Dyspnea

Description

A subjective experience of breathing discomfort that consists of qualitatively distinct sensations that varies in intensity

Pathophysiology

Abnormality in one of the following elements:

• Respiratory controller (breathing rate, depth)
• Ventilatory pump (chest wall, pleura, airways)
• Gas exchanger (alveoli, capillaries)
• Cardiovascular derangements (cardiac output)

Etiology

• Respiratory
  • Upper airway
    • Infection (croup, tracheitis, peritonsillar abscess, epiglottitis)
    • Foreign body
    • Anaphylaxis
    • Anatomic abnormalities
    • Vocal cord dysfunction (VCD)/paradoxical vocal fold movement (PVFM)
  • Lower airway
    • Asthma
    • Aspiration
    • Airway malacia
    • Hemorrhage
    • Internal/external fixed compression (tumor, cyst, vascular)
  • Parenchymal lung disease
    • Infection (viral, bacterial, fungal)
    • Interstitial lung disease (ILD)
    • Atelectasis
    • Chronic lung disease (chronic obstructive pulmonary disease [COPD], cystic fibrosis)
  • Chest wall disorder
    • Neuromuscular weakness (Duchenne muscular dystrophy [DMD], spinal muscular atrophy [SMA])
    • Scoliosis
    • Pectus excavatum
  • Pleural
    • Pleural effusion
    • Pneumothorax
• Cardiovascular
  • Cardiac
    • Elevated pulmonary venous pressure
    • Congestive heart failure (CHF)
  • Vascular
    • Pulmonary hypertension (PH)
    • Pulmonary embolism (PE)
• Toxic/metabolic
  • Metabolic acidosis (diabetic ketoacidosis [DKA], salicylate intoxication, renal tubular acidosis [RTA])
  • Renal failure causing fluid overload
• Other
  • Anemia
  • Deconditioning
  • Obesity
  • Panic attack
  • Pregnancy
  • Trauma
  • Gastroesophageal reflux disease (GERD)