Dyspnea(呼吸困难)课件.pptxVIP

Dyspnea u Dyspnea is defined as an awareness of difficulty in breathing. u Most patients suffer from actual difficulty, some patients just taste an awareness of hyperventilation(换气过度). Definition l Cannot get enough air l Air does not go all the way down l Smothering feeling in the chest l Tightness in the chest l Fatigue in the chest How to describe these sensations u Respiratory disease u Cardic disease u Toxic u Nero-Psychogenic u Haematological disease u Increase of abdominal pressure (massive ascites(腹水), pregnancy(怀孕) etc) Etiology uNormal person may experience the physiologic dyspnea during heavy exercise uEnvironment short of oxygen u Clinical characteristics: visible indrawing over the sternal notch, the supraclavicular spaces, the intercostal spaces and the epigastrium in the inspiration(三凹症). u Accompanied by a coarse, low pitched inspiratory wheezing and dry cough. u Stenosis and obstruction of larynx, trachea, and bronchi Inspiratory dyspnea u Clinical characteristics: breathing is difficult during both inspiration and expiration. Respiratory frequency increase and respiration superficial. u Cause: decrease of ventilators and gas exchange capacity u Familiar diseases: severe pneumonia(肺炎), pulmonary fibrosis(肺纤维化), massive atelectasis(大片肺不张) etc Mixed dyspnea Basal diseases: u Coronary heart disease u Hypertensive heart disease u Rheumatic heart disease u Congenital heart disease Left heart failure Mechanism: u Lung congestion decrease gas dispersion u Alveoli are stiff and more work is needed to overcome elastic recoil u The high alveolar pressure stimulate stretch receptor u High pulmonary circulation pressure stimulate respiratory nerve center Left heart failure Clinical representation: u Exhausted dyspnea(劳力性呼吸困难) u Orthopnea(端坐呼吸) u Paroxysmal nocturnal dyspnea(夜间阵发性呼 吸困难) Left heart failure uDifficulty in breathing when the