EXTREAM SHORTNESS OF BREATH

AIR HUNGRY? IT COULD BE DYSPNEA

One never really appreciates the importance of a functional breathing system, until Dyspnea comes calling and they can’t catch their breath. It is a rather a debilitating experience that reminds us that the very breath that is so freely given can be denied, instantly or insidiously threatening to cut us off. But what is Dyspnea if we may ask? Dyspnea is the medical term for shortness of breath, an uncomfortable sensation of breathlessness. Think of climbing up a flight of stairs or going about your daily chores and suddenly you realize that you no longer have the tolerance to pull through because you are air hungry, tasks that you are usually comfortable doing become difficult.

Who can have Dyspnea

My friend recently turned up for a hike expedition and everything was okay found myself stopping more so often to gasp for breath, stealing into my adventure time and having to rest instantaneously to replenish and compensate for lost breath. He was disappointed that he was not generating enough oomph to march on, sadly calling the whole exercise off, barely two hours into it. Worried and haggard, it did not occur to him that what was supposed to be a totally rejuvenating experience led to the discovery that he was dyspneic. He was worried because shortness of breath can be a sign of so many underlying conditions. He ruled out overexertion in the hiking at high altitude when he did not regain his normal breathing even after relaxing. Without any other leading symptoms like aggravated fever or coughing, he could not pick what was really amiss with him, and definitely not Corona Virus Disease, COVID-19. There was, however, rhythmic rapid shallow breathing coupled with heart palpitations and a nauseating feeling that made his chest so tight.

What are the symptoms

All these symptoms are indicative of Dyspnea, when presenting singly or altogether. Shortness of breath can be caused by many factors, and it is very important to actually settle at the very reason that is making you short of breath. Diseases like asthma, Chronic Obstructive Pulmonary Disease, COPD, anaemia, pneumonia and psychogenic pain exacerbated by anxiety can cause Dyspnea or seem to worsen it. Chocking or inhaling something that suddenly blocks your breathing passageways can cause Dyspnea, for example when enveloped by a cloud of smoke, you will definitely try to catch your breath.

What is likely to cause Dyspnea

Hypotension, low blood pressure can also cause Dyspnea, or even when a blood clot is trapped in an artery leading to the lung, what is usually referred to as pulmonary embolism. People who are allergic to certain types of environmental allergens such as pollen and mold may find themselves having difficulty breathing when they are exposed to those allergens for long periods of time. Dyspnea can either be acute or chronic. Acute Dyspnea is short-lived and usually relieves without major medical interventions. Breathlessness lasting for over a month is chronic and may be as a result of a terminal illness, or underlying lung conditions. Usually, patients of lung cancer, tuberculosis, and traumatic lung injury have chronically dyspneic.

When too much fluid collects in the lungs, pulmonary oedema or when the pleural membrane, the membrane surrounding the lungs is inflamed, breathing normally becomes compromised. Pulmonary hypertension, basically when there is increased pressure in the arteries leading to the lungs, normal breathing presents as a challenge. Heart problems such as cardiomyopathy, pericarditis (when the pericardium, the issue surrounding the heart becomes inflamed) and heart failure can also lead to Dyspnea.

Now more than ever, we must be on the lookout when we can’t breathe properly because it could also be a symptom of an infection with Corona Virus, although we must be on he look out for other symptoms like fever, headache, lethargy, body aches and or malaise if we suspect we could have been exposed to COVID-19 carriers.

Dyspnea on exertion is normal and is relieved when the body relaxes but is considered indicative of disease when it makes activity usually well tolerated difficult. The degree of functional impairment varies from different patients. Most patients will get up in the middle of the night worried and gasping for breath, usually after one to two hours of sleep and wonder what is happening to them. Upon sitting upright, they realize that breathing normally is regained. This is called paroxysmal nocturnal Dyspnea. Some people have a sensation of suffocating when they stand upright but later get relief when they lie down, others will have Dyspnea when they lie down and get relief when they stand up, orthopnea and platypnea respectively, classified as different types of Dyspnea.

What are the complications associated with Dyspnea

There are many complications that can arise from shortness of breath but most notably is hypoxia/hypoxemia, a condition where there is strained low blood oxygen levels which can lead to loss of consciousness and other serious conditions like heart failure or even stroke. Normally, oxygen is supplied from the lungs into the bloodstream and transported to vital body organs like the brain and the kidneys. When deficient of oxygen, there can be life-threatening outcomes, and severe Dyspnea could lead to organ failure. When exactly are we supposed to seek immediate medical attention? If you experience chest pain, nausea, loss of function due to shortness of breath or sudden onset of severe shortness of breath, do not wait any longer because these are indicators that your breathing system is at risk and need to urgently seek medical attention.

How is Dyspnea treated

The doctor will take your medical history and ask questions like, do you have difficulty breathing? When did you start feeling dyspneic? Has the sensation of shortness of breath been sudden or gradual? Conditions under which one feels dyspneic including body position? The doctor will also want to know if you suffer from sleep apnea, a sleep disorder in which breathing repeatedly stops and starts. Arriving at a diagnosis is considered complete when coupled with physical examination. X-rays, Computed Tomography images, CT, Electrocardiograms, ECG or even spirometry is required to measure the patient’s lung capacity. Severe cases of Dyspnea on emergency care are managed by oxygen therapy. Treatment and management of clinical presentation with Dyspnea is only possible when the cause is determined. Each cause is specific and is thus handled as such. For example, shortness of breath caused by asthma is managed by use of inhaled bronchodilators or steroids, Dyspnea caused by a bacterial infection like tuberculosis will usually be treated with antibiotics.

Can Dyspnea be prevented.

Exposure to an environmental allergen causing Dyspnea will be relieved by avoiding the allergen. If you are experiencing Dyspnea, do not be overly worried, but seek medical attention if you can’t breathe. As always, stay well and healthy.