6: Breathlessness Flashcards
What is Breathlessness?
- shortness of breath
- difficulty breathing
- can be acute or chronic
What is the medical term for breathlessness?
Dyspnoea
What is the general reason for breathlessness?
- body needs more oxygen than it is getting
- breathe faster = increase flow of air to lungs
Who is affected by breathlessness?
- everyone (when exercising)
- overweight/not fit
-underlying medical conditions: pneumonia/asthma/smokers/heart failure
How do you measure breathlessness?
- Grade 0 = dyspnea with strenuous exercise
- Grade 1 = hurrying/walking up a slight hill
- Grade 2 = walks slower than people of same age/ has to stop for breath when walking at own pace
- Grade 3 = stops for breath after walking 100 yards/ few mins
Grade 4 = cannot leave house/ breathless when dressing
What investigations will be advised?
- Sudden/Gradual?
-Triggers? - How far can you walk?
- Worse when lying down?
- Do you feel ill/fever/weight loss/cough?
-Pain in chest?
-Coughing up coloured sputum?
-Coughing up blood/travelled abroad/ in contact with TB?
-Long flight/bed-bound?
-Smoker?
What investigations will be conducted?
- Check heart/bp/lungs
- Lung function tests inc. peak flow reading
- Chest X-ray
-Blood tests: aneamia/underactive thyroid gland/ heart failure
Causes of Acute Breathlessness?
- Asthma
- Pneumonia
- COVID 19
- COPD
- Heart Disease
- Pulmonary Embolism
- Anxiety
- Medicines
- Other: Pain/Anaemia
Symptoms of Asthma?
-wheezy and breathless
-triggered by a cold/allergy
Symptoms of Pneumonia?
-severe chest infection = more breathless
-fever
-cough
-green sputum
Symptoms of COVID-19?
-causes breathlessness over a few days
Causes of COPD?
-long term lung condition = breathless and cough
-airways are inflamed and narrowed
-suddenly worse from chest infection
-usually affects smokers
Symptoms of Heart disease?
-causing heart failure
-no longer pumping efficiently
-build up of pressure in blood vessels which feed into the heart
-increased pressure makes fluid build up in body’s tissues
-gravity = extra fluid shows up as ankle swelling
Symptoms of Anxiety?
- feelings of panic
-rapid heartbeat (palpations)
-sweating
Symptoms of Pulmonary Embolism?
-clot in the lung usually due to blood clot in leg
-painful swollen calf
-clot develops after being immobile for a long time
-travels in blood stream to lungs
Symptoms of other medicines?
-beta-blockers (propranolol)
-aspirin (asthma)
What are the Long-term causes of breathlessness?
- Obesity: lack of fitness
- Asthma: poorly controlled
- COPD - lung diseases usually due to smoking
- Heart Failure
- Heart Rhythm Problems
- Anaemia
How does heart failure contribute to breathlessness?
- worse lying down
- affects elderly
How does heart rhythm problems contribute to breathlessness?
- irregular heart bead = heart inefficient = oxygen not pumped around properly
- breathe rapidly to get more oxygen into your lungs
- rapid breathing makes you feel breathless
How does anaemia contribute to breathlessness?
- not enough Hb in blood to carry oxygen to cells = causes tiredness and breathlessness
- heavy periods/ bleeding into gut in elderly (causes)
Are there any treatments for breathlessness?
- depends on cause
- stop smoking
-lose weight - referred to heart/lung specialist
- most cases managed by GP
What can you do if you feel very breathless?
- Keep calm
2 Call 999 if severe and sudden - no cause - Otherwise call GP
- Use inhaler if you have asthma
- Use oxygen if you have it
How to manage chronic breathlessness?
- Breathing control techniques
- Comfortable seating and standing positions
What are some breathing control techniques?
- Relaxed and slow and deep
- Paced: when walking or climbing stairs - try to breathe in rhythm with your steps
- Controlled: using diaphragm and lower chest muscles instead of upper chest and shoulder muscles - breathe gently - keep upper part relaxed
What are the different comfortable seating and standing positions?
- Standing: lean from hips/ forearms resting on something at comfortable height
- Standing/Walking: hands on hips/in your pockets
- Sitting: lean forward/ rest forearms on knees or chair
- Arrange things that are easy to reach/ stay active
How to avoid breathlessness?
- Find underlying cause and address it
- Don’t smoke or get help to quit smoking
- Maintain normal weight and regular exercise
What is the outlook?
- Depends on cause - but generally good
- Smokers tend to get worse
- Might need oxygen
