Dyspneu

Dyspneu, also written as dyspnea, is the subjective sensation of breathing discomfort or breathlessness. It is a symptom rather than a disease and can vary in intensity from mild to life-threatening. Dyspneu may occur at rest or with exertion and can be influenced by activity, anxiety, and environmental factors.

Causes are broad and include cardiopulmonary diseases such as heart failure, chronic obstructive pulmonary disease (COPD), asthma, pneumonia, pulmonary embolism, and interstitial lung disease; anemia; obesity hypoventilation; metabolic disturbances; deconditioning; neuromuscular disorders; and anxiety or panic disorders.

Evaluation begins with urgent assessment of oxygen saturation, vital signs, and signs of respiratory distress. Collect history on onset, duration, progression, triggers, chest pain, syncope, edema, exposures, and medications. Physical examination may reveal tachypnea, use of accessory muscles, wheeze, crackles, cyanosis, or signs of heart failure. Tests may include pulse oximetry, arterial blood gas, chest radiography, ECG, BNP, spirometry, CT if indicated, and echocardiography as needed.

Management targets the underlying cause and symptomatic relief. Oxygen therapy for hypoxemia; bronchodilators for COPD or asthma; diuretics for pulmonary edema; antibiotics for infection; anticoagulation for pulmonary embolism; and noninvasive ventilation in appropriate respiratory failure. Long-term strategies include treating the underlying disease, smoking cessation, vaccination, pulmonary rehabilitation, physical conditioning, and addressing comorbid anxiety.

Prognosis depends on the underlying condition and overall health; persistent dyspneu is associated with reduced quality of life and higher risk of adverse outcomes in many diseases. Seek urgent care for sudden onset severe dyspnea, chest pain, fainting, or cyanosis.