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Working on dyspnoea

Dr. Shalini Kapoor Kad
Aug. 13, 2010

A homoeopathic paediatrician, a counselling expert and a freelance writer are a few words to describe my profession. My sole aim is to put forth practical piece of information that guides every one right in the direction, blending the medicos to a layman with a simple gesture to make the medical things a little less convoluted and comprehendible.


Dyspnoea in simple words can be defined as shortness of breath or difficult breathing not originating from exertion. Here the hassle is prominent and clearly indicate for an ailment progressing inside.

What all to suspect in case of dyspnoea?

  • Heart involvement: breathing is difficult with a defective pumping organ surfacing regularly along with other signs and symptoms. A positive long standing history of high blood pressure or cardiac ailment is generally present. Here the characteristic symptoms indicating for a heart involvement such as dyspnoea at night, exertion dyspnoea may precede the acute attack by days or week. This acute phase is usually accompanied with cough and pink frothy expectoration. Further there is prominent profuse sweat, bluish appearance (cyanosis), increased pulse during the acute troublesome period. Clinical picture clearly reveals on the hypertension and the pathology beneath. An absolute confirmation comes with ECG, chest X ray, echocardiography and angiography.
  • Asthma: the condition as we all recognise has dramatic effects on breathing patterns for obvious reasons. Patient present with previous history of similar episodes. There may also be a positive family history of bronchial asthma, chronic eczema or allergic inclinations. Here dyspnoea usually begins with a triggering event for instance a respiratory infection, exposure to cold air  / dust, exercise, emotional stress or some sort of unsuitable drug / medicine
  • Pneumothorax: another respiratory tract related condition is pneumothorax that may result in the deadliest. Here the onset is sudden presenting in form of chest pain, dyspnoea resulting from excessive exertion or coughing. History of some other respiratory problem may be positive.  Profuse sweating, cyanosis, increased pulse is a few signs seen in the painful experience. Chest X rays along with arterial blood gas studies confirm diagnosis
  • Acute respiratory distress syndrome (ARDS): there is characteristic history of acute breathlessness in a patient with the underlying disease. The aetiology comprises of pneumonia, septicaemia, trauma, certain drugs or inhalation or aspiration of some toxic irritating substances. Just like above condition here too diagnosis is confirmed by chest X ray and arterial blood gas studies.
  • Laryngeal obstruction: larynx is strategically placed over the windpipe and the food pipe and any obstruction to the organ can have troublesome issues. Acute laryngeal obstruction usually follows as anaphylactic reactions to drugs or foreign body inhalation. Acute dyspnoea with foreign body ingestion is characterised with cyanosis, noisy breathing, and forced inspiration. Here in extreme cases surgical measures may have to be adopted to remove the alien element as untreated cases may progress to either coma or death.
  • Psychological upfront: this usually occurs in young females often after an emotional distress. These are common in attention seeking personalities which tend to seek attention via this distressing means. Here all tests may show negative signs with no pathology what so ever though increased pulse, hypertension and sweating are common symptoms to be seen. Restlessness, anxiety is also seen and may be exaggerated depending on the scenarios running parallel.

The situation is an emergency and requires every one nearby to act wise and quick. A doctor should be apt to relieve off the difficulty.


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