Cardiac dyspnea

Introduction Cardiac dyspnea is caused by left heart dysfunction due to various causes of heart disease. The patient is consciously breathing when the air is insufficient. The main cause of dyspnea in left heart failure is the decrease in pulmonary congestion and alveolar elasticity.

Cause

Cardiac pulmonary edema is common in left ventricular dysfunction. Dyspnea caused by left ventricular dysfunction is caused by congestion and increased capillary pressure in the pulmonary circulation. The tissue fluid accumulates in the alveolar and lung tissue spaces, and the formation of pulmonary edema pulmonary edema affects the gas exchange of the alveolar wall capillaries. It hinders the expansion and contraction of the lungs. It causes abnormal function of ventilation and ventilation, which causes the oxygen partial pressure in the alveoli to decrease and the partial pressure of carbon dioxide to rise, stimulating and exciting the respiratory center, and the patient feels that breathing is laborious.

an examination

Cardiac dyspnea manifested as severity: labor dyspnea, paroxysmal nocturnal dyspnea, cardiogenic asthma, sitting breathing, acute pulmonary edema.

First, the patient has a serious history of heart disease.

Second, mixed dyspnea, lying and obvious at night.

Third, the middle of the lungs may appear medium and small wet voice, and change with body position.

Fourth, X-ray examination: abnormal changes in heart shadow, congestion in the hilar and its vicinity or both pulmonary edema.

Five, congestive heart failure, dyspnea is the earliest main symptoms.

Sixth, pericardial effusion caused by any cause of acute or chronic pericarditis when a large amount of fluid accumulation, compression of the bronchi and lungs caused by breathing difficulties.

Differential diagnosis

1. Pneumatic dyspnea: caused by respiratory disease, mainly in the following three forms:

1) Inspiratory dyspnea: manifested as wheezing, inspiratory sternum, supraclavicular fossa and rib gap depression - three concave sign. Common in the throat, tracheal stenosis, such as inflammation, edema, foreign bodies and tumors.

2) Expiratory dyspnea: prolonged expiratory phase with wheezing, seen in bronchial asthma and obstructive pulmonary disease.

3) Mixed dyspnea: seen in pneumonia, pulmonary fibrosis, massive pleural effusion, pneumothorax, etc.

2. Cardiac dyspnea: Cardiac pulmonary edema caused by left ventricular dysfunction, its clinical features:

1) The patient has a history of severe heart disease.

2) Mixed dyspnea, obvious in the lying position and at night.

3) Middle and small wet voices may appear at the bottom of the lungs and vary with body position.

4) X-ray examination: abnormal changes in heart shadow; congestion of the hilar and its vicinity or both signs of pulmonary edema.

3. Toxic dyspnea: Acidosis caused by various causes can increase blood carbon dioxide, lower pH, stimulate peripheral chemoreceptors or directly stimulate the respiratory center, increase respiratory ventilation, and express deep and large breathing. Difficulties; respiratory inhibitors such as morphine, barbiturates and other poisoning, can also inhibit the respiratory center, making breathing shallow and slow.

4. Blood-borne dyspnea: severe anemia can be caused by red blood cells, blood oxygenation and shortness of breath, especially after the activity; major bleeding or shock due to ischemia and blood pressure, stimulate the respiratory center and cause breathing difficulties.

V. Neuropsychiatric and myopathy dyspnea: Severe brain diseases such as encephalitis, cerebrovascular accidents, brain tumors, etc. directly involve the respiratory center, abnormal respiratory rhythms, resulting in difficulty breathing; myasthenia gravis crisis causes respiratory muscles Paralysis, leading to severe breathing difficulties; In addition, snoring can also have dyspnea episodes, characterized by significant respiratory rate, superficial, respiratory alkalosis often accompanied by hand and foot convulsions.

Its clinical features:

1) The patient has a history of severe heart disease.

2) Mixed dyspnea, obvious in the lying position and at night.

3) Middle and small wet voices may appear at the bottom of the lungs and vary with body position.

4) X-ray examination: abnormal changes in heart shadow; congestion of the hilar and its vicinity or both signs of pulmonary edema.

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