SHORTNESS OF BREATH - What we should know

Introduction

Sudden shortness of breath, or breathing difficulty, is the most common reason for visiting a hospital accident and emergency department.

It's also one of the most common reasons people call 999 for an ambulance.

It is normal to get out of breath when you have over-exerted yourself, but when breathlessness comes on suddenly and unexpectedly, it is usually a warning sign of a medical condition. The medical name for it is dyspnoea.

What you should do

You should call your GP immediately if you have sudden shortness of breath, as there may be a problem with your airways or heart. Your GP will assess you over the phone and may either visit you at home or admit you to hospital. 

If your shortness of breath is due to anxiety, you may be asked to come to the surgery rather than a home visit.

Feeling that you cannot get enough air can be terrifying, but doctors are well trained in managing this. You will be given oxygen to breathe through a mask to help your symptoms while they investigate and treat the health condition causing your breathing problems.

If you have struggled with your breathing for a while, don't ignore it: see your GP as it is likely that you have a long-term condition, such as obesity, asthma or chronic obstructive pulmonary disease, which will need managing properly.

The information below outlines the most common reasons for:

• shortness of breath that has come on suddenly
• shortness of breath that has lasted for a while

This guide should not be used to self-diagnose your condition, but should give you an idea of what is causing your breathlessness.

Causes of sudden shortness of breath

Sudden and unexpected breathlessness is most likely to be caused by one of the following health conditions. Click on the links below for more information about these conditions.

A problem with your lungs or airways

Sudden breathlessness could be an asthma attack. This means your airways have narrowed and you will produce more phlegm (sticky mucus), which will cause you to wheeze and cough. You will feel breathless because it will be difficult to move air in and out of your airways.

Your GP may advise you to use a spacer device with your asthma inhaler. This will deliver more medicine to your lungs, helping to relieve your breathlessness.

Pneumonia (lung inflammation) may also cause shortness of breath and a cough. It is usually caused by an infection, so you will need to take antibiotics.

If you have chronic obstructive pulmonary disease (COPD), it is likely your breathlessness is a sign this condition has suddenly got worse.

A heart problem 

It is possible to have a "silent" heart attack without experiencing all the obvious symptoms, such as chest painand overwhelming anxiety. In this case, shortness of breath may be the only warning sign you are having a heart attack. If you or your GP think this is the case, they will give you aspirin and admit you to hospital straight away.

Heart failure can also cause breathing difficulties. This life-threatening condition means your heart is having trouble pumping enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly. It leads to a build-up of water inside the lungs, which makes breathing more difficult.

A combination of lifestyle changes and medicines or surgery will help the heart pump better and relieve your breathlessness.

Breathlessness could also relate to a problem with your heart rate or rhythm, such as atrial fibrillation (an irregular and fast heart rate) or supraventricular tachycardia (regular and fast heart rate).

Panic attack or anxiety

A panic attack or anxiety can cause you to take rapid or deep breaths, known as hyperventilating. Concentrating on slow breathing or breathing through a paper bag should bring your breathing back to normal.

More unusual causes

These include:

• partial collapse of your lung caused by a small tear in the lung surface, which allows air to become trapped in the space around your lungs (this is known as pneumothorax)
• a blockage in one of the blood vessels in the lung (known as a pulmonary embolism)
• idiopathic pulmonary fibrosis, a rare and poorly understood lung condition that causes scarring of the lungs
• a collection of fluid next to the lung (called pleural effusion)
• a complication of diabetes known as diabetic ketoacidosis, where acids build up in your blood and urine

Causes of breathlessness that has lasted a while

Long-term breathlessness is usually caused by:

• obesity or being unfit
• asthma that is not controlled properly
• chronic obstructive pulmonary disease (COPD), which is permanent damage to the lungs usually caused by years of smoking
• anaemia, which is a low level of oxygen in the blood due to a lack of red blood cells or lack of haemoglobin (the part of red blood cells that carries oxygen)
• heart failure, which means your heart is having trouble pumping enough blood around your body, usually because the heart muscle has become too weak or stiff to work properly
• a problem with your heart rate or rhythm, such as atrial fibrillation (an irregular and fast heart rate) or supraventricular tachycardia (regular and fast heart rate).

More unusual causes of long-term breathlessness are:

• a lung condition called bronchiectasis, where the airways are abnormally widened and you have a persistent phlegmy cough
• a recurrent blockage in one of the blood vessels in the lung (known as a pulmonary embolism)
• partial collapse of your lung caused by lung cancer
• a collection of fluid next to the lung (pleural effusion)
• narrowing of the main heart valve, restricting blood flow to the rest of the body
• frequent panic attacks, which can cause you to hyperventilate (take rapid or deep breaths) 

Questions to think about while you are waiting for the doctor

• Did the breathlessness come on suddenly or gradually?
• Did anything trigger it, such as exercise?
• How bad is it – does it only happen when you have been active, or when you are not doing anything?
• Is there any pain when you breathe?
• Do you have a cough?
• Do certain positions make it worse – for example, are you unable to lie down?

Page last reviewed: 19/02/2013

Next review due: 19/02/2015

Source: http://www.nhs.uk/

BREATHING PROBLEMS - Causes, Tests, and Treatments

There is an old proverb that states, "Life is in the breath. He who half breathes half lives."

If you have allergies, asthma, or other breathing problems, this proverb may sound very familiar. But a greater understanding of your breathing problems, along with an accurate medical diagnosis and effective treatment, can help you regain control. It doesn't matter what type of breathing problem you have. Daily control is vital to living an active, productive life.

What Causes Breathing Problems?

There are many causes of breathing problems. Some people have difficulty breathing when they get a cold. Others have trouble breathing because of occasional bouts of acute sinusitis. Sinusitis can make it difficult to breathe for a week or two until the inflammation subsides and the congested sinuses begin to drain.

Many breathing problems are chronic or long-term. These common breathing problems include chronic sinusitis, allergies, and asthma. These problems can cause a host of symptoms such as nasal congestion, runny nose, itchy or watery eyes, chest congestion, cough, wheezing, labored breathing, and shallow breathing.

The nasal passage is a pathway for viruses and allergens to enter your lungs. So the nose and sinuses are often associated with many lung disorders. A sinus or nasal passage inflammation may trigger reflexes and cause asthma attacks. And the No. 1 trigger for asthma is allergies.

More than 26 million Americans have hay fever or pollen allergies. And 14.6 million Americans have asthma. Oftentimes, asthma and allergies occur together. When they do, they can make life miserable if left untreated.

Millions of Americans have breathing problems because of chronic obstructive pulmonary disease, or COPD, which includes emphysema and chronic bronchitis. Breathing problems may also stem from other serious problems such as lung cancer, tuberculosis, pneumonia, and lung disease related to HIV/AIDS.

Which Tests Are Used to Diagnose Breathing Problems?

Doctors diagnose breathing problems by performing a physical exam, taking a patient history and family health history, and using different tests. For instance, pulmonary function tests, also known as lung function tests, are frequently used to assess lung function in people with asthma. These tests include spirometry and a test known as methacholine challenge.

Spirometry is a simple breathing test. It measures how much air you can blow out of your lungs and how fast you can blow it. This breathing test is used to determine the amount of airway obstruction. A methacholine challenge test may be performed to help establish adiagnosis of asthma. Your doctor will know which test is best for your situation.

In some cases, the doctor may take an X-ray to see the structures inside your chest, including the heart, lungs, and bones. A chest X-ray is a good test to diagnose pneumonia. It can't, though, identify most breathing problems by itself. For some people with breathing problems, a CT scan of the chest is needed. This scan looks for any problems in the lungs. A CT scan uses X-rays and a computer to create detailed images.

If you suffer with chronic sinusitis, your doctor may order a special sinus CT scan. This scan will be used to evaluate your sinuses. Once the problem is diagnosed, your doctor may prescribe effective treatment to help resolve the breathing difficulty.

Can Allergy Tests Determine the Cause of Breathing Problems?

Allergy tests may help your doctor identify the cause of your breathing problems. There are several types of allergy tests your doctor might use. One of them is the prick technique. In this test, the doctor first puts a tiny drop of allergen on your skin. Then the doctor makes a puncture with a needle directly in the drop of allergen extract. If you are allergic to the specific allergen, your body will react to it by turning red at the site. You may also experience itching and swelling at the site of the allergen placement.

If the prick technique is negative, your doctor may inject the allergen extract directly under the skin using a syringe. Other allergy tests include:

• the scratch test, which involves breaking the skin and then dropping the specific allergen into the site
• allergy blood tests (called a RAST or radioallergosorbent test)
• a challenge test, in which the doctor introduces tiny amounts of the suspected allergen by inhaled, oral, or other routes

These tests are used less frequently than the prick technique.

After performing allergy tests, your doctor may know what's triggering your breathing problems. Then the doctor will be able to treat yourallergy symptoms more effectively.

How Are Breathing Problems Treated?

Substances that cause breathing problem are known as triggers. Avoidance of triggers is the No. 1 way to control allergies and asthma. As an example, wearing a dust mask when doing housework or yard work may cut down on your exposure to allergy triggers. Avoiding a furry pet, washing bed linens at least once a week, staying indoors during peak pollen times, and changing the filter on your air conditioner frequently may also help prevent serious problems if you have allergies.  

Medications are also important in treating breathing problems. Allergy drugs such as antihistamines and decongestants can make it easier to breathe for some people. These medications can be delivered orally or through inhalers.

In addition, inhaled steroids may give relief to some with chronic allergies and sinusitis. These drugs work to reduce inflammation in the airways. Allergy shots are yet another way to reduce sensitivity to allergens and may give relief to some breathing problems.

Asthma is treated with inhaled or oral drugs that help open airways and reduce the primary inflammation in the airways. These asthma medications help ease or even block airway obstruction and excessive mucus production. People with asthma must control inflammation in order to keep the airways open and reduce sensitivity to asthma triggers. Asthma triggers may include:

• Viral infections (cold or flu)
• Pollen
• Pet dander
• Mold spores
• Dust mites
• Cockroaches
• Irritating pollutants in the air
• Fragrances and fumes
• Smoke
• Food allergies

Even exercise can be an asthma trigger in some people.

Can Medical Intervention Help Me Manage Breathing Problems?

So often, people seek medical intervention only after they have had breathing problems for weeks to months. Often by the time the medications are started, damage has occurred that takes more time to heal.

An accurate diagnosis is important before you can treat and prevent breathing problems. Each of us is different. The specific medication and treatment program that works for a family member or friend may notbe the correct one for your problem. In fact, it is difficult to really understand your respiratory problem without a clear and thorough understanding of how breathing works.

If you have symptoms of one or more of the common breathing problems discussed in this article, see your doctor for an accurate diagnosis. Write down any questions you have and seek answers. Prevention and treatment measures can dramatically help relieve and possibly end the breathing problems you experience.

Source: http://www.webmd.com/

BREATHING PROBLEMS - Symptoms Of Trouble In Breathing And Treatment For Breathing Problems

BY UPU ON APRIL 30, 2012

Nothing comes free in this materialistic world except the air we breathe in. Unfortunately, there are many people who have to pay (in the form of medication) even to breathe, as a consequence of their breathing trouble. Dyspnea, a medical word for troubled breathing is a common symptom produced due to lung and heart problems.

When a person has breathing trouble, he is not able to inhale enough amount of air or oxygen that is required by the body. This may have severe implications on his overall health, sometime even life threatening.

A person may experience shortness of breath in many circumstances. It can occur while doing exertional work which is considered normal, however when there is troubled breathing even at rest or while lying down or doing some non exertional work it is time to consult a doctor.

What Are The Causes Of Breathing Problems?

There are wide varieties of causes that can give rise to troubled breathing.

• Pulmonary diseases such as Asthma, bronchitis, pneumonia, lung fibrosis, lung cancer, emphysema, pleural effusion and pneumothorax are some them.

• At other times weakness of chest wall due to some muscular disease such as myasthenia gravis, polio myelitis or polyneuropathy may be the cause.

• Cardiovascular reasons include heart attack, left ventricular failure, heart valve diseases etc.

• Allergies to environmental pollution, smoking, obesity, physical overexertion, foreign body inhalation are other common causes triggering difficulty in breathing.

• Anxiety and hysteria are some of the psychological problems that may give rise to troubled breathing.

• Recently, sleep apnea syndrome has been recognized as an important cause of breathing difficulty. Typical symptoms include abnormal behavior during sleep, cough, snoring headache, chronic insomnia etc.

Signs And Symptoms Of Trouble Breathing

Here are some of the common sign and symptom that may indicate troubled breathing. In most cases the attitude of the patient gives a clue of respiratory distress.

• Rapid breathing is obvious sign of breathing trouble.

• Cough: it is the most important symptom that is present in most of the respiratory diseases. It is referred as a ‘watch dog’ of the respiratory system. When there is troubled breathing as a result of inhaling a foreign body or due to excessive accumulation of mucus, the body tries to expel it out by coughing.

• Use of accessory muscles of breathing, nasal flaring and retraction of ribs while examining a patient gives important clue for the physician regarding his dyspnea problem.

• Chest pain: pain in chest is one of the symptom associated with many respiratory problems such as pneumonia, pleural effusion, asthma etc. It can also occur in the event of heart attack together with breathing difficulty as a prominent symptom.

• Wheezing: it is an abnormal breath sound many times audible to other when a person is suffering from asthma, emphysema. It is low whistling sound mostly aggravated at night and while lying down in an asthmatic.

• Cyanosis: the tips of finger digits and nails become blue. Sometimes the lips and tongue may also appear blue. It occurs as a result of defect of gas transfer or due to obstruction in the air passages.

• Difficulty in talking: patient finds difficult to talk when he has breathing trouble.

• Weakness and excessive sweating are accompanying symptom.

• Congestion and expulsion of mucus.

• Nasal blockage.

 Treatment For Trouble In Breathing

• Those who experience breathing difficult, no matter how minor it is should always seek medical help. Early recognition and treatment can prevent untoward catastrophic event.

• It also gives a clue regarding the underlying disease. A person who may experience severe respiratory distress may require oxygen therapy. It is necessary to maintain normal oxygen saturation in the bloodstream. He may require to be hospitalized.

• In moderate and mild breathing trouble, use of bronchodilator as in case of asthma, bronchitis, and emphysema may be necessary.

• Besides, antibiotics are useful in certain conditions such as pneumonia.

• Preventing the stress level by doing yoga and meditation helps in reduce anxiety. It is also useful in patients who are known to have hysteria.

• Patient suffering from COPD (chronic obstructive pulmonary disease) may benefit by practicing breathing exercises. Deep inhalation with slow exhalation through pursed lips helps the gas mix within the lungs. Physiotherapy lung exercise helps to improve effort tolerance even though there may not be improvement in lung function.

Source: http://www.simple-remedies.com/

LUNGS - Causes and Home Remedies to Expel Water from Lungs

BY A R ON APRIL 22, 2011

Fluids inside the lungs may refer to the mucus or phlegm trapped on the lining of the respiratory tract. It’s easy to find a remedy for this condition, by following any of the suggested home treatments.

Home Remedies for Water in Lungs

• All it takes to expel the fluid in the lungs is to cough effectively. The right technique should be used, to prevent undue harm to the throat or lungs.
• Postural drainage is used in the medical world to drain the extra mucus from the lungs. It entails lying on the bed and requires another person to assist putting pressure into the chest as the patient starts to cough.
• The all-important activity to remember that can work against clogged lungs is exercise. It can also give the individual extra dose of energy to be able to cough more efficiently.

Causes of Water in Lungs

When fluids refuse to be expelled from the lungs, it can indicate any of the following causes.

• Heart disorders may prevent the veins from carrying blood into the lungs due to too much pressure within.
• The person’s normal flow of oxygen is affected because of the presence of water in the lungs.
• Lung damage due to infection or inhaling of noxious fumes may also bring about water in the lungs.
• Renal failure is also associated with symptoms like water in lungs.
• Certain medications have side effects like fluid retention in the pulmonary vein.

Water in Lungs Symptoms

• Heart arrhythmia, shortness of breath and rapid breathing are the most common indicators that there is water in the lungs.
• A person suffering from this condition may find it difficult to breathe after a physically challenging activity or when lying down.
• More symptoms are reported, including excessive sweat, anxiety, dull complexion and fatigue. Others may find themselves coughing up blood.

Treating Water in Lungs

• The person inhales high doses of oxygen through the mask to aid breathing.
• Medications including morphine, diuretics and nitroglycerine are often used in treating edema in the lungs.
• Seriously ill patients with pulmonary edema find assistance with a breathing machine.
• Reduction of salt intake in the diet is recommended.
• Cutting back on alcohol and smoking may help as well.
• Patients with water in their lungs may need to consult a heart specialist to overrule the presence of heart diseases.

Source: http://www.simple-remedies.com/

HEALTH - Respiratory disease

From Wikipedia, the free encyclopedia

Respiratory disease is a medical term that encompasses pathological conditions affecting the organs and tissues that make gas exchange possible in higher organisms, and includes conditions of the upper respiratory tract, trachea, bronchi,bronchioles, alveoli, pleura and pleural cavity, and the nerves and muscles of breathing. Respiratory diseases range from mild and self-limiting, such as the common cold, to life-threatening entities like bacterial pneumonia, pulmonary embolism, and lung cancer.

The study of respiratory disease is known as pulmonology. A doctor who specializes in respiratory disease is known as a pulmonologist, a chest medicine specialist, a respiratory medicine specialist, a respirologist or a thoracic medicine specialist.

UBET Respiratory diseases can be classified in many different ways, including by the organ or tissue involved, by the type and pattern of associated signs and symptoms, or by the cause (etiology) of the disease.

Inflammatory lung disease

Characterized by a high neutrophil count, e.g. asthma, cystic fibrosis, emphysema, chronic obstructive pulmonary disorder or acute respiratory distress syndrome.^[1]

Restrictive lung diseases

Restrictive lung diseases are a category of respiratory disease characterized by a loss of lung compliance,^[2] causing incomplete lung expansion and increased lung stiffness, such as in infants with respiratory distress syndrome.

Respiratory tract infections

Infections can affect any part of the respiratory system. They are traditionally divided into upper respiratory tract infections and lower respiratory tract infections.

Upper respiratory tract infection

The most common upper respiratory tract infection is the common cold. However, infections of specific organs of the upper respiratory tract such as sinusitis, tonsillitis,otitis media, pharyngitis and laryngitis are also considered upper respiratory tract infections.

Lower respiratory tract infection

The most common lower respiratory tract infection is pneumonia, an infection of the lungs which is usually caused by bacteria, particularly Streptococcus pneumoniaein Western countries. Worldwide, tuberculosis is an important cause of pneumonia. Other pathogens such as viruses and fungi can cause pneumonia for examplesevere acute respiratory syndrome and pneumocystis pneumonia. A pneumonia may develop complications such as a lung abscess, a round cavity in the lung caused by the infection, or may spread to the pleural cavity.

Malignant tumors

Malignant tumors of the respiratory system, particularly primary carcinomas of the lung, are a major health problem responsible for 15% of all cancer diagnoses and 30% of all cancer deaths. The majority of respiratory system cancers are attributable to smoking tobacco.

The major histological types of respiratory system cancer are:

• Small cell lung cancer
• Non-small cell lung cancer
  • Adenocarcinoma of the lung
  • Squamous cell carcinoma of the lung
  • Large cell lung carcinoma
• Other lung cancers (carcinoid, Kaposi’s sarcoma, melanoma)
• Lymphoma
• Head and neck cancer
• Pleural mesothelioma, almost always caused by exposure to asbestos dust.

In addition, since many cancers spread via the bloodstream and the entire cardiac output passes through the lungs, it is common for cancer metastases to occur within the lung. Breast cancer may invade directly through local spread, and through lymph node metastases. After metastasis to the liver, colon cancer frequently metastasizes to the lung. Prostate cancer, germ cell cancer and renal cell carcinoma may also metastasize to the lung.

Treatment of respiratory system cancer depends on the type of cancer. Surgical removal of part of a lung (lobectomy, segmentectomy, or wedge resection) or of an entire lung pneumonectomy), along with chemotherapy and radiotherapy, are all used. The chance of surviving lung cancer depends on the cancer stage at the time the cancer is diagnosed, and to some extent on the histology, and is only about 14-17% overall. In the case of metastases to the lung, treatment can occasionally be curative but only in certain, rare circumstances.

Benign tumors

Benign tumors are relatively rare causes of respiratory disease. Examples of benign tumors are:

• Pulmonary hamartoma
• Congenital malformations such as pulmonary sequestration and congenital cystic adenomatoid malformation (CCAM).

Pleural cavity diseases

Pleural cavity diseases include pleural mesothelioma which are mentioned above.

A collection of fluid in the pleural cavity is known as a pleural effusion. This may be due to fluid shifting from the bloodstream into the pleural cavity due to conditions such as congestive heart failure and cirrhosis. It may also be due to inflammation of the pleura itself as can occur with infection, pulmonary embolus, tuberculosis, mesothelioma and other conditions.

A pneumothorax is a hole in the pleura covering the lung allowing air in the lung to escape into the pleural cavity. The affected lung “collapses” like a deflated balloon. Atension pneumothorax is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life-threatening situation.

Pulmonary vascular disease

Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Examples are:^{[citation needed]}

• Pulmonary embolism, a blood clot that forms in a vein, breaks free, travels through the heart and lodges in the lungs (thromboembolism). Large pulmonary emboli are fatal, causing sudden death. A number of other substances can also embolise (travel through the blood stream) to the lungs but they are much more rare: fat embolism (particularly after bony injury), amniotic fluid embolism (with complications of labour and delivery), air embolism (iatrogenic - caused by invasive medical procedures).
• Pulmonary arterial hypertension, elevated pressure in the pulmonary arteries. Most commonly it is idiopathic (i.e. of unknown cause) but it can be due to the effects of another disease, particularly COPD. This can lead to strain on the right side of the heart, a condition known as cor pulmonale.
• Pulmonary edema, leakage of fluid from capillaries of the lung into the alveoli (or air spaces). It is usually due to congestive heart failure.
• Pulmonary hemorrhage, inflammation and damage to capillaries in the lung resulting in blood leaking into the alveoli. This may cause blood to be coughed up. Pulmonary hemorrhage can be due to auto-immune disorders such as Wegener's Granulomatosis and Goodpasture's syndrome.

Neonatal diseases

Pulmonary diseases may also impact newborns, such as pulmonary hyperplasia and Infant respiratory distress syndrome.

Diagnosis

Respiratory diseases may be investigated by performing one or more of the following tests

• Chest x-ray
• Pulmonary function test
• Computed tomography scan
• Culture of microorganisms from secretions such as sputum
• Bronchoscopy
• Biopsy of the lung or pleura
• Ventilation—perfusion scan
• blood investigation
• Ultrasound scanning can be useful to detect fluid such as pleural effusion

Epidemiology

Respiratory disease is a common and significant cause of illness and death around the world. In the US, approximately 1 billion "common colds" occur each year.it maybe caused by smoking.^[3] A study found that in 2010, there were approximately 6.8 million emergency department visits for respiratory disorders in the U.S. for patients under the age of 18.^[4]

In the UK, approximately 1 in 7 individuals are affected by some form of chronic lung disease, most commonly chronic obstructive pulmonary disease, which includesasthma, chronic bronchitis and emphysema.^[5]

Respiratory diseases (including lung cancer) are responsible for over 10% of hospitalizations and over 16% of deaths in Canada.^[6]

Source: http://en.wikipedia.org/