Dyspnoea or breathlessness

For the maintenance of life, breathing is highly essential. All animals, including human being, breathe in and out for taking in oxygen and for driving out carbon-dioxide. Not only animals, even the kingdom of plants take in carbon dioxide and expel oxygen for their survival.
That is why both animals and plants are essential for each other's survival. The breathing activity is quite natural and is performed without the knowledge of the incumbent.
The incumbent feels breathing only when it is troublesome and uncomfortable for him to breath. This trouble or discomfort in breathing called Dyspnoea or in simple language-breathlessness.
Breathlessness is an unpleasant subjective awaeness of the sensation of breathing.

Dr A K Md Ahsan Ali MBBS, DTCD, FRCP, Phd. FCCP TB & Chest Specialist Chamber: 65/D, Zigatala, Dhaka-1209 Phone: 9631007, Mobile: 01732540754, 01552319103

Breathlessness may be divided into 3 (three) categories. Short, Severe and Chronic breathlessness.
It is a common symptom of cardiac respiratory disease but it may also occur as a result of disorders of other system e.g.
diabetic, kitoacidosis or severe anemia.
In broad physiological terms, patient usually perceives discomfort either from an increased ventilatory rate or drive, which can be provoked by a variety of factors, or from any disease which causes sufficient reduction of ventilatory capacity.
Other factors, however, including the stimulation of intrapulmonary receptors in many broncho pulmonary disorder.
It follows that Dyspnoea or breathlessness, often as a multifactoral aetiology e.g. acute respiratory infections may stimulate the respiratory rate as a consequence of fever, hypoxaemia and in severe cases by oedema or hypercapnia.
This may also reduce ventilatory capacity by increasing bronchial resistance and restricting ventilation because of pleural pain. Dyspnoea or breathlessness may, therefore, be described in short as follows:
Cardiovascular Disease : Acute Dyspnoea at rest may occur during acute oedema and myocardial ischaemia while chronic
exertional Dyspnoea may
occur during chronic heart failure and also in myocardial ischaemia.
Respiratory Disease: Acute Dyspnoea at rest may occur during acute severe embolus, acute respiratory distress syndrome, inhaled foreign body (specially in children), Lobar collapse and Laryngeal oedema e.g. anaphylaxis.
While chronic exertional Dyspnoea may occur during COPD, chronic Asthma, bronchial carcinoma, interstitial lung disease (sarcoidosis, fibrosing
alveolitis, extrinsic allergic alveolitis, pneumoconiosis) chronic pulmonary thromboembolism, lymphatic carcinomatosis (may cause intolerable dyspnoea), large pleural effusions, Asthma, acute exacerbation of COPD, pneumothorax, pneumonia, pulmonary embolism.
Other causes of acute Dysponea at rest are metabolic acidosis e.g. (diabetic kitoacidosis, lactic acidosis, uraemia, overdose of salicylates, ethylene glycol poisoning), psychogenic hyperventilation (anxiety or panic related). Chronic exertional Dyspnoea may also occur during severe anaemia and obesity.
It may be concluded that Dyspnoea itself is not a disease but a symptom. When Dyspnoea occurs it should not be ignored.
The patient should immediately be brought to a doctor for diagnosis of the real cause of Dyspnoea to start proper treatment.
If the patient is not immediately brought to a doctor, the disease for which Dyspnoea is occurring may get complicated. Sometimes severe Dyspnoea may also cause death of the patient.