If shortness of breath and difficulty breathing what to do. When there is not enough air - the causes of shortness of breath and how to deal with it. Causes and types of breathing disorders

Shortness of breath or dyspnea is one of the most common complaints that patients present. This subjective feeling is often one of the symptoms of a serious respiratory or cardiovascular disease. It also occurs in obesity and anemia. The emerging feeling of lack of oxygen can be a reason for urgently seeking help from a doctor. In some cases, a patient with shortness of breath needs urgent hospitalization and emergency measures to maintain vital functions.

Table of contents:

Shortness of breath classification

Dyspnea is acute, subacute, and chronic. With shortness of breath, a person feels tightness in the chest. Objectively, the depth of inspiration increases, and the respiratory rate (RR) increases to 18 or more per minute.

Normally, a person never pays attention to how he breathes. Against the background of a more or less significant physical activity, the NPV and the depth of inhalation usually increase, since the body's need for oxygen increases, but this is not associated with discomfort. In this case, we are talking about physiological shortness of breath. After the termination of the load, the breathing of a healthy person is normalized in a few minutes. If the feeling of lack of air occurs when performing normal activities or at rest, then this is no longer the norm. In such cases, it is customary to talk about pathological dyspnea, indicating that the patient has a certain disease.

There are three types of shortness of breath:

• inspiratory;
• expiratory;
• mixed.

Inspiratory variety characterized by shortness of breath. It develops against the background of narrowing of the lumen of the respiratory system - the trachea and bronchi. Such shortness of breath is detected in some chronic diseases (asthma), as well as in acute inflammation of the pleura and injuries leading to compression of the bronchi.

When expiratory dyspnea it is difficult for the patient to exhale. The cause of the problem is the narrowing of the lumen of the small bronchi. Dyspnea of \u200b\u200bthis type is characteristic of emphysema and chronic obstructive pulmonary disease.

Among the most common causes of development in clinical practice dyspnea of \u200b\u200bmixed typeinclude neglected lung pathologies, as well as heart failure.

Based on the patient's complaints, the degree of dyspnea is determined on the MRC scale.

It is customary to distinguish 5 degrees:

• 0 degree - dyspnea develops only with significant physical exertion, i.e. we are not talking about pathological shortness of breath;
• Grade 1 - mild shortness of breath. Respiratory distress occurs when climbing up or walking at a fast pace;
• 2 - medium. Shortness of breath occurs during normal walking, and the patient has to make stops to breathe back to normal;
• 3 degree of shortness of breath - severe dyspnea. When walking, a person is forced to make stops every 2-3 minutes;
• Grade 4 - very severe dyspnea. Breathing becomes difficult against a background of minimal stress and even at rest.

There are 4 main reasons for the development of dyspnea:

• heart failure;
• respiratory failure;
• metabolic disorders;
• hyperventilation syndrome.

Note: respiratory failure can be caused by problems with the pulmonary vessels, diffuse lesions of the lung tissue, a decrease in the patency of the bronchi, as well as pathologies of the respiratory muscles.

Hyperventilation syndrome manifests itself in some varieties and against the background of neurocirculatory dystonia.

The cause of shortness of breath in heart disease, as a rule, is an increase in pressure in the vessels that feed the myocardium.

Dyspnea with cardiac pathologies increases as the disease progresses. In the early stages, it develops under stress, and when the process is running, it appears even at rest.

Note: with severe heart damage, nocturnal paroxysmal dyspnea is often noted, which is an attack of suffocation that suddenly develops in a dream. The pathology is also known as cardiac asthma; it is caused by fluid congestion in the lungs.

Shortness of breath in pathologies of the respiratory system is often chronic. It can be observed in a patient for months and years. This type of dyspnea is characteristic of chronic obstructive pulmonary disease, when the lumen of the airways narrows and sputum accumulates in it. In this case, in the patient, a short, rapid inhalation is followed by a difficult exhalation, accompanied by a noise. In parallel with expiratory shortness of breath, cough and discharge of a secretion of a viscous consistency are often noted. After using an inhaler with a bronchodilator, breathing usually returns to normal. If it is not possible to stop the attack with conventional drugs, then the patient's condition deteriorates very quickly. Lack of oxygen leads to loss of consciousness. In such cases, urgent medical attention is required.

In diseases of an infectious origin (acute and), the severity of shortness of breath directly depends on the severity of the pathological process. With adequate therapy, the symptoms stop in a few days. Severe pneumonia can lead to the addition of heart failure. At the same time, shortness of breath increases. This condition is an indication for urgent hospitalization of the patient.

Gradually increasing persistent dyspnea may indicate the presence of neoplasms in the lungs. The severity of the symptom increases as the tumor grows. In addition to shortness of breath, the patient has a hacking unproductive cough, often hemoptysis, general weakness and cachexia (significant weight loss).

Important: The most dangerous pathologies of the respiratory system, in which shortness of breath occurs, are toxic pulmonary edema, pulmonary embolism (PE) and local airway obstruction.

With thromboembolism, there is a blockage of the branches of the pulmonary artery with blood clots. As a result, a part of the organ ceases to participate in the act of breathing. Dyspnea in this situation develops suddenly, bothers with minimal exertion and even at rest. The patient complains of chest tightness and pain, which resembles the symptoms of an angina attack. In some cases, hemoptysis is noted.

Airway obstruction can be caused by aspiration of a foreign object, compression of the bronchi or trachea from the outside (with, aortic aneurysm and tumors), cicatricial narrowing of the lumen, or chronic inflammation in autoimmune diseases. With obstruction, shortness of breath is inspiratory in nature. The patient's breathing is loud with a hissing noise. The violation of the patency of the airways is accompanied by suffocation and a painful cough, which increases with a change in body position. Bronchodilators are ineffective in such cases; mechanical restoration of the patency of the trachea and bronchi and measures aimed at treating the underlying disease are necessary.

The cause of shortness of breath can be toxic edema, which develops as a result of inhalation of aggressive substances or against the background of an infectious lesion of the respiratory system with severe intoxication of the body. The patient has increasing shortness of breath, which, as the process progresses, is replaced by suffocation. When breathing, bubbling sounds are clearly audible. In this situation, urgent medical attention is needed, involving the maintenance of respiratory function and detoxification of the body.

Respiratory failure develops in such an acute condition as pneumothorax. With a penetrating wound of the chest, air enters the pleural cavity and presses on the lung, preventing it from expanding on inhalation. The patient needs emergency surgery.

Shortness of breath is one of the symptoms of tuberculosis, actinomycosis, and pulmonary emphysema.

Important: dyspnea can develop when expressed. The cause of difficulty breathing and shortness of breath in this case is the deformation of the chest.

To establish the factors leading to the development of respiratory failure, additional (instrumental) research methods are required: radiography (fluorography), spirometry, ECG, tomography, angiography and bronchoscopy.

One of the causes of shortness of breath is anemia. When in the blood, the number of red blood cells decreases or the hemoglobin content in red blood cells decreases. Since hemoglobin is responsible for the transfer of oxygen to all cells, hypoxia develops with its deficiency. The body reflexively tries to compensate for the lack of oxygen, so the breathing rate increases, and the person takes deeper breaths. The causes of anemia can be congenital metabolic disorders, insufficient intake of iron by the alimentary route, chronic blood loss, severe diseases, blood cancer, etc.

Patients with anemia complain of general weakness, memory impairment, decreased ability to concentrate, loss of appetite, etc. The skin of such patients is pale or has an icteric tint. The disease is easily diagnosed based on laboratory blood test data. The type of anemia is specified during additional studies. Treatment is carried out by a specialist hematologist.

Dyspnea often accompanies such endocrine pathologies as, (thyroid disease) and. With thyrotoxicosis, metabolism is accelerated, as a result of which the body's need for oxygen increases. An increase in the level of thyroid hormones increases the frequency of myocardial contractions, and the heart cannot pump blood to other tissues in the required volume. As a result, hypoxia develops, forcing a person to breathe more often and deeper.

Obesity significantly complicates the functioning of the lungs, heart and respiratory muscles, which also leads to oxygen deficiency.

Diabetes mellitus, as it progresses, affects the blood vessels, so all body tissues begin to suffer from a lack of oxygen. Diabetic nephropathy leads to anemia, which further increases hypoxia and causes shortness of breath.

Shortness of breath with nervous disorders

Up to 75% of patients of psychiatrists and neuropathologists complain of more or less severe shortness of breath from time to time. Such patients are disturbed by the feeling of lack of air, which is often accompanied by the fear of death from suffocation. Patients with psychogenic dyspnea are mostly suspicious people with an unstable psyche and a tendency to hypochondria. Shortness of breath can develop in them with stress or even for no apparent reason. In some cases, the so-called. attacks of false asthma.

A specific feature of dyspnea in neurotic states is its "noise appearance" by the patient. He breathes loudly and quickly, moans and groans, trying to attract attention.

During pregnancy, the total circulating blood volume increases. The woman's respiratory system must supply oxygen to two organisms at once - the expectant mother and the developing fetus. Since the uterus increases significantly in size, it presses on the diaphragm, somewhat reducing the respiratory excursion. These changes cause shortness of breath in many pregnant women. The respiratory rate increases to 22-24 breaths per minute and further increases with emotional or physical stress. Dyspnea may progress as the fetus grows; in addition, it is aggravated by anemia, which is often noted in expectant mothers. If the respiratory rate exceeds the above values, this is a reason to show increased alertness and consult with the antenatal clinic doctor conducting pregnancy.

Shortness of breath in children

In children, the respiratory rate is different; it gradually diminishes as it grows older.

You can suspect pathological shortness of breath in a child if the frequency of breaths per minute exceeds the following indicators:

• 0-6 months - 60;
• 6 months - 1 year - 50;
• 1 year -5 years - 40;
• 5-10 years old - 25;
• 10-14 years old - 20.

It is recommended to determine the NPV while the child is sleeping. In this case, the measurement error will be minimal. During feeding, as well as during physical activity or emotional arousal, the baby's breathing rate always increases, but this is not a deviation. It is worth worrying if the breathing rate does not return to normal at rest over the next few minutes.

Causes of dyspnea and shortness of breath in children include:

If the child has shortness of breath, it must be urgently shown to the local pediatrician. Severe respiratory failure requires calling an ambulance, as it is a life-threatening condition.

Shortness of breath is one of the most common symptoms in medical practice. The presence of mild shortness of breath (OD) does not always indicate the development of serious illness. Many people, including those who do not have cardiac pathologies or diseases of the respiratory system, have experienced shortness of breath after severe physical exertion, prolonged stay in a poorly ventilated or smoky room, stressful situations, severe fatigue, etc.

Some emotional patients complain that they do not have enough air when speaking (especially when public speaking is necessary). OD and heart pains occurring at the height of emotional stress in young people are frequent companions of cardioneurosis.

However, regular OD when walking for short distances or at rest, combined with severe dizziness, weakness, arrhythmias (sensations of interruption in the work of the heart), discoloration of the skin, etc., is a serious reason to consult a doctor for a comprehensive examination and detection the reasons for its occurrence.

Shortness of breath is a clinical symptom, manifested by a disturbance in the frequency and depth of breathing, as well as a change in the rhythm of respiratory movements usual for the patient. The development of OD is accompanied by a feeling of lack of air, up to a feeling of suffocation.

How to pronounce it correctly: shortness of breath or shortness of breath

The term shortness of breath, which is often used by many patients, does not exist in medicine. The feeling of shortness of breath is called shortness of breath or dyspnea.

Shortness of breath - symptoms

In addition to a feeling of lack of air, dyspnea can be accompanied by a feeling of tightness in the chest, suffocation, pale or reddening of the face, tachycardia, and the inability to fully inhale or exhale.

Also, in severe cases, the appearance of pathological types of breathing is possible:

Classification of dyspnea

The increased frequency of respiratory movements (while the breathing itself is shallow) is called tachypnea. Rapid breathing of patients with pronounced tachypnea can resemble "the breath of a driven animal" - noisy, frequent and shallow.

For reference. Shortness of breath, accompanied by an increase in the frequency of respiratory movements, is usually compensatory, that is, it occurs in response to a deficiency of O2 in organ and tissue structures. The development of such shortness of breath is indicative of heart failure (HF).

At the very beginning of the disease, shortness of breath and fatigue during physical activity may be the first and longest time the only signs of the disease. With the progression of the disease, the lack of air begins to appear not only during physical activity, but also with minimal movements or complete rest.

If rapid breathing is accompanied by deep, full breaths, then this type of shortness of breath is called hyperpnea. It should be noted that if cardiac dyspnea is compensatory and occurs as a response of the body to the developed hypoxia, hyperpnea is often a controlled type of breathing.

An example of controlled hyperventilation (hyperpnea) is rapid breathing during exercise. In this case, rapid breathing will not be compensatory, but adaptive, helping to endure an increased load without developing hypoxia.

Physiological shortness of breath will differ from pathological shortness of breath in heart failure in that it will not be accompanied by:

• significant feeling of suffocation,
• pain in the heart
• dizziness
• severe weakness.

This is due to the fact that when cardiac dyspnea occurs, due to a violation of the ability of the myocardium to contract, an increased respiratory rate makes it possible to slightly compensate for oxygen starvation of tissues.

Important. In healthy people who do not have heart problems, such physiological shortness of breath will contribute to the full adaptation of the body to increased tissue oxygen consumption.

In addition to the cardiac cause of shortness of breath, tachypnea can occur when:

• anemias,
• febrile conditions,
• nervous excitement,
• initial stages of shocks.

Decreased number of breaths

In some cases, dyspnea may be accompanied by a decrease in the frequency of respiratory movements. This shortness of breath is called bradypnea. Decrease in respiratory rate develops due to lengthening of respiratory pauses.

Shortness of breath accompanied by superficial bradypnea is called oligopnea.

Attention. Severe lack of air, accompanied by a sharp suppression of the frequency of respiratory movements, can be observed in patients with head injuries, cerebral hemorrhage, with severe intoxication, etc.

The complete cessation of breathing is called apnea. Apnea can often be intermittent. Physiological short
apnea can sometimes occur in young children. Such breathing stops are short-lived and are not accompanied by a change in the baby's complexion.

In an adult, this variant of dyspnea can occur during sleep. Risk factors for the development of sleep apnea in an adult patient are:

• the presence of obesity;
• chronic pulmonary pathologies;
• taking sedatives or tranquilizers;
• alcoholism;
• hormonal diseases, menopause;
• long-term smoking;
• the presence of diabetes mellitus, COPD (chronic obstructive pulmonary disease), curvature of the nasal septum.

Specific shortness of breath in heart failure, which develops when the patient tries to take a horizontal position (lie down to rest), is called orthopnea. For this variant of shortness of breath, it is characteristic that when the patient assumes a forced position (sitting, with a slight forward tilt, leaning slightly on his hands), OD decreases.

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Classification of dyspnea by form

Depending on which phase of breathing is disturbed (inhalation or exhalation), shortness of breath is usually divided into inspiratory, expiratory and mixed. The development of suffocation is taken out in a separate class.

Inspiratory dyspnea is a breathing disorder associated with shortness of breath. The development of such dyspnea occurs when there is an obstacle that impedes the flow of air into the lungs.

Inspiratory dyspnea is indicative for patients:

• with swelling of the vocal cords or subglottic space,
• in the presence of tumors in the lungs,
• in the presence of foreign bodies in the bronchi,
• with retropharyngeal abscess,
• with the development of a false croup.

In contrast to inspiratory dyspnea, expiratory dyspnea develops due to the inability to perform a full exhalation. The development of expiratory OD is associated with the inability to perform a full exhalation by the patient due to narrowing, spasm or edema of the bronchial mucosa. Expiratory OD develops in the presence of:

• chronic inflammatory process in the bronchi;
• pathological destruction of the alveolar septa;
• excessive air retention syndrome, due to the impossibility of its full exhalation from the lungs when:
  • bronchial asthma,
  • chronic obstructive pulmonary disease,
  • pulmonary emphysema.

Heart dyspnea is mixed. That is, shortness of breath with heart failure is accompanied by difficulty in both inhalation and exhalation. Also, mixed dyspnea occurs in patients with:

• pneumonia
• bronchitis,
• chronic respiratory failure
• pneumothorax,
• ascites (both with chronic heart failure and arising from other reasons).

In some cases, mixed shortness of breath after eating may occur in patients with severe flatulence or in very obese patients. Shortness of breath after eating, combined with abdominal pain (pain occurs 10-15 minutes after eating) and dyspeptic disorders, is typical for patients with Dunbar's syndrome - compression stenosis of the celiac trunk.

Important. An extreme manifestation of respiratory failure is an attack of suffocation. This type of dyspnea is characteristic of an asthma attack, with the development of status asthmaticus.

By the time and duration of dyspnea attacks, dyspnea can be temporary and permanent. An example of temporary shortness of breath is breathing disorder with pneumonia.

Attention. Cardiac dyspnea, as well as OD in chronic respiratory failure or obstructive pulmonary disease, are persistent and intensify during physical activity. In severe cases, shortness of breath begins to bother patients even at rest.

What can be shortness of breath

Normally, shortness of breath can occur when:

• prolonged stay in a stuffy or smoky room;
• excessive physical activity;
• overheating (visiting a sauna, bath) or hypothermia;
• pregnancy.

Pathological shortness of breath is characteristic of CVS diseases (cardiac dyspnea), pulmonary pathologies, moderate and severe anemias, blood diseases accompanied by suppression of bone marrow hematopoiesis (severe leukemia).

Shortness of breath can also occur when:

• intoxications;
• high temperature (fever);
• dehydration, infectious diseases accompanied by damage to the lung tissue (pneumonia) or significant intoxication;
• severe allergic reactions (OD associated with laryngeal edema can be observed with Quincke's edema, anaphylactic shock);
• cardioneurosis;
• neurocirculatory dystonia;
• obesity;
• severe flatulence;
• dunbar syndrome;
• hepatolienal syndrome (enlargement of the liver and spleen;
• diseases of the endocrine system (thyrotoxicosis);
• hormonal disruption due to the onset of menopause;
• hemorrhage in the brain;
• traumatic brain injury.

Shortness of breath during pregnancy

Moderate shortness of breath during pregnancy is absolutely normal and does not require special treatment if it is not accompanied by:

• paleness, redness, or blue discoloration of the face;
• bradyarrhythmia or severe tachycardia;
• sensations of interruptions in the work of the heart and pain in the chest;
• the appearance of anxiety, restlessness or disturbance of consciousness, lethargy, loss of consciousness;
• the appearance of the smell of acetone.

For reference. OD during pregnancy is most pronounced in the third trimester. Such shortness of breath is associated with a pronounced load on the woman's body, a significant increase in body weight and increased pressure of the enlarged uterus (due to the growth of the fetus) on the diaphragm.

This makes it difficult to breathe and leads to breathing problems, increased shortness of breath in pregnant women is observed after walking or eating.

Also, shortness of breath during pregnancy may be associated with temporary pressure on the celiac trunk and abdominal aorta.

After childbirth, breathing is fully restored.

Shortness of breath in children

Severe breathing disorder in newborns is observed when:

• asphyxia of newborns,
• hypoxia (fetal distress),
• malformations of the lungs,
• deep prematurity,
• congenital heart defects.

Also, the causes of dyspnea in children can be:

• cystic fibrosis,
• false croup,
• anemia,
• bronchitis,
• pneumonia,
• severe allergic reactions,
• intoxication,
• anemia, etc.

Shortness of breath with lung diseases

Breathing disorder is a constant companion of patients with bronchial asthma and chronic obstructive pulmonary diseases. Regular shortness of breath and coughing can also be troubling for long-term smokers.

Also, severe dyspnea is observed in patients with cystic fibrosis, pulmonary emphysema, pneumothorax.

In the presence of a foreign body, respiratory failure may be accompanied by wheezing, convulsive breathing. The severity of dyspnea will depend on the level of bronchial obstruction.

Attention. OD with cough and symptoms of intoxication are observed in patients with malignant tumors or metastatic foci in the lungs.

Of the infectious causes of shortness of breath, pneumonia, bronchitis, pleurisy, tuberculosis, and false croup syndrome (in young children) can be isolated.

Shortness of breath with pathologies of the cardiovascular system

Pathological cardiac OD can accompany:

Shortness of breath is an unusual sensation of breathing or the need to breathe more vigorously. Shortness of breath can be defined as respiratory discomfort, shortness of breath, uncomfortable or uncomfortable feeling of breathing on your own, or awareness of difficulty breathing.

Shortness of breath as a sign of respiratory failure appears when the human respiratory system is unable to meet the body's needs for gas exchange. This situation occurs when the body's need for oxygen increases or oxygen delivery to tissues is impaired (in a number of cardiovascular and bronchopulmonary diseases).

Causes of shortness of breath when walking

Most often, the causes of shortness of breath when walking are pathologies in the work of the heart, diseases of the lungs and bronchi, throat and disruption of the circulatory system. It is worth noting that even with minor deviations, it is easy for an outsider who is quite observant to determine and diagnose shortness of breath. Shortness of breath manifests itself as shortness of breath, sore throat and blood vessels, pain in the heart and interruptions in its work, and in addition, sometimes a person may bleed from the throat or nose.

There are several groups of reasonsthat can cause shortness of breath:

1. Physical exercises;
2. Neuroses, panic attacks, fears and anxieties;
3. Chronic obstructive pulmonary disease;
4. Obesity;
5. Diseases of the lungs;
6. Coronary heart disease;
7. Congestive heart failure;
8. , or paroxysmal nocturnal shortness of breath;
9. Pulmonary embolism (clogging with blood clots).

The diseases and conditions listed above are the most common. If you develop shortness of breath, it is best to see your doctor to determine the specific cause of your shortness of breath.

It is very important to see a specialist immediately or call an ambulance if you suddenly develop shortness of breath, especially if it is accompanied by chest pain, nausea, vomiting, or fever. These signs can indicate a very serious illness. In any situation, the doctor will be able to determine an individual examination plan to find out the cause.

Causes of Pulmonary Dyspnea

Pulmonary dyspnea is one that is caused by diseases and pathologies of the lungs.

1. Expiratory dyspnea - the most common form, which is determined by difficulty in exhaling and occurs when the lumen in the bronchi narrows due to their edema, spasm or sputum blockage. To cope with this problem in the process of breathing, it is necessary to strengthen the work of the respiratory muscles, but this is not enough, and the exhalation cycle can be difficult.
2. Inspiratory dyspnea... The patient has difficulty breathing. This is due to the accumulation of fluid in the chest with tumor phenomena, laryngeal edema, fibrosis, pleurisy and others. A person cannot speak without repeated breaths. The appearance of such shortness of breath is possible even with little physical exertion. Inhalation is accompanied by a hissing sound.

Shortness of breath with heart failure

There are also shortness of breath when. Its occurrence is directly affected by the thinning of the walls of blood vessels, septal defects, heart failure, stenosis. Also, one of the causes of cardiac dyspnea is heart defects. As a result, oxygen starvation appears, it is also the cause of shortness of breath when walking. Symptoms of this shortness of breath are orthopnea and polypnoea.

1. Polypnea. The condition is caused by excessive blood flow to the heart when the patient is in a horizontal position. This may be due to heart failure. Frequent and deep breathing is noted, sometimes to hyperventilation.
2. Orthopnea is a syndrome of cardiac dyspnea, which forces a person to stay upright all the time, as this relieves his condition. Orthopnea is associated with left ventricular and left atrial failure.

Central dyspnea

This type of shortness of breath occurs with pathologies of the central nervous system, with neuroses, and also under the influence of neurotropic substances. Central dyspnea is not a consequence of pathology, it is itself the cause. It manifests itself in different ways: hypernea, oligopnea, arrhythmia.

Hematogenous dyspnea

It is very rare, and is associated with the toxic effects of decomposition products during metabolism. It is characterized by very rapid and deep breathing. The causes are: anemia, endocrine disorders, and kidney or liver failure.

Symptoms

The main symptoms of shortness of breath:

• breathing quickens;
• pulse rises;
• suffocation is felt;
• breathing becomes noisy;
• the depth of inhalation and exhalation changes.

Shortness of breath begins in the following cases:

• while walking - this is due to cardiac activity;
• climbing stairs - speaks of an infection in the lungs, a cold;
• going out into the cold - the reason is an allergy to cold due to lung pathology;
• during rest at night - stagnant process of the heart muscle;
• during sex - any reasons are possible, for example, anemia, iron deficiency in the blood.

Shortness of breath when walking has certain reasons, and treatment with folk remedies is far from always able to cope with the source of shortness of breath. Therefore, do not self-medicate at home if you have this symptom.

How to treat shortness of breath when walking?

Before starting the fight against shortness of breath, you should not go to the pharmacy and buy pills that a friend advised. First of all, it is necessary:

1. Quit the bad habit of smoking if you smoke;
2. Reduce weight, if available in excess;
3. Adjust blood pressure if present in abnormal numbers.

To establish the cause of the violation of respiratory activity, you will also need to undergo an examination, which includes:

1. R-graph of the chest;
2. Ultrasound of the heart;
3. Analysis of the function of external respiration.

The most important method of dealing with shortness of breath is to treat the disease that caused the shortness of breath. As soon as the doctor finds out the cause, an effective treatment plan will be immediately determined.

For example, with ischemic heart disease and myocardial infarction - treatment with tablets. With COPD and bronchial asthma - regular treatment with inhalers. Since the main cause of shortness of breath in many cases is hypoxia and hypoxemia (low oxygen content in the body), oxygen therapy is one of the effective ways to reduce shortness of breath.

At present, devices have been developed - oxygen concentrators, which make it possible to "extract" oxygen from the air around the clock. Inhalation of oxygen at an increased concentration allows you to eliminate hypoxia and hypoxemia.

Which doctor to contact with shortness of breath

When the diagnosis is not yet known to a person, it is best to make an appointment with a therapist. After the examination, the doctor will be able to establish a presumptive diagnosis, if necessary, refer the patient to a specialized specialist.

If shortness of breath is associated with lung pathology, it is necessary to consult a pulmonologist, in case of heart disease - with a cardiologist. Anemia is treated by a hematologist, pathology of the nervous system - by a neurologist, diseases of the endocrine glands - by an endocrinologist, mental disorders accompanied by shortness of breath - by a psychiatrist.

One of the main complaints most often voiced by patients is shortness of breath. This subjective feeling forces the patient to go to the clinic, call an ambulance, and may even be an indication for emergency hospitalization. So what is shortness of breath and what are the main causes of it? You will find answers to these questions in this article. So…

What is shortness of breath

In chronic heart disease, shortness of breath first occurs after physical exertion, and over time begins to bother the patient and at rest.

As mentioned above, shortness of breath (or dyspnea) is a subjective sensation of a person, an acute, subacute or chronic feeling of lack of air, manifested by tightness in the chest, clinically - by an increase in the respiratory rate over 18 per minute and an increase in its depth.

A healthy person at rest does not pay attention to his breathing. With moderate physical exertion, the frequency and depth of breathing change - a person is aware of this, but this condition does not cause him discomfort, besides, the respiration indicators return to normal within a few minutes after the cessation of the load. If shortness of breath with moderate exertion becomes more pronounced, or appears when a person performs elementary actions (when tying shoelaces, walking around the house), or, even worse, does not go away at rest, we are talking about pathological shortness of breath, indicating a particular disease ...

Shortness of breath classification

If the patient is concerned about difficulty breathing, this is called inspiratory shortness of breath. It appears when the lumen of the trachea and large bronchi narrows (for example, in patients with bronchial asthma or as a result of compression of the bronchus from the outside - with pneumothorax, pleurisy, etc.).

If discomfort occurs during exhalation, such shortness of breath is called expiratory. It occurs as a result of narrowing of the lumen of the small bronchi and is a sign of chronic obstructive pulmonary disease or emphysema.

There are a number of reasons for mixed shortness of breath - with a violation of both inhalation and exhalation. The main among them are lung diseases in the late, advanced stages.

There are 5 degrees of severity of shortness of breath, determined based on the patient's complaints - the MRC scale (Medical Research Council Dyspnea Scale).

Severity	Symptoms
0 - no	Shortness of breath is not bothering, except for very heavy exertion
1 - light	Shortness of breath occurs only when walking fast or while climbing an elevation
2 - medium	Shortness of breath leads to a slower pace of walking compared to healthy people of the same age, the patient is forced to stop while walking to catch his breath.
3 - heavy	The patient stops every few minutes (approximately 100 m) to catch his breath.
4 - extremely hard	Shortness of breath occurs with the slightest physical exertion or even at rest. Due to shortness of breath, the patient is forced to constantly stay at home.

Causes of shortness of breath

The main causes of shortness of breath can be divided into 4 groups:

1. Respiratory failure due to:
   • violation of bronchial patency;
   • diffuse diseases of the tissue (parenchyma) of the lungs;
   • diseases of the blood vessels of the lungs;
   • diseases of the respiratory muscles or chest.
2. Heart failure.
3. Hyperventilation syndrome (with neurocirculatory dystonia and neuroses).
4. Metabolic disorders.

Shortness of breath with pathology of the lungs

This symptom is observed in all diseases of the bronchi and lungs. Depending on the pathology, shortness of breath may occur acutely (pleurisy, pneumothorax) or disturb the patient for many weeks, months and years ().

Shortness of breath in COPD is caused by a narrowing of the lumen of the airways, the accumulation of viscous secretions in them. It is constant, expiratory in nature and, in the absence of adequate treatment, becomes more and more pronounced. Often combined with a cough followed by sputum discharge.

In bronchial asthma, shortness of breath manifests itself in the form of sudden attacks of suffocation. It has an expiratory character - a light short inhalation is followed by a noisy, difficult exhalation. When inhaling special medicines that dilate the bronchi, breathing quickly normalizes. Asthma attacks occur usually after contact with allergens - by inhaling them or eating them. In especially severe cases, the attack is not stopped by bronchomimetics - the patient's condition progressively worsens, he loses consciousness. This is an extremely life-threatening condition that requires urgent medical attention.

It is accompanied by shortness of breath and acute infectious diseases - bronchitis and. Its severity depends on the severity of the underlying disease and the extent of the process. In addition to shortness of breath, the patient is worried about a number of other symptoms:

• an increase in temperature from subfebrile to febrile digits;
• weakness, lethargy, sweating and other symptoms of intoxication;
• unproductive (dry) or productive (phlegm) cough;
• chest pain.

With timely treatment of bronchitis and pneumonia, their signs stop within a few days and recovery occurs. In severe cases of pneumonia, cardiac insufficiency is added to respiratory failure - shortness of breath increases significantly and some other characteristic symptoms appear.

Lung tumors in the early stages are asymptomatic. If a recently emerged tumor was not detected by chance (during preventive fluorography or as an accidental finding in the process of diagnosing non-pulmonary diseases), it gradually grows and, when it reaches a sufficiently large size, causes certain symptoms:

• at first not intense, but gradually increasing constant shortness of breath;
• harsh cough with a minimum of phlegm;
• hemoptysis;
• chest pain;
• weight loss, weakness, pallor of the patient.

Treatment of lung tumors may include surgery to remove the tumor, chemotherapy and / or radiation therapy, and other modern methods of treatment.

The greatest threat to the patient's life is carried by such conditions manifested by shortness of breath as pulmonary embolism, or PE, local obstruction of the airways and toxic pulmonary edema.

PE is a condition in which one or more branches of the pulmonary artery are clogged with blood clots, as a result of which part of the lungs are excluded from the act of breathing. The clinical manifestations of this pathology depend on the extent of the lung lesion. It usually manifests itself as sudden shortness of breath, disturbing the patient with moderate or insignificant physical exertion or even at rest, a feeling of suffocation, tightness and chest pain similar to that of, often hemoptysis. The diagnosis is confirmed by appropriate changes on the ECG, chest x-ray, and angiopulmography.

Airway obstruction is also manifested by the symptom complex of suffocation. Shortness of breath is inspiratory in nature, breathing is heard at a distance - noisy, stridorious. A frequent companion of shortness of breath in this pathology is a painful cough, especially when changing the position of the body. The diagnosis is made on the basis of spirometry data, bronchoscopy, X-ray or tomographic examination.

Airway obstruction can be caused by:

• violation of the patency of the trachea or bronchi due to compression of this organ from the outside (aortic aneurysm, goiter);
• damage to the trachea or bronchi by a tumor (cancer, papilloma);
• ingress (aspiration) of a foreign body;
• the formation of cicatricial stenosis;
• chronic inflammation leading to destruction and fibrosis of the cartilage tissue of the trachea (in rheumatic diseases - systemic lupus erythematosus).

Therapy with bronchodilators for this pathology is ineffective. The main role in the treatment belongs to adequate therapy of the underlying disease and mechanical restoration of airway patency.

It can occur against the background of an infectious disease, accompanied by severe intoxication or due to exposure to the respiratory tract of toxic substances. At the first stage, this condition is manifested only by gradually increasing shortness of breath and rapid breathing. After a while, shortness of breath is replaced by excruciating suffocation, accompanied by bubbling breathing. The leading direction of treatment is detoxification.

Less often, shortness of breath is manifested by the following lung diseases:

• pneumothorax is an acute condition in which air enters the pleural cavity and lingers there, compressing the lung and preventing the act of breathing; occurs due to trauma or infectious processes in the lungs; requires urgent surgical care;
• - a serious infectious disease caused by mycobacterium tuberculosis; requires long-term specific treatment;
• actinomycosis of the lungs - a disease caused by fungi;
• emphysema of the lungs - a disease in which the alveoli stretch and lose the ability to normal gas exchange; develops as an independent form or accompanies other chronic respiratory diseases;
• silicosis - a group of occupational lung diseases arising from the deposition of dust particles in the lung tissue; recovery is impossible, the patient is prescribed supportive symptomatic therapy;
• , defects of the thoracic vertebrae, - in these conditions, the shape of the chest is disrupted, which makes breathing difficult and causes shortness of breath.

Shortness of breath with pathology of the cardiovascular system

Persons suffering from one of the main complaints note shortness of breath. In the early stages of the disease, shortness of breath is perceived by patients as a feeling of lack of air during exercise, but over time this feeling is caused by less and less stress, in advanced stages it does not leave the patient even at rest. In addition, for advanced stages of heart disease, paroxysmal nocturnal dyspnea is characteristic - an attack of suffocation that develops at night, leading to the awakening of the patient. This condition is also known as. It is caused by stagnation of fluid in the lungs.

Shortness of breath in neurotic disorders

Complaints of dyspnea of \u200b\u200bone degree or another are presented by ¾ patients of neurologists and psychiatrists. The feeling of a lack of air, the impossibility of inhaling deeply, often accompanied by anxiety, fear of death from suffocation, a feeling of "flap", an obstruction in the chest that prevents full inhalation - the complaints of patients are very diverse. Usually such patients are easily excitable, acutely reacting to stress people, often with hypochondriacal tendencies. Psychogenic respiratory disorders are often manifested against the background of anxiety and fear, depressed mood, after the experienced nervous overexcitation. Even attacks of false asthma are possible - suddenly developing attacks of psychogenic shortness of breath. The clinical feature of the psychogenic characteristics of breathing is its noisy design - frequent sighs, groans, groans.

Dyspnea in neurotic and neurosis-like disorders is treated by neuropathologists and psychiatrists.

Shortness of breath with anemia

With anemia, the organs and tissues of the patient's body experience oxygen starvation, in order to compensate for which, the lungs are trying to pump more air into themselves.

Anemias are a group of diseases characterized by changes in the composition of the blood, namely, a decrease in the content of hemoglobin and erythrocytes in it. Since oxygen is transported from the lungs directly to organs and tissues with the help of hemoglobin, then with a decrease in its amount, the body begins to experience oxygen starvation - hypoxia. Of course, he is trying to compensate for this condition, roughly speaking, to pump more oxygen into the blood, as a result of which the frequency and depth of breaths increase, that is, shortness of breath occurs. Anemias are of different types and they arise due to different reasons:

• insufficient intake of iron from food (in vegetarians, for example);
• chronic bleeding (with peptic ulcer, uterine leiomyoma);
• after recently suffered severe infectious or somatic diseases;
• with congenital metabolic disorders;
• as a symptom of cancer, in particular blood cancer.

In addition to shortness of breath with anemia, the patient complains of:

• severe weakness, loss of strength;
• decreased sleep quality, decreased appetite;
• dizziness, headaches, decreased performance, impaired concentration, memory.

Persons suffering from anemia are characterized by pallor of the skin, in some types of the disease - its yellow tint, or jaundice.

It is not difficult to diagnose - it is enough to pass a general blood test. With the changes in it, indicating anemia, a number of laboratory and instrumental examinations will be assigned to clarify the diagnosis and identify the causes of the disease. Treatment is prescribed by a hematologist.

Shortness of breath in diseases of the endocrine system

People suffering from diseases such as obesity and diabetes mellitus also often complain of shortness of breath.

With thyrotoxicosis, a condition characterized by excessive production of thyroid hormones, all metabolic processes in the body are sharply increased - at the same time it experiences an increased need for oxygen. In addition, an excess of hormones causes an increase in the number of heart contractions, as a result of which the heart loses the ability to fully pump blood to tissues and organs - they experience a lack of oxygen, which the body is trying to compensate for - shortness of breath occurs.

An excess amount of adipose tissue in the body during obesity hinders the work of the respiratory muscles, heart, lungs, as a result of which the tissues and organs do not receive enough blood and lack oxygen.

With diabetes mellitus, sooner or later the vascular system of the body is affected, as a result of which all organs are in a state of chronic oxygen starvation. In addition, over time, the kidneys are also affected - diabetic nephropathy develops, which in turn provokes anemia, as a result of which hypoxia is further enhanced.

Shortness of breath in pregnant women

During pregnancy, the respiratory and cardiovascular systems of a woman's body experience increased stress. This load is due to the increased volume of circulating blood, compression from the bottom of the diaphragm by the enlarged uterus (as a result of which the chest organs become cramped and respiratory movements and heart contractions are somewhat hampered), the need for oxygen not only for the mother, but also for the growing embryo. All these physiological changes lead to the fact that during pregnancy many women develop shortness of breath. At the same time, the respiratory rate does not exceed 22-24 per minute, it becomes more frequent with physical exertion and stress. As pregnancy progresses, shortness of breath also progresses. In addition, expectant mothers often suffer from anemia, as a result of which shortness of breath increases even more.

If the respiratory rate exceeds the above figures, shortness of breath does not go away or does not significantly decrease at rest, the pregnant woman should definitely consult a doctor - obstetrician-gynecologist or therapist.

Shortness of breath in children

The respiratory rate in children of different ages is different. Dyspnea should be suspected if:

• in a 0–6 month old child, the number of respiratory movements (RR) is more than 60 per minute;
• in a 6–12 month old child, NPV is over 50 per minute;
• in a child over 1 year old, the NPV is over 40 per minute;
• in a child over 5 years of age, the NPV is over 25 per minute;
• a child 10-14 years old has an NPV of more than 20 per minute.

During emotional arousal, during physical exertion, crying, feeding, the respiratory rate is always higher, however, if the NPV at the same time significantly exceeds the norm and slowly recovers at rest, you should inform the pediatrician about this.

Most often, shortness of breath in children occurs with the following pathological conditions:

• respiratory distress syndrome of a newborn (often recorded in premature babies whose mothers suffer from diabetes mellitus, cardiovascular disorders, diseases of the genital area; intrauterine hypoxia, asphyxia contribute to it; clinically manifested by shortness of breath with a respiratory rate of more than 60 per minute, a blue tint of the skin and their pallor, chest rigidity is also noted; treatment should be started as early as possible - the most modern method is the introduction of a pulmonary surfactant into the trachea of \u200b\u200ba newborn in the first minutes of his life);
• acute stenosing laryngotracheitis, or false croup (a feature of the structure of the larynx in children is its small lumen, which, with inflammatory changes in the mucous membrane of this organ, can lead to a disruption in the passage of air through it; usually false croup develops at night - edema grows in the vocal cords, leading to pronounced inspiratory shortness of breath and suffocation; in this condition, it is required to provide the child with an influx of fresh air and immediately call an ambulance);
• congenital heart defects (due to intrauterine developmental disorders, the child develops pathological messages between the main vessels or cavities of the heart, leading to mixing of venous and arterial blood; as a result, the organs and tissues of the body receive blood that is not saturated with oxygen and experience hypoxia; depending on the severity defect indicated dynamic observation and / or surgical treatment);
• viral and bacterial bronchitis, pneumonia, bronchial asthma, allergies;
• anemia.

In conclusion, it should be noted that only a specialist can determine the reliable cause of shortness of breath, therefore, if this complaint occurs, one should not self-medicate - the most correct solution would be to consult a doctor.

Which doctor to contact

If the diagnosis is not yet known to the patient, it is best to consult a general practitioner (pediatrician for children). After the examination, the doctor will be able to establish a presumptive diagnosis, if necessary, refer the patient to a specialized specialist. If shortness of breath is associated with a pathology of the lungs, it is necessary to consult a pulmonologist, in case of heart disease, a cardiologist. Anemia is treated by a hematologist, diseases of the endocrine glands - by an endocrinologist, pathology of the nervous system - by a neurologist, mental disorders accompanied by shortness of breath - by a psychiatrist.

Another ailment can develop from excess weight, an inactive lifestyle, heredity and for other reasons. With a healthy airway, a person has no unpleasant symptoms, and breathing is silent and effortless. With normal breathing, a person should have 15-18 breaths per minute. If the patient has a violation of the patency of the respiratory tract, then the person begins to breathe more often and harder.

Etiology

Heavy breathing in a child and an adult can be triggered by the development of various pathologies, for example, of an infectious nature. Also, the cause of the manifestation of such a symptom can be such etiological factors, or rather, diseases:

• or ;
• violation of the structure of the respiratory tract;
• rheumatic heart disease.

A common cause of the manifestation of a symptom in adults and children is prolonged stay in the same body position.

The following etiological factors can also provoke difficulty breathing:

• sport;
• constant fatigue;
• vascular spasms of the brain.

In addition to a pathological condition, such a symptom can also develop according to the physiological characteristics of the body. In this case, shortness of breath manifests itself exclusively in childhood, when the baby is not yet one and a half years old. A sign is formed from the high elasticity of tissues in the respiratory tract. By the age of 1.5 years, the structure of the cartilage of the larynx becomes denser, and breathing is normalized.

In older children, a symptom can appear from various bacterial and viral infections:

In adult women, the cause of shortness of breath also lies in pregnancy. During this period, a strong load is exerted on the entire body, especially on the respiratory system. The fetus grows and the uterus grows, which begins to press on the diaphragm. After the birth of a child, breathing returns to normal, so during pregnancy you should not worry about the appearance of such a symptom.

Symptoms

With heavy inhalation and exhalation, children and adults may complain of various additional symptoms. During shortness of breath, the patient has the following clinical picture:

• sensation;
• suffocating cough;
• anxiety and.

When a person does not have enough air, his brain slows down. He takes words and questions hard and slowly, all brain activity slows down a little.

Diagnostics

If such an unpleasant symptom occurs without good reason, the patient needs to urgently seek help from doctors. Also, the following manifestations can become a factor for contacting a specialist:

• lack of air in a calm state;
• painful swallowing;
• feeling of a foreign body in the throat;
• allergies;
• wheezing.

During diagnostic activities, the physician must take a history, conduct a physical examination. The doctor needs to identify the following points:

• wheezing;
• the duration of the feature;
• lack of air at rest or under stress;
• symptom progression;
• injury.

If the initial examination did not provide the doctor with the exact reasons for the onset of shortness of breath, then the patient is assigned the following laboratory and instrumental examinations:

• blood test;
• radiography;
• tomography;
• spirometry;

Treatment

The principles for eliminating a symptom completely depend on the identified cause of the occurrence. If ordinary physiological factors are the cause, then doctors advise not to allow the throat to dry out. To do this, you need to humidify the air with special devices or carry out daily wet cleaning.

If the cause of the development of the symptom is not very serious infectious diseases, then shortness of breath can be dealt with with the help of inhalations. Their doctors recommend to carry out on the basis of mineral waters, baking soda solution, water vapor. You can also do:

• mustard plasters on the chest;
• warm baths for hands and feet.

If the cause of the shortness of breath is an allergic reaction, then the first step is to rid the patient of the allergen. It is also allowed to use vasoconstrictor drops and take antihistamines.

• take a lying or sitting position and maintain an even back with a pillow, it is important that the shoulders are laid back;
• put your palms on the lower part of the chest;
• breathe through the nose.

When heavy breathing appears, doctors recommend using this exercise every hour, several times throughout the day. All deep breaths must be taken carefully so as not to provoke dizziness. After exercise, you need a little rest to fully normalize breathing.

Prevention

Lack of air can be prevented by simple methods. For the risk group, people who have allergies or infectious ailments, it is recommended to give up bad habits, go in for light sports, and regularly come for a mandatory medical examination.