The Dilemma Of Dyspnea Flashcards
Give the MMRC rating
0: I get breathless on strenous exercise
1: I get breathless when hurrying on a level or up a slight hill
2: I walk slower than people of the same age as me on the level because of breathlessness/ I have to stop for breath when walking at my own pace
3: I stop for breath after 100m
4: I am to breathless to leave the house
Give NYHA rating
what are the typical qualities of how dyspnoea is described
work/effort
tightness
air hunger: which is aggrevated by hypercapnia and hypoxaemia
How do patients with COPD complain/describe of dyspnoea
- Increased work of breathing
- Unrewarded resp
- Inspiratory difficulty
what 3 things form part of the pathophysiology of dyspnoea
increased loading
increased resp drive
inadequate performance of resp apparatus
what will cause increased loading of airways
chest cage deformities eg. scoliosis
lung abnormalities eg. interstitial lung disease/pulmonary fibrosis
airways
what will cause increased respiratory drive in pathophysiology
hypoxaemia, hypercapnia, pulmonary embolism
pulmonary congestion
how will kyphoscoliosis/respiratory muscle weakness cause dyspnoea
causes inadequate performance of respiratory apparatus
what investigation is commonly used for possible dyspnoea
spirometry
what are the reasons in the pulmonary system for dyspnoea to occur.
increased airflow resistance eg. asthma, copd, upper airway obstruction
decreased compliance: ILD, pulmonary congestion, pleural disease like effusion or pneumothorax, kyphoscoliosis
V-Q mismatch
reflex
resp muscle weakness
pulmonary vascular resistance
what diseases will cause V-Q mismatch (ventilation perfusion mismatch)
ILD, pulmonary congestion, pneumonia
what diseases will causes increased airflow resistance
copd, asthma, upper airway obs
what will cause reflex dyspnoea
pulmonary oedema/embolism
how does reflex dyspnoea happen
the oedema or embolus causes stretching of the J receptors which activates the breathing centre in the brain causing short shallowed breathing
what will cause decreased compliance
ILD, pulmonary congestion(LVF), pleural disease like effusion or pneumothorax
