Orthopneu

Orthopneu is not a standard term in medical literature; in many contexts it appears as a misspelling or regional variant of orthopnea, the sensation of shortness of breath that worsens when lying flat and improves with upright positioning. Some non-peer-reviewed sources may use orthopneu to denote similar symptoms or regional spellings.

In typical orthopnea, dyspnea improves when seated or propped up; the condition is most commonly associated with left-sided heart failure or other causes of pulmonary edema, but it can occur with obesity, chronic lung disease, or neuromuscular weakness. Pathophysiology involves redistribution of circulating blood volume when recumbent, increased venous return, elevated pulmonary capillary pressure, and interstitial edema.

Evaluation includes clinical history and examination, assessment of symptom severity, chest imaging, and cardiac testing such as echocardiography; laboratory tests may include natriuretic peptides (BNP/NT-proBNP). Differentials include paroxysmal nocturnal dyspnea and other causes of dyspnea.

Management focuses on treating the underlying cause and relieving pulmonary congestion: diuretics for fluid overload, vasodilators if appropriate, optimization of heart failure therapy, supplemental oxygen if needed, and noninvasive ventilation in acute cases. Long-term prognosis depends on the underlying cardiac or pulmonary disease and its severity.