6: Breathlessness Flashcards

1
Q

What is Breathlessness?

A
  • shortness of breath
  • difficulty breathing
  • can be acute or chronic
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2
Q

What is the medical term for breathlessness?

A

Dyspnoea

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3
Q

What is the general reason for breathlessness?

A
  • body needs more oxygen than it is getting
  • breathe faster = increase flow of air to lungs
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4
Q

Who is affected by breathlessness?

A
  • everyone (when exercising)
  • overweight/not fit
    -underlying medical conditions: pneumonia/asthma/smokers/heart failure
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5
Q

How do you measure breathlessness?

A
  • 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
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6
Q

What investigations will be advised?

A
  • 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?
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7
Q

What investigations will be conducted?

A
  • Check heart/bp/lungs
  • Lung function tests inc. peak flow reading
  • Chest X-ray
    -Blood tests: aneamia/underactive thyroid gland/ heart failure
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8
Q

Causes of Acute Breathlessness?

A
  1. Asthma
  2. Pneumonia
  3. COVID 19
  4. COPD
  5. Heart Disease
  6. Pulmonary Embolism
  7. Anxiety
  8. Medicines
  9. Other: Pain/Anaemia
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9
Q

Symptoms of Asthma?

A

-wheezy and breathless
-triggered by a cold/allergy

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10
Q

Symptoms of Pneumonia?

A

-severe chest infection = more breathless
-fever
-cough
-green sputum

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11
Q

Symptoms of COVID-19?

A

-causes breathlessness over a few days

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12
Q

Causes of COPD?

A

-long term lung condition = breathless and cough
-airways are inflamed and narrowed
-suddenly worse from chest infection
-usually affects smokers

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13
Q

Symptoms of Heart disease?

A

-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

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14
Q

Symptoms of Anxiety?

A
  • feelings of panic
    -rapid heartbeat (palpations)
    -sweating
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15
Q

Symptoms of Pulmonary Embolism?

A

-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

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16
Q

Symptoms of other medicines?

A

-beta-blockers (propranolol)
-aspirin (asthma)

17
Q

What are the Long-term causes of breathlessness?

A
  1. Obesity: lack of fitness
  2. Asthma: poorly controlled
  3. COPD - lung diseases usually due to smoking
  4. Heart Failure
  5. Heart Rhythm Problems
  6. Anaemia
18
Q

How does heart failure contribute to breathlessness?

A
  • worse lying down
  • affects elderly
19
Q

How does heart rhythm problems contribute to breathlessness?

A
  • 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
20
Q

How does anaemia contribute to breathlessness?

A
  • not enough Hb in blood to carry oxygen to cells = causes tiredness and breathlessness
  • heavy periods/ bleeding into gut in elderly (causes)
21
Q

Are there any treatments for breathlessness?

A
  • depends on cause
  • stop smoking
    -lose weight
  • referred to heart/lung specialist
  • most cases managed by GP
22
Q

What can you do if you feel very breathless?

A
  1. Keep calm
    2 Call 999 if severe and sudden - no cause
  2. Otherwise call GP
  3. Use inhaler if you have asthma
  4. Use oxygen if you have it
23
Q

How to manage chronic breathlessness?

A
  1. Breathing control techniques
  2. Comfortable seating and standing positions
24
Q

What are some breathing control techniques?

A
  1. Relaxed and slow and deep
  2. Paced: when walking or climbing stairs - try to breathe in rhythm with your steps
  3. Controlled: using diaphragm and lower chest muscles instead of upper chest and shoulder muscles - breathe gently - keep upper part relaxed
25
What are the different comfortable seating and standing positions?
1. Standing: lean from hips/ forearms resting on something at comfortable height 2. Standing/Walking: hands on hips/in your pockets 3. Sitting: lean forward/ rest forearms on knees or chair 4. Arrange things that are easy to reach/ stay active
26
How to avoid breathlessness?
1. Find underlying cause and address it 2. Don’t smoke or get help to quit smoking 3. Maintain normal weight and regular exercise
27
What is the outlook?
1. Depends on cause - but generally good 2. Smokers tend to get worse 3. Might need oxygen