La dyspnée

Appareil Respiratoire - Clinique

• Dyspnée Définition: Subjective perception of breathing discomfort, not limited to respiratory problems, for activities not normally causing discomfort. Symptoms include shortness of breath, wheezing, or difficulty breathing.
• Dyspnée Types:
  • Inspiration: Problems during inhalation, usually related to upper airway issues (e.g., upper airway obstruction).
  • Expiration: Issues with exhalation, often linked to chronic diseases like asthma or chronic obstructive pulmonary disease (COPD).
  • Biphasic: Problems during both inhalation and exhalation, more complex issues.
• Dyspnea Rhythmn, Volume, & Position:
  • Rhythm: Changes include apnea (cessation of breathing), bradypnea (slow breathing), tachypnea (rapid breathing), and polypnea (fast and shallow breathing).
  • Volume: Variations in tidal volume (VT), characterized by hyperpnea (increased VT) and hypopnea (decreased VT).
  • Position: Orthopnea (dyspnea worsened in supine position), and platypnea (dyspnea improved in supine position).
• Dyspnea Frequency: Respiratory rate measured over 30 seconds, doubled to get the rate per minute.
• Dyspnea Intensity: Measured using scales, focusing on how many stairs/steps the individual can climb before symptoms set in.
• Causes of Dyspnea (for general understanding only , not for exams):
  • Increased work of breathing
  • Decreased breathing capacity
  • Ventilation/perfusion mismatch
  • Alveolar-capillary surface changes
  • Cellular hypoxia (anemia, poisoning)
  • Metabolic acidosis (Kussmaul respiration)
  • Respiratory system alterations (e.g., asthma, bronchitis, COPD, etc.)
  • Cardiovascular system alterations (e.g., heart failure)
  • Other causes (e.g., foreign body, pneumothorax, etc.)

Types of Dyspnea

• Acute Dyspnea:
  • Symptoms experienced within minutes hours or days for the first time. Signifies a serious condition requiring rapid diagnosis and treatment to determine the potential cause and avoid critical situations or death
  • Possible conditions: acute respiratory distress syndrome, acute asthma attack, pulmonary embolism, or cardiac failure
  • Immediate diagnosis and treatment are necessary.
• Chronic Dyspnea:
  • Symptoms developing gradually over weeks or months
    • Conditions may include chronic obstructive pulmonary disease (COPD), chronic heart failure, or other long-term lung or heart conditions
• Underlying Respiratory and Cardiac Conditions: The underlying cause often determines the type and severity of dyspnea
• Classification of Cardiac and Pulmonary Disorders:
  • Cardiac: New York Heart Association (NYHA) functional classification, to evaluate the severity of heart conditions.
  • Pulmonary: Modified Medical Research Council (mMRC) scale is used to evaluate the severity of lung conditions.

Diagnosing Dyspnea

• Identifying the type and duration of dyspnea is extremely important to identify potential causes
• Thorough evaluation for identifying underlying causes, considering patient's symptoms, medical history, and physical examination findings.
• Respiratory Examinations:
  • Auscultation: listening to breath sounds, to determine whether there are any abnormal breath sounds (e.g., wheezes, rales, or rhonchi).
  • Chest X-ray: For diagnosis of lung diseases, foreign bodies, and other concerns.
  • Blood tests: Lab tests can measure blood oxygen levels or detect infections.
  • Other medical tests: Further assessments could include EKG (electrocardiogram), CT scan, or pulmonary function test (PFT) to obtain more specifics information of the possible conditions.
• Treatment for Acute Dyspnea:
  • Oxygen therapy
  • Medication to ease breathing
  • Assisted ventilation for severe conditions.

Ce quiz explore les aspects cliniques de l'appareil respiratoire, notamment la définition, les types et les caractéristiques de la dyspnée. Les questions portent sur les dysfonctionnements respiratoires et leur impact sur la santé. Testez vos connaissances sur ce sujet essentiel de la médecine.