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    Dyspnea Presentation

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    amgopera
    This document provides an overview of dyspnea (shortness of breath) and approaches to evaluating patients presenting with dyspnea. It discusses the mechanisms of dyspnea and lists common causes organized by respiratory system, cardiovascular system, and non-cardiogenic pulmonary diseases. Specific conditions covered include asthma, COPD, pulmonary edema, pulmonary embolism, foreign body obstruction, and others. The document aims to guide clinicians in systematically assessing dyspnea based on its underlying causes.

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    Dyspnea Presentation

    Uploaded by

    amgopera
    113 views37 pages
    This document provides an overview of dyspnea (shortness of breath) and approaches to evaluating patients presenting with dyspnea. It discusses the mechanisms of dyspnea and lists common causes organized by respiratory system, cardiovascular system, and non-cardiogenic pulmonary diseases. Specific conditions covered include asthma, COPD, pulmonary edema, pulmonary embolism, foreign body obstruction, and others. The document aims to guide clinicians in systematically assessing dyspnea based on its underlying causes.

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    This document provides an overview of dyspnea (shortness of breath) and approaches to evaluating patients presenting with dyspnea. It discusses the mechanisms of dyspnea and lists common causes organized by respiratory system, cardiovascular system, and non-cardiogenic pulmonary diseases. Specific conditions covered include asthma, COPD, pulmonary edema, pulmonary embolism, foreign body obstruction, and others. The document aims to guide clinicians in systematically assessing dyspnea based on its underlying causes.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    113 views37 pages

    Dyspnea Presentation

    Uploaded by

    amgopera
    This document provides an overview of dyspnea (shortness of breath) and approaches to evaluating patients presenting with dyspnea. It discusses the mechanisms of dyspnea and lists common causes organized by respiratory system, cardiovascular system, and non-cardiogenic pulmonary diseases. Specific conditions covered include asthma, COPD, pulmonary edema, pulmonary embolism, foreign body obstruction, and others. The document aims to guide clinicians in systematically assessing dyspnea based on its underlying causes.

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    The document discusses various causes, mechanisms, and approaches to dyspnea. Dyspnea can be caused by issues in the respiratory, cardiovascular, or pulmonary systems, as well as other factors like anemia or obesity. A thorough history and physical exam is needed to evaluate a patient experiencing dyspnea.

    Common causes of dyspnea discussed include asthma, COPD, pulmonary edema, pulmonary embolism, foreign body obstruction, pharyngeal edema, epiglottitis, and croup. Dyspnea can also be caused by issues in the heart, lungs, airways, chest wall, or other medical conditions and injuries.

    Mechanisms that can cause dyspnea include changes in chemoreceptors, mechanoreceptors, and metaboreceptors. Other mechanisms discussed are efferent-afferent mismatch and contributions from emotional or affective factors. Increased work of breathing from issues like bronchospasm or fluid in the lungs can also cause dyspnea.

    Dyspnea

    Approach to Dyspnea

    Presented by:
    Corina Ann Bonus

    Perpetual Help Medical Center


    Las Pinas
    Dyspnea
    • Subjective experience of breathing discomfort.
    • Difficulty in breathing or Shortness of breath.
    • A signs of increased work of breathing.
    • Deviations from normal functions in the cardiovascular
    and respiratory systems.
    Mechanism of DYSPNEA
     Motor Efferent
     Sensory Afferent
    1. Chemoreceptors
    2. Mechanoreceptors
    3. Metaboreceptors
     Efferent-Afferent Mismatch
     Contribution Of Emotional Or Affective Factors To Dyspnea
    Mechanism of DYSPNEA
    Approach to the patient: DYSPNEA
    Respiratory System Dyspnea
     Disease in the airway
    1. COPD
    2. Asthma
    3. Acute Bronchoconstriction
     Disease of the chest wall
    1. Kyphoscoliosis
    2. Myasthenia gravis
    3. Guillian- Barre syndrome
     Disease in the lung parenchyma
    1. Interstitial lung disease-infection, occupational exposure or autoimmune
    disorders
    Cardiovascular System Dyspnea
     Disease in the Left heart
    1. Myocardium->coronary artery disease
    non ischemic cardiomyopathies ->
    left ventricular end-diastolic volume
    elevation of the left ventricular end diastolic pressure->
    interstitial edema
    stimulation of pulmonary receptors->
    dyspnea.
    2. Diastolic dysfunction
     Disease of the pulmonary Thromboembolic disease, pulmonary hypertension and pulmonary vasculitis
     Disease of the Pericardium
    1. Constrictive pericarditis
    2. Cardiac tamponade
    Dyspnea with Normal Respiratory and
    Cardiovascular system
    Anemia
    Obesity
    Poor fitness
    Common causes of non cardiogenic
    pulmonary disease
     Direct injury to lung
    1. Chest trauma, pulmonary contusion
    2. Aspiration
    3. Smoke inhalation
    4. Pneumonia
    5. Oxygen toxicity
    6. Pulmonary embolism, reperfusion
     Hematogenous injury to lung
    1. Sepsis
    2. Pancreatitis
    3. Non thoracic Trauma
    4. Leukoagglutination reactions
    5. Multiple transfusion
    6. Intravenous drug used (e.g., heroin)
    7. Cardiopulmonary bypass
     Possible lung injury + Elevated Hydrostatic
    Pressures
    1. High altitude pulmonary edema
    2. Neurogenic pulmonary edema
    3. Re expansion pulmonary edema
    Upper Airway Foreign Body Obstruction

    Pharyngeal Edema
    Croup
    Epiglottitis
    Foreign Body Obstruction Partial or complete

    Most common cause of pediatric airway


    obstruction
    Foreign Body Obstruction

    Suspect in any child with Sudden onset of


    dyspnea
    Decreased LOC
    Suspect in any adult who develops dyspnea
    or loses consciousness while eating
    Pharyngeal Edema

    Swelling of soft tissues of throat


    Allergic reactions, upper airway burns
    Hoarseness, stridor, drooling
    Epiglottitis Bacterial infection

    Causes edema of epiglottis


    Children age 4-7 years
    Increasingly common in adults
    Rapid onset, high fever, stridor, sore
    throat, drooling
    Croup Laryngotracheobronchitis

    Viral infection
    Causes edema of larynx/trachea
    Children ages 6 months to 4 years
    Lower Airway Asthma
    Chronic Obstructive Pulmonary Disease
    Chronic bronchitis
    Emphysema
    Asthma Reversible obstructive pulmonary disease
    Younger persons disease (80 have first
    episode before age 30)

    Lower airway hypersensitive to


    allergens, emotional stress, irritants, infection
    Asthma Bronchospasm
    Bronchial edema
    Increased mucus production, plugging
    Resistance to airflow, work of breathing increase
    Asthma Airway narrowing interferes with
    exhalation
    Air trapped in chest interferes with gas exchange
    Wheezing, coughing, respiratory distress
    Asthma
    All that wheezes is not asthma

    Other possibilities
    Pulmonary edema
    Pulmonary embolism
    Anaphylaxis (severe allergic reaction)
    Foreign body aspiration
    Pneumonia
    Chronic Obstructive Pulmonary Disease
    Chronic Bronchitis
    Emphysema
    Chronic Bronchitis Chronic lower airway
    inflammation
    Increased bronchial mucus production
    Productive cough
    Urban male smokers at 30 years old
    Chronic Bronchitis Mucus, swelling interfere with
    ventilation
    Increased CO2, decreased O2
    Cyanosis occurs early in disease
    Lung disease overworks right ventricle
    Right heart failure occurs
    RHF produces peripheral edema
    Blue Bloater
    Emphysema Loss of elasticity in small airways
    Destruction of alveolar walls
    Urban male smokers at 40-50 years old
    Emphysema Lungs lose elastic recoil
    Retain CO2, maintain near normal O2
    Cyanosis occurs late in disease
    Barrel chest (increased AP diameter)
    Thin, wasted
    Prolonged exhalation through pursed lips
    Pink Puffer
    COPD Prone to periods of decompensation
    Triggered by respiratory infections, chest trauma
    Signs/Symptoms
    Respiratory distress
    Tachypnea
    Cough productive of green, yellow sputum
    Alveolar Function Problems
    Pulmonary Edema Fluid in/around alveoli, small
    airways
    Causes
    Left heart failure
    Toxic inhalants
    Aspiration
    Drowning
    Trauma
    Pulmonary Edema Signs/Symptoms
    Labored breathing
    Coughing
    Rales, rhonchi
    Wheezes
    Pink, frothy sputum
    Pulmonary Edema Signs/Symptoms
    Sit up
    High concentration O2
    Assist ventilation
    Pulmonary Embolism Clot from venous
    circulation
    Passes through right heart
    Lodges in pulmonary circulation
    Shuts off blood flow past part of alveoli
    Pulmonary Embolism Associated with
    Prolonged bed rest or immobilization
    Casts or orthopedic traction
    Pelvic or lower extremity surgery
    Phlebitis
    Use of BCPs
    Pulmonary Embolism Signs/Symptoms
    Dyspnea
    Chest pain
    Tachycardia
    Tachypnea
    Hemoptysis
    Sudden Dyspnea No Readily Identifiable Cause
    Pulmonary Embolism
    Pulmonary Embolism Management
    Oxygen
    Assisted ventilation
    Transport

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