exertion is
the earliest symptom of left ventricular failure.
(2) Acute pulmonary edema: Usually it occurs in
individuals with already compromised heart,
with sudden increase of blood pressure in
hypertensive person, sudden increases of pulse
rate, unusual exertion, rapid intravenous
infusions of fluid, and so on.
(3) Orthopnea: a form of dyspnea in which the
patient must assume a sitting position to avoid
respiratory distress.
(4)Paroxysmal nocturnal dyspnea: The cause is that
the patient is already on the borderline of
pulmonary edema. The result is an increase of
pulmonary capillary pressure and pulmonary
edema.
(5)Cardiac asthma: It is asthmatic breathing in the
patient with heart disease. It frequently occurs
during attacks of paroxysmal nocturnal dyspnea.