Düspnoe

Düspnoe, also known as dyspnea, is the subjective experience of breathing discomfort or breathlessness. It is a symptom rather than a disease and can range from mild unease to an urgent need for relief. Acute or chronic onset is common, and intensity may be influenced by activity, position, or emotional state.

Common etiologies span cardiopulmonary diseases and other conditions. Primary respiratory causes include chronic obstructive pulmonary disease, asthma, pneumonia, pulmonary embolism, pneumothorax, interstitial lung disease, and other lung pathologies. Cardiac origins such as heart failure, ischemia, or valvular disease are also frequent. Nonpulmonary contributors include anemia, obesity hypoventilation, metabolic acidosis, anxiety, and deconditioning.

Pathophysiology involves ventilation–perfusion mismatch, reduced oxygen delivery to tissues, increased work of breathing, and stimulation of chemoreceptors. Severity is often assessed with scales such as the modified Medical Research Council (mMRC) dyspnea scale or the Borg scale. Objective assessment uses oxygen saturation, arterial blood gases, chest imaging, and, when appropriate, spirometry and diffusion capacity. Further evaluation may include ECG, echocardiography, and laboratory tests (for BNP, troponin, infection markers).

Management aims to identify and treat the underlying cause while providing supportive care. In acute settings, secure the airway and breathing, provide supplemental oxygen if hypoxemic, and consider noninvasive ventilation. Treatments vary by cause and may include bronchodilators and corticosteroids for airway disease, diuretics for heart failure, antibiotics for infection, and disease-specific therapies. Long-term management includes smoking cessation, vaccination, rehabilitation, and management of comorbidities.

Prognosis depends on the underlying condition and dyspnea severity; it is a marker of morbidity and, in many diseases, mortality. Multidisciplinary care and early intervention can improve outcomes.