Mild shortness of breath causes. Nine main causes of shortness of breath. What to do in an emergency

Description of the main conditions characterized by shortness of breath inpeace

Shortness of breath can appear in a person for no apparent reason. So a potential patient may feel tightness in the chest and lack of air. Sometimes health problems are more complex nature, and the patient begins to suffer from attacks of suffocation at night. This makes it difficult to inhale and exhale. Why shortness of breath occurs, read on.

The main cause of shortness of breath in calm state- this is a lack of oxygen.

The brain receives an alarm signal, and breathing begins to quicken. Considering that breathing, both at rest and under stress, this is an unconscious process controlled by the subcortical center(medulla oblongata), then a person does not always control the rhythms fast breathing. If shortness of breath occurs after physical exertion, then breathing returns to normal quickly, especially if a person performs movements aimed at restoring the cycle of inhalation and exhalation.

If a person experiences shortness of breath after eating, legs swell, pain in the chest, cold feet and hands appear, then this indicates disturbances in the respiratory system and the functioning of the heart or blood vessels.

Causes of shortness of breath may be, for example stressful conditions. A nonspecific reaction of the body can be caused by fear, excitement, anger, anxiety, which contribute to the production of adrenaline.

Adrenaline has an increased effect on the heart, resulting in an increase in heart rate. Hyperventilation also occurs, that is, rapid breathing. Shortness of breath may be bothersome normal life. Let's look at the main causes of shortness of breath without physical activity.

Types of shortness of breath

Dyspnea of ​​central type.

The causes of this type of shortness of breath at rest occur due to a violation of the cortical regulation of the breathing process, with damage to the respiratory center. This type of shortness of breath appears in neuroses. It is characterized by shallow breathing, with a frequency of up to 50-70 inhalations and exhalations per minute.

Treatment. The doctor’s task is to normalize breathing. To do this, breath-holding techniques are used. Then the techniques of deep breaths and exhalations. This will allow the patient to calm down. After breathing has been restored, the patient is given an infusion of valerian (at the rate of one teaspoon per 30 ml of water).

If the respiratory center is affected (depressed) as a result of an overdose of sleeping pills or narcotics, then the patient is injected intravenously with a 0.5% solution of nalorphine, caffeine benzoate sodium 2 ml 20% intramuscularly.

Dyspnea due to thoradiaphragmatic disorders.

There may be several reasons for this type of shortness of breath:

1. Scoliosis or kyphosis;
2. Chest pain;
3. Flatulence.

There may be other reasons for this shortness of breath, such as fluid accumulation in the pleural cavity. At the same time, the depth of inspiration decreases, and the patient sometimes experiences the consequences of lack of air. Examination reveals bloating in the patient's abdomen or one of the types of curvature of the spinal column (scoliosis or kyphosis).

Treatment aimed at eliminating shortness of breath and shortness of breath. If the patient has hydrothorax, then a puncture of the pleura is performed. In case of flatulence, a tube is inserted to remove gases.

Such measures lead to a reduction in stress and pressure on internal organs and normalization of breathing.

Pulmonary dyspnea.

The main causes of pulmonary dyspnea:

• insufficient extensibility of lung tissue;
• reduction of lumens in the bronchi;
• decreased alveolar diffusion.

As a result of a decrease in the vital volume of the lungs, the depth of inspiration is also reduced. When listening to the lungs, wheezing can be heard. Shortness of breath can be the result of increased stress on the organs of the respiratory system and a symptom of the development of pneumosclerosis, pneumonia, pulmonary fibrosis and other lung diseases. Shortness of breath is characterized by cyanosis of the skin and mucous membranes.

Treatment is directed to normalize the inhalation and exhalation system and eliminate shortness of breath. The patient is prescribed treatment in the form of oxygen inhalation and a number of other therapeutic measures.

Features of pulmonary dyspnea

This type of shortness of breath is formed as a result of bronchial spasm,

blockage of the bronchi with phlegm. Due to the load and increased pressure on the lungs, swelling of the large vessels of the neck occurs during exhalation. The latter symptom may be the cause of emphysema.

Treatment Pulmonary dyspnea involves the prescription of medications that eliminate spasms in the lumens of the bronchi, expand the space for normal air flow, reduce swelling and stronger sputum production.

Recovery normal condition and work of the respiratory organs, oral treatment, intramuscular and intravenous injections are prescribed:

1. Bronchodilators (ephedrine hydrochloride, belladonna, theophedrine, euphilin).
2. Expectorants for the separation of mucus.

Cardiac dyspnea

Violation cardiac cycle leads to a decrease in the force of blood ejection. There are several failure results:

• blood stagnation in the lungs;
• violation of gas exchange in organs;
• ventilation conditions are violated.

The patient begins to breathe deeper, and shortness of breath appears as a result of the unnatural load on the lungs. A clear sign of disturbances in the functioning of the heart and blood vessels is cold feet and hands, acrocyanosis. Swelling of the arms and legs appears. At night, the patient suffers from attacks of lack of air at night. While listening to the lungs, fine rales are heard.

Treatment. The paramedic puts the patient in a semi-sitting position to calm the patient. A solution of strophanthin 0.5 ml (0.05%) with 10 ml of a 40% glucose solution is injected into a vein. But the solution is administered if the patient has not taken digitalis-based medications. Along with these drugs, diuretics are given.

Hematogenous shortness of breath occurs when acidosis or products of impaired metabolism enter the blood. The causes of shortness of breath can be either renal or liver failure. In a diabetic coma, the patient's breathing is noisy. The doctor prescribes immediate treatment aimed at combating acidosis.

Shortness of breath can sometimes be mixed, observed as a result of the development of simultaneous diseases of the heart and lungs or several other organs. All these points must be taken into account when treating a patient.

One of the main complaints most often voiced by patients is shortness of breath. This subjective feeling forces the patient to go to the clinic and call an ambulance medical care and may even be an indication for emergency hospitalization. So what is shortness of breath and what are the main reasons that cause it? You will find answers to these questions in this article. So…

What is shortness of breath

As mentioned above, shortness of breath (or dyspnea) is a subjective human sensation, an acute, subacute or chronic feeling of lack of air, manifested by tightness in the chest, clinically - an increase in the respiratory rate above 18 per minute and an increase in its depth.

A healthy person at rest does not pay attention to his breathing. With moderate physical activity, the frequency and depth of breathing change - the person is aware of this, but this condition does not cause him discomfort, and breathing parameters return to normal within a few minutes after stopping the exercise. If shortness of breath becomes more pronounced during moderate exertion, or appears when a person performs basic actions (tying shoelaces, walking around the house), or, even worse, does not go away at rest, we are talking about pathological shortness of breath, indicating a particular disease .

Classification of shortness of breath

If the patient has difficulty breathing, this is called inspiratory shortness of breath. It appears when the lumen of the trachea and large bronchi narrows (for example, in patients with bronchial asthma or as a result of compression of the bronchus from the outside - with pneumothorax, pleurisy, etc.).

If discomfort occurs during exhalation, such shortness of breath is called expiratory shortness of breath. It occurs due to narrowing of the lumen of the small bronchi and is a sign of chronic obstructive pulmonary disease or emphysema.

There are a number of reasons that cause mixed shortness of breath - with disturbances in both inhalation and exhalation. The main ones among them are lung diseases in late, advanced stages.

There are 5 degrees of severity of shortness of breath, determined based on the patient’s complaints - the MRC scale (Medical Research Council Dyspnea Scale).

Causes of shortness of breath

The main causes of shortness of breath can be divided into 4 groups:

1. Respiratory failure caused by:
   • violation of bronchial obstruction;
   • diffuse diseases of the tissue (parenchyma) of the lungs;
   • pulmonary vascular diseases;
   • diseases of the respiratory muscles or chest.
2. Heart failure.
3. Hyperventilation syndrome (with neurocirculatory dystonia and neuroses).
4. Metabolic disorders.

Shortness of breath due to lung pathology

This symptom is observed in all diseases of the bronchi and lungs. Depending on the pathology, shortness of breath can occur acutely (pleurisy, pneumothorax) or bother the patient for many weeks, months and years ().

Shortness of breath in COPD is caused by a narrowing of the airways and the accumulation of viscous secretions in them. It is constant, expiratory in nature, and in the absence of adequate treatment becomes more and more pronounced. Often combined with a cough followed by sputum discharge.

In bronchial asthma, shortness of breath manifests itself in the form of sudden attacks of suffocation. It is expiratory in nature - a light short inhalation is followed by a noisy, difficult exhalation. When you inhale special medications that dilate the bronchi, breathing quickly normalizes. Choking attacks usually occur after contact with allergens - when inhaling them or eating them. In especially severe cases, the attack is not stopped by bronchomimetics - the patient’s condition progressively worsens, he loses consciousness. This is an extremely life-threatening condition that requires emergency medical attention.

Accompanied by shortness of breath and acute infectious diseases– bronchitis and. Its severity depends on the severity of the underlying disease and the extent of the process. In addition to shortness of breath, the patient is concerned about a number of other symptoms:

• increase in temperature from subfebrile to febrile numbers;
• weakness, lethargy, sweating and other symptoms of intoxication;
• nonproductive (dry) or productive (with sputum) cough;
• chest pain.

With timely treatment of bronchitis and pneumonia, their symptoms stop within a few days and recovery occurs. In severe cases of pneumonia, respiratory failure is accompanied by cardiac failure - shortness of breath increases significantly and some other characteristic symptoms appear.

Lung tumors in the early stages are asymptomatic. If a recently emerging tumor was not detected by chance (during preventive fluorography or as an accidental finding in the process of diagnosing non-pulmonary diseases), it gradually grows and, upon reaching it, is sufficiently large sizes causes certain symptoms:

• at first mild, but gradually increasing constant shortness of breath;
• hacking cough with minimal sputum;
• hemoptysis;
• chest pain;
• weight loss, weakness, pallor of the patient.

Treatment for lung tumors may include surgery to remove the tumor, chemotherapy and/or radiation therapy, and other modern techniques treatment.

The greatest threat to the patient's life is caused by shortness of breath conditions such as pulmonary embolism, or PE, local airway obstruction and toxic pulmonary edema.

PE is a condition in which one or more branches of the pulmonary artery are blocked by blood clots, as a result of which part of the lungs is excluded from the act of breathing. Clinical manifestations of this pathology depend on the volume lung lesions. It is usually manifested by sudden shortness of breath, disturbing the patient during moderate or minor physical activity or even at rest, a feeling of suffocation, tightness and chest pain, similar to that with, often hemoptysis. The diagnosis is confirmed by corresponding changes in the ECG, chest x-ray, and angiopulmography.

Airway obstruction is also manifested by the symptom complex of suffocation. The shortness of breath is inspiratory in nature, breathing can be heard from a distance - noisy, stridorous. A frequent accompaniment of shortness of breath in this pathology is a painful cough, especially when changing body position. The diagnosis is made on the basis of spirometry, bronchoscopy, X-ray or tomographic examination.

Airway obstruction can result from:

• violation of the patency of the trachea or bronchi due to compression of this organ from the outside (aortic aneurysm, goiter);
• damage to the trachea or bronchi by a tumor (cancer, papillomas);
• entry (aspiration) of a foreign body;
• formation of cicatricial stenosis;
• chronic inflammation leading to destruction and fibrosis of the cartilaginous tissue of the trachea (in rheumatic diseases - systemic lupus erythematosus,).

Bronchodilator therapy for this pathology is ineffective. The main role in treatment belongs to adequate therapy of the underlying disease and mechanical restoration of airway patency.

It may occur against the background of an infectious disease accompanied by severe intoxication or due to exposure to toxic substances in the respiratory tract. At the first stage, this condition manifests itself only as gradually increasing shortness of breath and rapid breathing. After some time, shortness of breath gives way to painful suffocation, accompanied by bubbling breathing. The leading direction of treatment is detoxification.

Less commonly, the following lung diseases manifest themselves as shortness of breath:

• pneumothorax – acute condition, in which air penetrates the pleural cavity and lingers there, compressing the lung and preventing the act of breathing; occurs due to injury or infectious processes in the lungs; requires urgent surgical care;
• – a serious infectious disease caused by Mycobacterium tuberculosis; requires long-term specific treatment;
• actinomycosis of the lungs - a disease caused by fungi;
• emphysema is a disease in which the alveoli become stretched and lose their ability to carry out normal gas exchange; develops as an independent form or accompanies others chronic diseases respiratory organs;
• silicosis is a group of occupational lung diseases resulting from the deposition of dust particles in the lung tissue; recovery is impossible, the patient is prescribed supportive symptomatic therapy;
• , defects of the thoracic vertebrae - with these conditions, the shape of the chest is disrupted, which makes breathing difficult and causes shortness of breath.

Shortness of breath due to pathology of the cardiovascular system

Persons suffering from one of the main complaints note shortness of breath. In the early stages of the disease, shortness of breath is perceived by patients as a feeling of lack of air during physical activity, but over time this feeling is caused by less and less exercise; in advanced stages it does not leave the patient even at rest. In addition, advanced stages of heart disease are characterized by paroxysmal nocturnal dyspnea - an attack of suffocation that develops at night, leading to the awakening of the patient. This condition is also known as. It is caused by stagnation of fluid in the lungs.

Dyspnea in neurotic disorders

Complaints of shortness of breath of varying degrees are made by ¾ of patients of neurologists and psychiatrists. A feeling of lack of air, the inability to breathe deeply, often accompanied by anxiety, fear of death from suffocation, a feeling of a “blockage”, an obstruction in the chest that prevents a full breath - the complaints of patients are very diverse. Typically, such patients are excitable people who react sharply to stress, often with hypochondriacal tendencies. Psychogenic disorders breathing often appears against a background of anxiety and fear, depressed mood, after experiencing nervous overexcitation. Even attacks of false asthma are possible - suddenly developing attacks of psychogenic shortness of breath. Clinical feature psychogenic features of breathing is its noise design - frequent sighs, groans, groans.

Neurologists and psychiatrists treat shortness of breath in neurotic and neurosis-like disorders.

Shortness of breath with anemia

Anemia is a group of diseases characterized by changes in the composition of the blood, namely a decrease in the content of hemoglobin and red blood cells. Since the transport of oxygen from the lungs directly to the organs and tissues is carried out precisely with the help of hemoglobin, when its amount decreases, the body begins to experience oxygen starvation - hypoxia. Of course, he tries to compensate for this condition, roughly speaking, to pump more oxygen into the blood, as a result of which the frequency and depth of breaths increases, i.e. shortness of breath occurs. There are different types of anemia and they arise due to different reasons:

• insufficient intake of iron from food (for vegetarians, for example);
• chronic bleeding (with peptic ulcer, uterine leiomyoma);
• after recent severe infectious or somatic diseases;
• for congenital metabolic disorders;
• as a symptom oncological diseases, in particular blood cancer.

In addition to shortness of breath with anemia, the patient complains of:

• severe weakness, loss of strength;
• decreased quality of sleep, decreased appetite;
• dizziness, headaches, decreased performance, impaired concentration and memory.

Persons suffering from anemia are distinguished by pale skin, and in some types of the disease - by a yellow tint, or jaundice.

Diagnosis is easy - just take a general blood test. If there are changes in it that indicate anemia, a series of examinations, both laboratory and instrumental, will be prescribed to clarify the diagnosis and identify the causes of the disease. Treatment is prescribed by a hematologist.

Shortness of breath in diseases of the endocrine system

Persons suffering from diseases such as obesity and diabetes mellitus also often complain of shortness of breath.

With thyrotoxicosis, a condition characterized by excessive production of thyroid hormones, all metabolic processes in the body sharply increase - at the same time, it experiences an increased need for oxygen. In addition, an excess of hormones causes an increase in the number of heart contractions, as a result of which the heart loses the ability to fully pump blood to tissues and organs - they experience a lack of oxygen, which the body tries to compensate for, and shortness of breath occurs.

Excessive amounts of adipose tissue in the body during obesity impede the functioning of the respiratory muscles, heart, and lungs, as a result of which tissues and organs do not receive enough blood and lack oxygen.

With diabetes, sooner or later the vascular system of the body is affected, as a result of which all organs are in a state of chronic oxygen starvation. In addition, over time, the kidneys are also affected - diabetic nephropathy develops, which in turn provokes anemia, as a result of which hypoxia intensifies even more.

Shortness of breath in pregnant women

During pregnancy, a woman's respiratory and cardiovascular systems experience increased stress. This load is due to the increased volume of circulating blood, compression from below the diaphragm by the enlarged uterus (as a result of which the chest organs become crowded and breathing movements and heart contractions are somewhat difficult), the need for oxygen not only of the mother, but also of the growing embryo. All these physiological changes lead to many women experiencing shortness of breath during pregnancy. The breathing rate does not exceed 22–24 per minute; it becomes more frequent during physical activity and stress. As pregnancy progresses, shortness of breath also progresses. In addition, expectant mothers often suffer from anemia, which worsens shortness of breath.

If the respiratory rate exceeds the above figures, shortness of breath does not go away or does not decrease significantly at rest, the pregnant woman should definitely consult a doctor - an obstetrician-gynecologist or therapist.

Shortness of breath in children

Respiratory rate in children of different ages different. Dyspnea should be suspected if:

• baby is 0–6 months old breathing movements(NPV) more than 60 per minute;
• in a child 6–12 months of age, the respiratory rate is over 50 per minute;
• in a child over 1 year of age, the respiratory rate is over 40 per minute;
• in a child over 5 years of age, the respiratory rate is over 25 per minute;
• in a child 10–14 years old, the respiratory rate is over 20 per minute.

During emotional excitement, during physical activity, crying, feeding, the respiratory rate is always higher, however, if the respiratory rate is significantly higher than normal and slowly recovers at rest, you should inform your pediatrician about this.

Most often, shortness of breath in children occurs under the following pathological conditions:

• respiratory distress syndrome of the newborn (often recorded in premature babies whose mothers suffer from diabetes mellitus, cardiovascular disorders, diseases of the genital area; it is facilitated by intrauterine hypoxia, asphyxia; clinically manifested by shortness of breath with a respiratory rate over 60 per minute, a blue tint of the skin and their pallor, chest rigidity is also noted; treatment should begin as early as possible - the most modern method is the introduction of pulmonary surfactant into the trachea of ​​a newborn in the first minutes of his life);
• acute stenosing laryngotracheitis, or false croup(a feature of the structure of the larynx in children is its small lumen, which, with inflammatory changes in the mucous membrane of this organ, can lead to disruption of the passage of air through it; usually false croup develops at night - swelling increases in the area of ​​the vocal cords, leading to severe inspiratory shortness of breath and suffocation; with this condition, it is necessary to provide the child with a flow of fresh air and immediately call an ambulance);
• congenital heart defects (due to intrauterine development disorders, the child develops pathological communications between the great vessels or cavities of the heart, leading to mixing of venous and arterial blood; as a result, the organs and tissues of the body receive blood that is not saturated with oxygen and experience hypoxia; depending on the severity dynamic observation and/or surgical treatment is indicated);
• viral and bacterial bronchitis, pneumonia, bronchial asthma, allergies;
• anemia.

In conclusion, it should be noted that only a specialist can determine the true cause of shortness of breath, therefore, if this complaint occurs, you should not self-medicate - the most correct decision would be to consult a doctor.

Which doctor should I contact?

If the diagnosis is not yet known to the patient, it is best to consult a therapist (pediatrician for children). After the examination, the doctor will be able to establish a presumptive diagnosis and, if necessary, refer the patient to a specialized specialist. If shortness of breath is associated with lung pathology, you should consult a pulmonologist; if you have heart disease, consult a cardiologist. Anemia is treated by a hematologist, diseases of the endocrine glands - by an endocrinologist, pathology of the nervous system - by a neurologist, mental disorders accompanied by shortness of breath - psychiatrist.

Medicine defines shortness of breath as dyspnea. Severe shortness of breath when walking manifests itself in a lack of oxygen, an increase in the number of breaths taken, and also affects. Many people have a question: “Why do I get out of breath when walking?” Your body gives signals about the need for air, which can mean the presence of various ailments. When walking, due to a significant increase in the load on the heart muscle, as well as on the respiratory system.

Often shortness of breath appears when walking in the elderly, because with the onset of lung capacity begins to decrease and certain chronic diseases appear. It happens that even non-elderly people experience difficulties with shortness of breath after climbing another flight of stairs, without any special problems with the respiratory system.

So, in this material we will discuss why shortness of breath occurs when walking, and how to get rid of it. Also, we will refer to traditional medicine, which will help solve the problem of shortness of breath when walking or various loads.

Causes of difficulty breathing when walking

This form of pathology differs in many ways and also depends on the general physical condition. Let's look briefly at each of them:

Expiratory option– considered the most common cause of shortness of breath.


It appears due to the fact that the lumens in the bronchi narrow as a result of swelling and spasms; it can also appear if the bronchi are clogged with phlegm. However, shortness of breath when walking appears during inhalation. Exacerbation of this type is most often most typical during attacks of bronchial asthma. In addition, one of the reasons may be chronic bronchitis or swelling of the bronchi due to allergies.

Inspiratory option– this type of pathology is much less common. The development of shortness of breath occurs as a result of swelling or swelling of the larynx. In this case, when walking, it becomes difficult to breathe while inhaling, which occurs with a slight whistle. The occurrence of inspiratory dyspnea may be due to certain diseases, for example, ascites or ankylosing spondylitis. Distinctive feature is a feeling of constant oxygen deficiency. Shortness of breath may occur with exertion or light walking.

Hematogenous variant– may appear as a result of poisoning with toxic substances or diabetes mellitus and liver failure. At the same time, rapid breathing appears, and noises arise when inhaling air.

Heart option- causes severe shortness of breath when walking can be hidden in a variety of diseases. For example, it occurs with mycoma of the left atrium, heart failure of the left ventricle, etc.

There are also many other options for breathing problems:

• Bad physical training - most often people who do not engage physical exercise and move little during the day, over time they begin to suffer from shortness of breath. When muscles are in a state of inactivity for a long time, with the most minimal load on them, including walking, a much larger amount of air is required, which is the reason for problems with the respiratory system.
• Obese option– in this state, the body quite often does not know what to do. You need to understand that it is disrupted not because of subcutaneous fat deposits, but because of internal fat deposits that cover various organs. For example, fat begins to cover not only the lungs, but also the liver and heart, which impairs them normal work. So, for problems with shortness of breath, the only solution may be.
• , fears and panic attacks – often lead to the fact that suspicious people begin to choke when walking and feel a lack of air. As a rule, when enduring a strong experience, our body pumps a lot of adrenaline into the blood, which leads to shortness of breath and.

Methods for treating shortness of breath

Before starting a set of treatment procedures, it is necessary identify main reason breathing problems. First, it becomes clear what exactly causes shortness of breath, and only then proceed to corrective procedures. The prescription of treatment measures will depend on what type of shortness of breath worries the patient.

To determine the causes and treatment of shortness of breath when walking, it is necessary to provide additional oxygen to the heart, which activates cardiac output. Measures to reduce pulmonary congestion should also be implemented.

In order to more successfully continue the fight against shortness of breath, you must definitely discard all possible harmful addictions, such as, and narcotic substances. It is also necessary to get rid of it if necessary. When various organ diseases occur, it is necessary to carry out treatment. In case of poisoning by toxins, cleansing is carried out from them.

Only a medical specialist can identify the causes and treatment of severe shortness of breath when walking. Therefore, in order to exclude the possibility of various diseases that can be dangerous, be sure to consult a doctor.

The use of traditional medicine in the fight against shortness of breath

In addition to official methods of eliminating breathing difficulties, there are folk remedies treatment of shortness of breath when walking:

1. Fresh horseradish roots you need to put it through a meat grinder (300 g) and then put it in a jar. You need to add juice from five to the container. squeezed lemons. The ingredients must be thoroughly mixed and refrigerated. You need to take one teaspoon of medicine until it gets better.
2. Dried fruits are very helpful in getting rid of shortness of breath when walking. dill seeds and branches. Both ingredients need to be mixed well, and then proceed to preparing the infusion: pour 2 teaspoons of the dill mixture with boiling water. You need to take the infusion before, remembering to strain it.
3. To treat the causes of shortness of breath when walking, it is recommended to take a drink from warm milk (goat) with the addition of honey. After 30 days there should be a noticeable improvement.
4. As an excellent folk method, one cannot fail to mention wild lilac. 2 tablespoons with flowers should be placed in hot water and placed in a warm place. You should take one sip throughout the day. The course will last 21 days, after which you need to stop for 7 days and continue drinking again.

Now you know what causes shortness of breath when walking, what its causes are, and what means you can get rid of it.

It is worth noting that if you suddenly start to feel out of breath while walking, then you cannot immediately use only traditional methods. After all, this may mean the manifestation of asthma or another bronchial disease that may threaten your health. So, if you experience such symptoms, you should immediately visit a doctor to get treatment.

Video. Arrhythmia and shortness of breath during exercise

Not enough air: causes of breathing difficulties - cardiogenic, pulmonary, psychogenic, others

Breathing is a natural physiological act that occurs constantly and to which most of us do not pay attention, because the body itself regulates the depth and frequency of breathing movements depending on the situation. The feeling of not having enough air is probably familiar to everyone. It may appear after a quick run, climbing stairs to a high floor, or with strong excitement, but healthy body quickly copes with such shortness of breath, bringing breathing back to normal.

If short-term shortness of breath after exercise does not cause serious concern, quickly disappearing during rest, then long-term or suddenly occurring sudden difficulty breathing can signal a serious pathology, often requiring immediate treatment. Acute lack of air when the airways are blocked by a foreign body, pulmonary edema, or an asthmatic attack can cost life, so any breathing disorder requires clarification of its cause and timely treatment.

Not only the respiratory system is involved in the process of breathing and providing tissues with oxygen, although its role, of course, is paramount. It is impossible to imagine breathing without the proper functioning of the muscular frame of the chest and diaphragm, the heart and blood vessels, and the brain. Breathing is influenced by blood composition, hormonal status, activity of the nerve centers of the brain and many external reasons - sports training, abundant food, emotions.

The body successfully adapts to fluctuations in the concentration of gases in the blood and tissues, increasing the frequency of respiratory movements if necessary. When there is a lack of oxygen or an increased need for it, breathing becomes more frequent. Acidosis, which accompanies a number of infectious diseases, fever, and tumors, provokes increased breathing to remove excess carbon dioxide from the blood and normalize its composition. These mechanisms turn on themselves, without our will or effort, but in some cases they become pathological.

Any respiratory disorder, even if its cause seems obvious and harmless, requires examination and a differentiated approach to treatment, therefore, if you feel that there is not enough air, it is better to immediately go to a doctor - a general practitioner, cardiologist, neurologist, or psychotherapist.

Causes and types of breathing problems

When a person has difficulty breathing and lacks air, they speak of shortness of breath. This symptom is considered an adaptive act in response to an existing pathology or reflects the natural physiological process of adaptation to changing external conditions. In some cases, it becomes difficult to breathe, but the unpleasant feeling of lack of air does not arise, since hypoxia is eliminated by an increased frequency of respiratory movements - in case of poisoning carbon monoxide, working in breathing apparatus, sudden rise to height.

Dyspnea can be inspiratory or expiratory. In the first case, there is not enough air when inhaling, in the second - when exhaling, but a mixed type is also possible, when it is difficult to both inhale and exhale.

Shortness of breath does not always accompany illness; it can be physiological, and this is a completely natural condition. The causes of physiological shortness of breath are:

• Physical exercise;
• Excitement, strong emotional experiences;
• Being in a stuffy, poorly ventilated room, in the highlands.

Physiological increased breathing occurs reflexively and goes away after a short time. People in poor physical shape who have a sedentary “office” job suffer from shortness of breath in response to physical effort more often than those who regularly visit the gym, pool, or simply take daily walks. As general physical development improves, shortness of breath occurs less frequently.

Pathological shortness of breath can develop acutely or be a constant concern, even at rest, significantly worsening with the slightest physical effort. A person suffocates when the airways are quickly closed by a foreign body, swelling of the laryngeal tissues, lungs and other serious conditions. When breathing in this case, the body does not receive what it needs even minimum quantity oxygen, and other severe disorders are added to shortness of breath.

The main pathological reasons why it is difficult to breathe are:

• Diseases respiratory system- pulmonary shortness of breath;
• Pathology of the heart and blood vessels - cardiac shortness of breath;
• Disorders of the nervous regulation of the act of breathing - central type shortness of breath;
• Violation of the blood gas composition - hematogenous shortness of breath.

Heart reasons

Heart disease is one of the most common reasons why it becomes difficult to breathe. The patient complains that he does not have enough air and notes the appearance of swelling in the legs, fatigue, etc. Typically, patients whose breathing is impaired due to changes in the heart are already examined and even take appropriate medications, but shortness of breath can not only persist, but in some cases it gets worse.

With heart pathology, there is not enough air when inhaling, that is, inspiratory shortness of breath. It accompanies, can persist even at rest in its severe stages, and is aggravated at night when the patient is lying down.

The most common reasons:

1. Arrhythmias;
2. and myocardial dystrophy;
3. Defects - congenital ones lead to shortness of breath in childhood and even the neonatal period;
4. Inflammatory processes in the myocardium, pericarditis;
5. Heart failure.

The occurrence of breathing difficulties in cardiac pathology is most often associated with the progression of heart failure, in which either there is no adequate cardiac output and the tissues suffer from hypoxia, or congestion occurs in the lungs due to failure of the left ventricular myocardium ().

In addition to shortness of breath, often combined with dry, painful pain, in people with cardiac pathology, other characteristic complaints arise that make diagnosis somewhat easier - pain in the heart area, “evening” swelling, cyanosis of the skin, interruptions in the heart. It becomes more difficult to breathe in a lying position, so most patients even sleep half-sitting, thus reducing the flow of venous blood from the legs to the heart and the manifestations of shortness of breath.

symptoms of heart failure

During an attack of cardiac asthma, which can quickly turn into alveolar pulmonary edema, the patient literally suffocates - the respiratory rate exceeds 20 per minute, the face turns blue, the neck veins swell, and the sputum becomes foamy. Pulmonary edema requires emergency care.

Treatment of cardiac dyspnea depends on the underlying cause that caused it. An adult patient with heart failure is prescribed diuretics (furosemide, veroshpiron, diacarb), ACE inhibitors (lisinopril, enalapril, etc.), beta blockers and antiarrhythmics, cardiac glycosides, oxygen therapy.

Diuretics (diacarb) are indicated for children, and drugs of other groups are strictly dosed due to possible side effects and contraindications in childhood. Congenital defects in which a child begins to choke from the very first months of life may require urgent surgical correction and even heart transplantation.

Pulmonary causes

Pathology of the lungs is the second reason leading to difficulty breathing, and both difficulty in inhaling and exhaling is possible. Pulmonary pathology with respiratory failure is:

• Chronic obstructive diseases - asthma, bronchitis, pneumosclerosis, pneumoconiosis, pulmonary emphysema;
• Pneumo- and hydrothorax;
• Tumors;
• Foreign bodies of the respiratory tract;
• in the branches pulmonary arteries.

Chronic inflammatory and sclerotic changes in the pulmonary parenchyma greatly contribute to respiratory failure. They are aggravated by smoking, poor environmental conditions, and recurrent infections of the respiratory system. Shortness of breath is initially disturbing during physical exertion, gradually becoming permanent as the disease progresses to a more severe and irreversible stage of its course.

With lung pathology, the gas composition of the blood is disrupted, and a lack of oxygen occurs, which, first of all, is lacking in the head and brain. Severe hypoxia provokes metabolic disorders in nerve tissue and the development of encephalopathy.

Patients with bronchial asthma are well aware of how breathing is disrupted during an attack: it becomes very difficult to exhale, discomfort and even pain in the chest appears, arrhythmia is possible, sputum is difficult to separate when coughing and is extremely scarce, the neck veins swell. Patients with such shortness of breath sit with their hands on their knees - this position reduces venous return and the load on the heart, alleviating the condition. Most often, it is difficult for such patients to breathe and lack air at night or in the early morning hours.

In a severe asthmatic attack, the patient suffocates, the skin becomes bluish, panic and some disorientation are possible, and status asthmaticus may be accompanied by convulsions and loss of consciousness.

In case of breathing problems due to chronic pulmonary pathology, the patient’s appearance changes: the chest becomes barrel-shaped, the spaces between the ribs increase, the neck veins are large and dilated, as well as the peripheral veins of the extremities. The expansion of the right half of the heart against the background of sclerotic processes in the lungs leads to its failure, and shortness of breath becomes mixed and more severe, that is, not only the lungs cannot cope with breathing, but the heart cannot provide adequate blood flow, filling the venous part of the systemic circulation with blood.

There is also not enough air in case pneumonia, pneumothorax, hemothorax. With inflammation of the pulmonary parenchyma, it becomes not only difficult to breathe, the temperature also rises, there are obvious signs of intoxication on the face, and the cough is accompanied by sputum production.

An extremely serious cause of sudden respiratory failure is considered to be the entry of a foreign body into the respiratory tract. This could be a piece of food or a small part of a toy that the baby accidentally inhales while playing. A victim with a foreign body begins to choke, turns blue, quickly loses consciousness, and cardiac arrest is possible if help does not arrive in time.

Thromboembolism of the pulmonary vessels can also lead to sudden and rapidly increasing shortness of breath and cough. It occurs more often in people suffering from pathology of the blood vessels of the legs, heart, and destructive processes in the pancreas. With thromboembolism, the condition can be extremely severe with increasing asphyxia, bluish skin, rapid cessation of breathing and heartbeat.

In some cases, the cause of severe shortness of breath is allergy and Quincke's edema, which are also accompanied by stenosis of the lumen of the larynx. The reason may be food allergen, wasp sting, pollen inhalation, medicine. In these cases, both the child and the adult require emergency medical care to relieve the allergic reaction, and in case of asphyxia, tracheostomy and artificial ventilation may be required.

Treatment of pulmonary dyspnea should be differentiated. If the cause is a foreign body, then it must be removed as quickly as possible; in case of allergic edema, a child or an adult should be given antihistamines, glucocorticoid hormones, adrenaline. In case of asphyxia, a tracheo- or conicotomy is performed.

For bronchial asthma, treatment is multi-stage, including beta-adrenergic agonists (salbutamol) in sprays, anticholinergics (ipratropium bromide), methylxanthines (aminophylline), glucocorticosteroids (triamcinolone, prednisolone).

Acute and chronic inflammatory processes require antibacterial and detoxification therapy, and compression of the lungs with pneumo- or hydrothorax, obstruction of the airways by a tumor is an indication for surgery (puncture of the pleural cavity, thoracotomy, removal of part of the lung, etc.).

Cerebral causes

In some cases, breathing difficulties are associated with damage to the brain, because the most important nerve centers that regulate the activity of the lungs, blood vessels, and heart are located there. Shortness of breath of this type is characteristic of structural damage to brain tissue - trauma, neoplasm, stroke, edema, encephalitis, etc.

Disorders of respiratory function in brain pathology are very diverse: it is possible to either slow down or increase breathing, and the appearance of different types of pathological breathing. Many patients with severe brain pathology are on artificial ventilation because they simply cannot breathe on their own.

The toxic effect of microbial waste products and fever leads to an increase in hypoxia and acidification of the internal environment of the body, which causes shortness of breath - the patient breathes frequently and noisily. In this way, the body strives to quickly get rid of excess carbon dioxide and provide tissues with oxygen.

A relatively harmless cause of cerebral dyspnea can be considered functional disorders in the activity of the brain and peripheral nervous system - neurosis, hysteria. In these cases, shortness of breath is of a “nervous” nature, and in some cases this is noticeable to the naked eye, even to a non-specialist.

With intercostal neuralgia, the patient feels severe pain in half of the chest, which intensifies with movement and inhalation; especially impressionable patients may panic, breathe quickly and shallowly. With osteochondrosis, it is difficult to breathe, and constant pain in the spine can provoke chronic shortness of breath, which can be difficult to distinguish from difficulty breathing due to pulmonary or cardiac pathology.

Treatment of difficulty breathing in diseases of the musculoskeletal system includes physical therapy, physiotherapy, massage, drug support in the form of anti-inflammatory drugs, analgesics.

Many expectant mothers complain that as their pregnancy progresses, it becomes more difficult for them to breathe. This sign may be quite normal, because the growing uterus and fetus raise the diaphragm and reduce the expansion of the lungs, hormonal changes and the formation of the placenta contribute to an increase in the number of respiratory movements to provide the tissues of both organisms with oxygen.

However, during pregnancy, breathing should be carefully assessed so as not to miss a serious pathology behind its seemingly natural increase, which could be anemia, thromboembolic syndrome, progression of heart failure due to a defect in the woman, etc.

One of the most dangerous reasons why a woman may begin to choke during pregnancy is pulmonary embolism. This condition is life-threatening and is accompanied by a sharp increase in breathing, which becomes noisy and ineffective. Asphyxia and death without emergency assistance are possible.

Thus, having considered only the most common causes of difficulty breathing, it becomes clear that this symptom can indicate dysfunction of almost all organs or systems of the body, and in some cases it can be difficult to identify the main pathogenic factor. Patients who have difficulty breathing require a thorough examination, and if the patient is suffocating, emergency qualified assistance is needed.

Any case of shortness of breath requires a trip to the doctor to find out its cause; self-medication in this case is unacceptable and can lead to very serious consequences. This is especially true for breathing problems in children, pregnant women and sudden attacks of shortness of breath in people of any age.

Video: what prevents you from breathing? The program “Live Healthy!”

Dyspnea is a breathing disorder that is accompanied by a change in its frequency and depth. As a rule, breathing during shortness of breath is rapid and shallow, which is a compensatory mechanism ( adaptation of the body) in response to lack of oxygen. Dyspnea that occurs during inhalation is called inspiratory, and shortness of breath during exhalation is called expiratory. It can also be mixed, that is, occur both on inhalation and exhalation. Subjectively, shortness of breath is felt as a lack of air, a feeling of compression of the chest. Normally, shortness of breath may appear in a healthy person, in which case it is called physiological.

Physiological shortness of breath may appear in the following cases:

• as the body’s reaction to excessive physical activity, especially if the body is not constantly exposed to physical activity;
• at high altitudes, where hypoxic conditions are created ( lack of oxygen);
• in confined spaces with an increased number of carbon dioxide (hypercapnia).

Depending on the etiology(reasons for occurrence)shortness of breath can be of the following types:

• cardiac dyspnea;
• pulmonary shortness of breath;
• shortness of breath as a consequence of anemia.

Doctors to contact if you experience shortness of breath include:

• therapist;
• family doctor;
• cardiologist;
• pulmonologist

How does human breathing occur?

The respiratory system consists of the following organs:

• nasal and oral cavity;
• larynx;
• trachea;
• bronchi;
• lungs.

Atmospheric air through airways enters the lungs and further into the pulmonary alveoli. Gas exchange occurs in the alveoli, that is, carbon dioxide is released, and the blood is saturated with oxygen. Next, oxygenated blood is sent to the heart through the pulmonary veins, which drain into the left atrium. From the left atrium blood is flowing into the left ventricle, from where it goes through the aorta to organs and tissues. Caliber ( size) arteries, through which blood is carried throughout the body, moving away from the heart, gradually decreases to capillaries, through the membrane of which gases are exchanged with tissues.

The act of breathing consists of two stages:

• Inhale, in which atmospheric air saturated with oxygen enters the body. Inhalation is an active process that involves the respiratory muscles.
• Exhalation, in which air saturated with carbon dioxide is released. When you exhale, the respiratory muscles relax.

Cardiac dyspnea

Causes of cardiac dyspnea

The most common causes of cardiac dyspnea include:

• heart failure;
• acute coronary syndrome;
• hemopericardium, cardiac tamponade.

In most cases, heart failure develops under such pathological conditions as:

• arterial hypertension;
• IHD ( cardiac ischemia);
• constrictive pericarditis ( inflammation of the pericardium, accompanied by its hardening and impaired heart contraction);
• restrictive cardiomyopathy ( inflammation of the heart muscle with decreased compliance);
• pulmonary hypertension (increased blood pressure in the pulmonary artery);
• bradycardia ( decrease in heart rate) or tachycardia ( increased heart rate) of various etiologies;
• heart defects.

In the early stages of heart failure, shortness of breath may be absent. Further, as the pathology progresses, shortness of breath appears under heavy loads, under light loads, and even at rest.

Symptoms of heart failure associated with shortness of breath are:

• cyanosis ( bluish discoloration of the skin);
• cough, especially at night;
• hemoptysis ( hemoptysis) – expectoration of sputum mixed with blood;
• orthopnea – rapid breathing in a horizontal position;
• nocturia – increased urine formation at night;

Symptoms of acute coronary syndrome are considered to be:

• pain behind the sternum, which can also radiate to the left shoulder, left arm, lower jaw; as a rule, the pain lasts more than 10 minutes;
• shortness of breath, feeling of lack of air;
• feeling of heaviness behind the sternum;
• paleness of the skin;

First aid for symptoms of acute coronary syndrome is sublingual nitroglycerin ( under the tongue), unfastening tight clothing that compresses the chest, supply fresh air and calling an ambulance.

Heart defects
A heart defect is a pathological change in the structures of the heart that leads to impaired blood flow. Blood flow is disrupted in both the systemic and pulmonary circulation. Heart defects can be congenital or acquired. They may concern the following structures - valves, septa, vessels, walls. Congenital heart defects appear as a consequence of various genetic abnormalities and intrauterine infections. Acquired heart defects can occur against the background of infective endocarditis ( inflammation of the inner lining of the heart), rheumatism, syphilis.

Heart defects include the following pathologies:

• ventricular septal defect– this is an acquired heart defect, which is characterized by the presence of a defect in certain parts of the interventricular septum, which is located between the right and left ventricles of the heart;
• patent oval window– a defect in the interatrial septum, which occurs due to the fact that the oval window, which participates in the blood circulation of the fetus, does not close;
• open arterial ( botalls) duct, which in the prenatal period connects the aorta to the pulmonary artery, and must close during the first day of life;
• coarctation of the aorta– heart disease, which manifests itself as a narrowing of the aortic lumen and requires cardiac surgery;
• heart valve insufficiency– this is a type of heart defect in which complete closure of the heart valves is impossible and reverse flow of blood occurs;
• heart valve stenosis characterized by narrowing or fusion of the valve leaflets and disruption of normal blood flow.

The most common symptoms of heart defects are:

• dyspnea;
• cyanosis of the skin;
• pale skin;
• loss of consciousness;
• retardation in physical development;

Heart defects are diseases that can be alleviated with the help of therapeutic methods, however, it can only be completely cured through surgery.

Cardiomyopathy
Cardiomyopathy is a disease characterized by damage to the heart and manifests itself as hypertrophy ( increase in the volume of cardiac muscle cells) or dilatation ( increase in the volume of the heart chambers).

There are two types of cardiomyopathies:

• primary (idiopathic), the cause of which is unknown, but it is assumed that these may be autoimmune disorders, infectious factors ( viruses), genetic and other factors;
• secondary, which appears against the background of various diseases ( hypertension, intoxication, coronary heart disease, amyloidosis and other diseases).

The most common manifestations of cardiomyopathy are considered to be:

• shortness of breath;
• cough;
• pale skin;
• increased fatigue;
• increased heart rate;
• dizziness.

Myocarditis
Myocarditis is damage to the myocardium ( heart muscle) predominantly inflammatory in nature. Symptoms of myocarditis are shortness of breath, chest pain, dizziness, and weakness.

Among the causes of myocarditis are:

• Bacterial and viral infections more often than other causes cause infectious myocarditis. The most common causative agents of the disease are viruses, namely the Coxsackie virus, measles virus, and rubella virus.
• Rheumatism, in which myocarditis is one of the main manifestations.
• Systemic diseases such as systemic lupus erythematosus, vasculitis ( inflammation of the walls of blood vessels) lead to myocardial damage.
• Taking certain medications ( antibiotics), vaccines, serums can also lead to myocarditis.

Pericarditis
Pericarditis is an inflammatory lesion of the pericardium ( pericardial sac). The causes of pericarditis are similar to the causes of myocarditis. Pericarditis manifests itself as prolonged chest pain ( which, unlike acute coronary syndrome, do not improve with nitroglycerin), fever, severe shortness of breath. With pericarditis, due to inflammatory changes in the pericardial cavity, adhesions can form, which can then grow together, which significantly complicates the functioning of the heart.

With pericarditis, shortness of breath often occurs in a horizontal position. Shortness of breath with pericarditis is a constant symptom and it does not disappear until the cause is eliminated.

Cardiac tamponade
Cardiac tamponade is a pathological condition in which fluid accumulates in the pericardial cavity and hemodynamics are disrupted ( movement of blood through vessels). The fluid that is in the pericardial cavity compresses the heart and limits heart contractions.

Cardiac tamponade can appear as acutely ( for injuries), and for chronic diseases ( pericarditis). It manifests itself as painful shortness of breath, tachycardia, and decreased blood pressure. Cardiac tamponade can cause acute heart failure and shock. This pathology is very dangerous and can lead to complete cessation of cardiac activity. Therefore, timely medical intervention is of utmost importance. As an emergency, pericardial puncture and removal of pathological fluid are performed.

Diagnosis of cardiac dyspnea

The following methods are used to diagnose shortness of breath:

• physical examination ( conversation with the patient, examination, palpation, percussion, auscultation);
• ultrasonography (transesophageal, transthoracic);
• X-ray examination of the chest organs;
• CT ( CT scan);
• MRI ( );
• ECG ( electrocardiography), ECG monitoring;
• cardiac catheterization;
• bicycle ergometry.

When collecting anamnesis, you need to pay attention to the following information:

• Characteristics of shortness of breath, which can be on inspiration, on expiration or mixed.
• The intensity of shortness of breath may also indicate a certain pathological condition.
• Hereditary factor. The likelihood of heart disease if your parents had it is several times higher.
• Availability of various chronic diseases hearts.
• You should also pay attention to the time at which shortness of breath appears, its dependence on body position and physical activity. If shortness of breath appears during physical activity, it is necessary to clarify the intensity of the exercise.

Cardiac percussion provides information about an increase in the boundaries of the heart, which occurs due to the phenomena of hypertrophy or dilatation. Normally, percussion produces a dull sound. Changes and shifts in the boundaries of cardiac dullness indicate cardiac pathologies or pathologies of other mediastinal organs.

The next step in examining the patient is auscultation ( listening). Auscultation is performed using a phonendoscope.

Using cardiac auscultation, the following changes can be determined:

• weakening of the sonority of heart sounds ( myocarditis, myocardial infarction, cardiosclerosis, valve insufficiency);
• increased sonority of heart sounds ( atrioventricular orifice stenosis);
• split heart sounds ( mitral stenosis, non-simultaneous closure of the bicuspid and tricuspid valves);
• pericardial friction rub ( dry or effusion pericarditis, after myocardial infarction);
• other noises ( with valve insufficiency, orifice stenosis, aortic stenosis).

In a general blood test for cardiac pathologies, changes in the following indicators are of interest:

• Hemoglobin is a component of red blood cells that is involved in oxygen transport. If the hemoglobin level is low, this indirectly indicates that there is a lack of oxygen in the tissues, including the myocardium.
• Leukocytes. White blood cells may be elevated in the event of an infectious process in the body. An example is infective endocarditis, myocarditis, pericarditis. Sometimes leukocytosis ( increased white blood cell count) is observed during myocardial infarction.
• Red blood cells often reduced in patients with chronic heart disease.
• Platelets participate in blood clotting. An increased number of platelets can occur due to blockage of blood vessels; when the level of platelets decreases, bleeding is observed.
• ESR () is a nonspecific factor in the inflammatory process in the body. An increase in ESR occurs with myocardial infarction, with infectious lesion heart, rheumatism.

To diagnose the causes of cardiac dyspnea, the following biochemical parameters are analyzed:

• Lipidogram, which includes such indicators as lipoproteins, cholesterol, triglycerides. This indicator indicates a disturbance in lipid metabolism, the formation of atherosclerotic plaques, which, in turn, are a factor leading to most heart diseases.
• AST (aspartate aminotransferase). This enzyme is found in large quantities in the heart. Its increase indicates the presence of damage to the muscle cells of the heart. As a rule, AST is elevated during the first day after myocardial infarction, then its level may be normal. By how much the AST level is increased, one can judge the size of the area of ​​necrosis ( cell death).
• LDH (lactate dehydrogenase). For the analysis of cardiac activity, the total level of LDH, as well as the fractions of LDH-1 and LDH-2, are important. An increased level of this indicator indicates necrosis in the muscle tissue of the heart during myocardial infarction.
• KFC (creatine phosphokinase) is a marker of acute myocardial infarction. Also, CPK can be increased with myocarditis.
• Troponin is a protein that is an integral part of cardiomyocytes and is involved in heart contraction. An increase in troponin levels indicates damage to myocardial cells during acute myocardial infarction.
• Coagulogram (blood clotting) indicates the risk of blood clots and pulmonary embolism.
• Acid phosphatase increases in patients with myocardial infarction with severe course and complications.
• Electrolytes (K, Na, Cl, Ca) increase with cardiac arrhythmia or cardiovascular failure.

If cardiac shortness of breath is suspected, an x-ray examination is one of the most important and informative.

X-ray signs that indicate cardiac pathology and pathology of the heart vessels are:

• Heart sizes. An increase in heart size may occur with myocardial hypertrophy or chamber dilatation. This can occur with heart failure, cardiomyopathy, hypertension, coronary heart disease.
• Shape, configuration of the heart. You may notice an enlargement of the heart chambers.
• Saccular protrusion of the aorta due to aneurysm.
• Accumulation of fluid in the pericardial cavity during pericarditis.
• Atherosclerotic lesion of the thoracic aorta.
• Signs of heart defects.
• Congestion in the lungs, hilar infiltration in the lungs in heart failure.

CT scan of the heart and blood vessels
CT scan– this is a layer-by-layer research method internal organs using X-rays. CT is an informative method that allows you to detect various pathologies heart, and also allows you to determine possible risk IHD ( cardiac ischemia) according to the degree of calcification ( deposition of calcium salts) coronary arteries.

Computed tomography can detect changes in the following structures of the heart:

• condition of the coronary arteries - the degree of calcification of the coronary arteries ( by volume and mass of calcifications), coronary artery stenosis, coronary bypass grafts, coronary artery anomalies;
• aortic diseases – aortic aneurysm, aortic dissection; measurements necessary for aortic replacement can be taken;
• condition of the heart chambers – fibrosis ( connective tissue proliferation), ventricular dilatation, aneurysm, thinning of the walls, presence of space-occupying formations;
• changes in the pulmonary veins - stenosis, abnormal changes;
• CT can detect almost all heart defects;
• pericardial pathologies – constrictive pericarditis, pericardial thickening.

An MRI allows you to obtain the following information:

• assessment of heart and valve functions;
• degree of myocardial damage;
• thickening of the myocardial walls;
• heart defects;
• pericardial diseases.

MRI is contraindicated in the presence of a pacemaker or other implants ( prosthetics) with metal parts. The main advantages of this method are its high information content and the absence of radiation to the patient.

Ultrasonography
Ultrasound is a method of examining internal organs using ultrasonic waves. Ultrasound is also one of the leading methods for diagnosing heart diseases.

Ultrasound has a number of significant advantages:

• non-invasiveness ( no tissue damage);
• harmlessness ( no radiation);
• low cost;
• quick results;
• high information content.

The following types are used to diagnose cardiac pathologies: ultrasound examination:

• Transthoracic echocardiography. In transthoracic echocardiography, the ultrasound transducer is placed on the surface of the skin. Different images can be obtained by changing the position and angle of the sensor.
• Transesophageal ( transesophageal) echocardiography. This type of echocardiography allows you to see what may be difficult to see with transthoracic echocardiography due to the presence of obstructions ( fatty tissue, ribs, muscles, lungs). In this test, the probe passes through the esophagus, which is key because the esophagus is in close proximity to the heart.

ECG
An electrocardiogram is a method of graphically recording the electrical activity of the heart. ECG is an extremely important research method. With its help, you can detect signs of cardiac pathology and signs of a previous myocardial infarction. An ECG is performed using an electrocardiograph, the results are given immediately on the spot. A qualified doctor then conducts a thorough analysis ECG results and draws conclusions about the presence or absence of characteristic signs of pathology.

An ECG is done both once and so-called daily ECG monitoring is carried out ( according to Holter). This method uses continuous ECG recording. At the same time, physical activity, if any, and the appearance of pain are recorded. Usually the procedure lasts 1 – 3 days. In some cases, the procedure lasts much longer - months. In this case, sensors are implanted under the skin.

Cardiac catheterization
The most commonly used method is Seldinger cardiac catheterization. The progress of the procedure is monitored by a special camera. Local anesthesia is first performed. If the patient is restless, a sedative may also be administered. A special needle is used to puncture the femoral vein, then a guide is installed along the needle, which reaches the inferior vena cava. Next, a catheter is placed on the guidewire, which is inserted into the right atrium, from where it can be inserted into the right ventricle or pulmonary trunk, and the guidewire is removed.

Cardiac catheterization allows you to:

• accurate measurement of systolic and diastolic pressure;
• oximetry analysis of blood obtained through a catheter ( determination of blood oxygen saturation).

Coronary angiography
Coronary angiography is a method for studying coronary ( coronary) heart arteries using x-rays. Coronary angiography is performed using catheters through which contrast agent. After administration, the contrast agent completely fills the lumen of the artery, and with the help of an X-ray machine, several images are taken in different projections, which allow us to assess the condition of the vessels.

Bicycle ergometry ( ECG with stress)
Bicycle ergometry is a research method that is performed using a special installation - a bicycle ergometer. A bicycle ergometer is a special type of exercise machine that can accurately dose physical activity. The patient sits on a bicycle ergometer, on his hands and feet ( possibly on the back or shoulder blades) the electrodes are fixed, with the help of which the ECG is recorded.

The method is quite informative and allows you to assess the body’s tolerance to physical activity and establish an acceptable level of physical activity, identify signs of myocardial ischemia, evaluate the effectiveness of treatment, and determine the functional class of exertional angina.

Contraindications to bicycle ergometry are:

• acute myocardial infarction;
• pulmonary embolism;
• unstable angina;
• late stages of pregnancy;
• 2nd degree atrioventricular block ( disruption of the conduction of electrical impulses from the atria to the ventricles of the heart);
• other acute and severe diseases.

Treatment of cardiac dyspnea

Both pharmaceuticals and surgical interventions, as well as traditional medicine, can be used in treatment. In addition to the basic course of treatment, adherence to diet, daily routine and lifestyle adjustments are very important. It is recommended to limit excessive physical activity, stress, and treat heart disease and the risk factors leading to it.

Treatment of cardiac dyspnea is etiopathogenetic, that is, it is aimed at the causes and mechanism of its occurrence. Thus, to eliminate cardiac dyspnea, it is necessary to combat heart disease.

Groups of drugs used in the treatment of cardiac dyspnea

Traditional methods for treating shortness of breath include the following:

• Hawthorn normalizes blood circulation, has a tonic effect, hypotonic effect, lowers cholesterol levels. You can make tea, juice, infusion, and balm from hawthorn.
• Fish fat Helps reduce heart rate and helps prevent heart attacks.
• Mint, lemon balm have a calming, vasodilating, hypotensive, anti-inflammatory effect.
• Valerian It is used for strong palpitations, heart pain, and has a calming effect.
• Calendula helps with tachycardia, arrhythmia, hypertension.

Surgical methods for treating cardiac dyspnea include the following procedures:

• Coronary artery bypass surgery is an operation whose purpose is to restore normal blood flow in the coronary arteries. This is done with the help of shunts, which allow you to bypass the affected or narrowed section of the coronary artery. To do this, a section of a peripheral vein or artery is taken and sutured between the coronary artery and the aorta. Thus, blood flow is restored.
• Valve replacement, valve restoration- this is the only type of operation with which you can radically ( fully) eliminate heart defects. Valves can be natural ( biological material, human or animal) and artificial ( synthetic materials, metals).
• Pacemaker- This is a special device that supports cardiac activity. The device consists of two main parts - a generator of electrical impulses and an electrode that transmits these impulses to the heart. Pacing can be external ( however, this method is now rarely used) or internal ( implantation of a permanent pacemaker).
• Heart transplant. This method is the most extreme and, at the same time, the most difficult. Heart transplantation is performed at a time when it is no longer possible to cure the disease and maintain the patient’s condition using any other methods.

Pulmonary dyspnea

Causes of pulmonary dyspnea

Conditions that most often lead to pulmonary dyspnea:

• pneumothorax;
• hemothorax;
• pulmonary embolism;
• aspiration.

The most common causes of COPD are the following:

• Smoking. 90% of COPD cases are caused by smoking ( this includes passive smoking );
• Pollution of atmospheric and indoor air with various harmful substances (dust, pollution by substances emitted by street transport and industrial enterprises);
• Recurrent ( frequently repeated) infections bronchi and lungs often lead to exacerbation and progression of COPD;
• Frequent infections respiratory tract in childhood.

The main symptoms of COPD are:

• Cough It rarely appears in the early stage and becomes chronic as the disease progresses.
• Sputum initially allocated to small quantities, then its quantity increases, it becomes viscous and purulent.
• Dyspnea- this is the latest symptom of the disease, it can appear several years after the onset of the disease, at first it appears only during intense physical exertion, then appears during normal exercise. Shortness of breath is usually mixed type, that is, both on inhalation and exhalation.

Bronchial asthma
Bronchial asthma is a chronic inflammatory disease of the respiratory tract, which is characterized by periodic attacks of breathlessness. The number of asthma patients is about 5–10% of the population.

The causes of bronchial asthma include:

• hereditary factor, which occurs in approximately 30% of cases;
• allergic substances in the environment ( pollen, insects, mushrooms, animal hair);
• professional factors in the workplace ( dust, harmful gases and fumes).

The most characteristic manifestations of bronchial asthma are:

• periodic occurrence of episodes of shortness of breath;
• cough;
• feeling of discomfort in the chest;
• the appearance of sputum;
• panic.

Emphysema
Emphysema is an irreversible expansion of the air space of the distal bronchioles as a result of destructive changes in their alveolar walls.

Among the causes of pulmonary emphysema, there are 2 main factors:

• COPD;
• alpha-1 antitrypsin deficiency.

The main symptoms of emphysema are:

• dyspnea;
• sputum;
• cough;
• cyanosis;
• “barrel” chest;
• expansion of intercostal spaces.

Pneumonia
Pneumonia is an acute or chronic inflammation of the lungs that affects the alveoli and/or interstitial tissue of the lungs. Every year, about 7 million cases of pneumonia worldwide result in death.

Pneumonia is predominantly caused by various microorganisms and is an infectious disease.

The most common pathogens that cause pneumonia are the following:

• Pneumococcus;
• respiratory viruses ( adenovirus, influenza virus);
• legionella.

The most characteristic symptoms of pneumonia are the following:

• acute onset with fever;
• cough with copious discharge sputum;
• dyspnea;
• headache, weakness, malaise;
• chest pain.

Pneumothorax
Pneumothorax is the accumulation of air in the pleural cavity. Pneumothorax can be open or closed, depending on the presence of communication with the environment.

Pneumothorax may occur in the following cases:

• Spontaneous pneumothorax which occurs most often. Typically, spontaneous pneumothorax is caused by rupture of blisters during emphysema.
• Injury– penetrating ( penetrating) chest injuries, rib fractures.
• Iatrogenic pneumothorax (related to medical care) – after pleural puncture, chest surgery, catheterization of the subclavian vein.

Clinical manifestations of pneumothorax are:

• stabbing pain in the affected part of the chest;
• dyspnea;
• asymmetrical movements of the chest;
• pale or bluish discoloration of the skin;
• coughing attacks.

Hemothorax appears as a consequence of the following factors:

• injuries ( penetrating chest wounds, closed injuries);
• medical procedures ( after surgery, puncture);
• pathologies ( tuberculosis, cancer, abscess, aortic aneurysm).

Symptoms characteristic of hemothorax are:

• pain in the chest that gets worse when coughing or breathing;
• dyspnea;
• forced sitting or semi-sitting position ( to alleviate the condition);
• tachycardia;
• pale skin;
• fainting.

Pulmonary embolism
Pulmonary embolism is a blockage of the lumen of the pulmonary artery by emboli. An embolus may be a thrombus ( most common cause of embolism), fat, tumor tissue, air.

Clinically, pulmonary embolism is manifested by the following symptoms:

• shortness of breath ( most common symptom);
• tachycardia;
• severe chest pain;
• cough, hemoptysis ( hemoptysis);
• fainting, shock.

Pulmonary embolism can lead to pulmonary infarction, acute respiratory failure, instant death. In the initial stages of the disease, with timely medical care, the prognosis is quite favorable.

Aspiration
Aspiration is a condition characterized by the penetration of foreign bodies or liquid into the respiratory tract.

Aspiration is manifested by the following symptoms:

• expiratory shortness of breath;
• sharp cough;
• suffocation;
• loss of consciousness;
• noisy breathing, audible at a distance.

Diagnosis of pulmonary dyspnea

Diagnosis of pulmonary dyspnea is carried out using the following methods:

• physical examination;
• general blood analysis;
• general urine analysis;
• biochemical analysis blood;
• determination of the level of D-dimers in the blood;
• chest x-ray;
• CT, MRI;
• scintigraphy;
• pulse oximetry;
• body plethysmography;
• spirometry;
• sputum examination;
• bronchoscopy;
• laryngoscopy;
• thoracoscopy;
• Ultrasound of the lungs.

When collecting anamnesis, the following factors are of great importance:

• age;
• presence of chronic pulmonary diseases;
• conditions at the workplace, since a large number of pulmonary diseases occur due to inhalation of harmful substances and gases during work;
• smoking is an absolute risk factor for pulmonary diseases;
• decreased immunity ( protective forces body), when the body is unable to fight pathogenic factors;
• heredity ( bronchial asthma, tuberculosis, cystic fibrosis).

When examining a patient, pay attention to the following details:

• Skin color. Skin color may be pale or bluish, reddish ( hyperemia).
• Forced position. With pleural effusion, lung abscess ( unilateral lesions) the patient tries to lie on the affected side. During an attack of bronchial asthma, the patient sits or stands and leans on the edge of a bed, table, or chair.
• Chest shape. A “barrel-shaped” chest can be caused by emphysema. Asymmetrical chest occurs with unilateral lesions.
• Fingers shaped like drumsticks appear with prolonged respiratory failure.
• Breathing characteristics– increase or decrease in the frequency of respiratory movements, shallow or deep, arrhythmic breathing.

After palpation, begin percussion ( tapping). During percussion, the lower border of the lungs and the apex of the lung are determined, and the percussion sound on the right and left is compared. Normally, the percussion sound in the area where the lungs are located is ringing and clear. With pathological changes, a clear pulmonary sound is replaced by a tympanic, dull, box sound.

Auscultation of the lungs is performed while sitting or standing. In this case, the main respiratory sounds are heard, additional ( pathological) breath sounds ( rales, crepitus, pleural friction rub).

General blood analysis
In a general blood test, there are a number of indicators that are characterized by changes in pulmonary diseases.

A complete blood count provides the following information important for diagnosing shortness of breath:

• Anemia– in pulmonary diseases it is established due to the phenomenon of hypoxia.
• Leukocytosis – purulent diseases lungs, infectious diseases of the respiratory tract ( bronchitis, pneumonia).
• Increase in ESR ( erythrocyte sedimentation rate) indicates the presence of inflammatory diseases.

Blood chemistry
A biochemical blood test is a very important method of laboratory research, the results of which make it possible to judge the condition of various organs. Biochemical blood test allows you to detect active and latent diseases, inflammatory processes

For pulmonary diseases, the following biochemical blood test indicators are important:

• Total protein. With diseases of the respiratory system, it often decreases.
• Albumin-globulin ratio, in which changes occur during inflammatory lung diseases, namely, the amount of albumin decreases and the amount of globulins increases.
• SRB ( C-reactive protein ) increases in inflammatory and dystrophic lung diseases.
• Haptoglobin (a protein found in blood plasma that binds hemoglobin) increases in pneumonia and other inflammatory diseases.

D-dimer level
D-dimer is a component of the fibrin protein that is involved in blood clot formation. An increase in D-dimers in the blood indicates the process of excessive thrombus formation, although it does not indicate the exact location of the thrombus. The most common causes of increased D-dimers are pulmonary embolism and malignant neoplasms. If this indicator is normal, pathology cannot be excluded, since there is a possibility of obtaining false negative results.

X-ray of the chest organs
Chest x-ray is the most common x-ray examination method.

The list of diseases detected using radiography is extensive and includes the following:

• pneumonia;
• tumors;
• bronchitis;
• pneumothorax;
• pulmonary edema;
• injuries;
• other.

Diseases of the respiratory system can be detected by the following signs:

• decreased transparency of lung tissue;
• darkening of the pulmonary fields is the main radiological sign of pneumonia ( associated with inflammatory changes in lung tissue), atelectasis;
• increased pulmonary pattern - COPD, tuberculosis, pneumonia;
• expansion of the root of the lung - chronic bronchitis, tuberculosis, expansion of the pulmonary arteries;
• foci of pneumosclerosis in COPD, chronic bronchitis, atelectasis, pneumoconiosis;
• smoothness of the costophrenic angle – pleural effusion;
• a cavity with a horizontal level of fluid is characteristic of a lung abscess.

Thus, using CT and MRI, the following diseases can be diagnosed:

• tumors;
• tuberculosis;
• pneumonia;
• pleurisy;
• enlarged lymph nodes.

The procedure is carried out in two stages:

• Blood supply scintigraphy. A labeled radioactive substance is injected intravenously. When the substance decays, it emits radiation, which is recorded by a camera and visualized on a computer. The absence of radiation indicates the presence of an embolism or other pulmonary disease.
• Ventilation scintigraphy. The patient inhales a radioactive substance, which, along with the inhaled air, spreads through the lungs. If you find an area where gas does not enter, this indicates that something is blocking the flow of air ( tumor, fluid).

Pulse oximetry
Pulse oximetry is a diagnostic method for determining blood oxygen saturation. Normal oxygen saturation should be 95 – 98%. When this indicator decreases, they speak of respiratory failure. The manipulation is carried out using a pulse oximeter. This device is fixed on a finger or toe and calculates the content of oxygenated ( oxygenated) hemoglobin and pulse rate. The device consists of a monitor and a sensor that detects pulsation and provides information to the monitor.

Bodyplethysmography
Body plethysmography is a more informative method compared to spirography. This method allows you to analyze in detail the functional capacity of the lungs, determine the residual lung volume, total lung capacity, functional residual lungs, which cannot be determined with spirography.

Spirometry
Spirometry is a diagnostic method that examines the function of external respiration. The study is carried out using a spirometer. During the examination, the nose is pinched with fingers or with a clamp. To avoid unwanted effects ( dizziness, fainting) it is necessary to strictly follow the rules and constantly monitor the patient.

Spirometry can be performed with calm and forced ( reinforced) breathing.

During quiet breathing, vital capacity is determined(vital capacity)and its components:

• expiratory reserve volume ( after taking the deepest breath possible, take the maximum deep exhale );
• inspiratory volume ( after exhaling as deeply as possible deep breath ).

With forced breathing, FVC is determined ( forced vital capacity). To do this, exhale calmly, inhale as deeply as possible, and then immediately exhale as deeply as possible without pause. FVC decreases with pathology of the pleura and pleural cavity, obstructive pulmonary diseases, and disturbances in the functioning of the respiratory muscles.

Sputum analysis
Sputum is a pathological discharge secreted by the glands of the bronchi and trachea. Normally, these glands produce a normal secretion, which has bactericidal effect, helps in releasing foreign particles. With various pathologies of the respiratory system, sputum is formed ( bronchitis, tuberculosis, lung abscess).

Before collecting material for research, it is recommended to drink a large volume of water 8–10 hours in advance.

Sputum analysis includes the following points:

• Initially, the characteristics of sputum are analyzed ( content of mucus, pus, blood, color, smell, consistency).
• Then microscopy is performed, which informs about the presence of various formed elements in the sputum. Microorganisms can be detected.
• Bacteriological analysis is carried out to detect microorganisms that may cause infection.
• Determination of sensitivity to antibiotics ( antibiogram) allows you to find out whether the detected microorganisms are sensitive or resistant to antibacterial drugs, which is very important for adequate treatment.

Using bronchoscopy, the mucous membrane of the trachea and bronchi is examined ( even the smallest branches). This is the most suitable method for visualizing the inner surface of the bronchi. Bronchoscopy allows you to assess the condition of the mucous membrane of the respiratory tract, identify the presence of inflammatory changes and the source of bleeding, take material for a biopsy, and remove foreign bodies.

Preparation for bronchoscopy consists of the following:

• the last meal should be 8 hours before the procedure to prevent aspiration of gastric contents in case of possible vomiting;
• Before the procedure, premedication is recommended ( pre-administration of drugs);
• conducting a detailed blood test and coagulogram before the procedure;
• It is recommended not to drink liquids on the day of the test.

• local anesthesia of the nasopharynx is performed;
• the bronchoscope is inserted through the nose or mouth;
• the doctor gradually examines the condition of the mucous membrane as the device is introduced;
• if necessary, material is taken for a biopsy, a foreign body is removed, or other necessary medical procedure;
• At the end of the procedure, the bronchoscope is removed.

Laryngoscopy
Laryngoscopy is a research method in which the larynx is examined using special apparatus, which is called a laryngoscope.

There are two methods for performing this manipulation:

• Indirect laryngoscopy. This method is currently considered outdated and is used quite rarely. The idea is to insert a special small mirror into the oropharynx and visualize the mucous membrane using a reflector that illuminates it. To avoid gagging, local spraying with an anesthetic solution is carried out ( pain reliever).
• Direct laryngoscopy. This is a more modern and informative research method. There are two options – flexible and rigid. In flexible laryngoscopy, the laryngoscope is inserted through the nose, the larynx is examined, and then the device is removed. Rigid laryngoscopy is a more complex method. During this procedure, it is possible to remove foreign bodies and take material for a biopsy.

Thoracoscopy has several advantages:

• low-injury;
• information content
• manipulation can be carried out before open operations to argue for the need for one or another type of treatment.

However, there are a number of lung diseases that can be diagnosed using ultrasound:

• accumulation of fluid in the pleural cavity;
• lung tumors;
• lung abscess;
• pulmonary tuberculosis.

Treatment of pulmonary dyspnea

Treatment of pulmonary dyspnea is carried out using the following methods:

• Therapeutic, which includes medications and non-drug therapy.
• Surgical method.

Non-drug therapy for pulmonary dyspnea includes:

• rejection of bad habits ( primarily from smoking);
• breathing exercises;
• active immunization against pneumococcus, influenza virus;
• rehabilitation of chronic foci of infection.

Drug therapy

If other treatment methods are ineffective, surgical methods of treatment are resorted to. In some cases, surgery is the only chance for a patient’s recovery.

Surgical methods for treating pulmonary dyspnea include:

• Pleural puncture (thoracentesis) is a puncture of the pleural cavity. The pleural cavity is located between the two layers of the pleura. The puncture is performed in a sitting position. A place for puncture is selected, disinfected, then done local anesthesia novocaine solution ( if there is no allergic reaction to it). After this, an injection is given in this area; when a feeling of failure is felt, this means that the parietal pleura has been punctured and the manipulation is successful. Next, the syringe plunger is pulled and the liquid is evacuated ( blood, pus, effusion). It is not recommended to pull out a large amount of liquid at one time, as this is fraught with complications. After removing the needle, the puncture site is treated with an antiseptic and a sterile bandage is applied.
• Thoracotomy is an operation in which open access to the chest organs is performed through opening the chest wall.
• Drainage of the pleural cavity (Bülau drainage) is a manipulation to remove fluid and air from the pleural cavity using drainage.
• Surgical reduction of lung volume. The part of the lungs damaged by emphysema cannot be treated or restored. In this regard, an operation is performed to surgically reduce the volume of the lungs, that is, the non-functional part of the lung is removed so that the less damaged part can function and provide gas exchange.
• Lung transplant. This is a very serious operation that is performed for progressive, chronic fibrosing lung diseases. Transplantation is a radical surgical method that consists of completely or partially replacing the diseased lungs of a sick person with healthy ones taken from a donor. Transplantation, despite the complexity of its implementation and postoperative therapy, significantly increases the length and quality of life of the patient.

Anemia as a cause of shortness of breath

Causes of anemia

Nutritional deficiencies most often occur for the following reasons:

• vegetarian diets;
• long-term diets on exclusively dairy products;
• poor quality nutrition among low-income populations.

A lack of iron in the body causes disturbances in the formation of hemoglobin, which binds and transports oxygen to tissues. Thus, tissue hypoxia and corresponding symptoms develop. Anemia associated with a lack of iron is called iron deficiency and is the most common.

Malabsorption nutrients
In some cases, the necessary nutrients are present in the required quantities in the diet, but due to certain pathologies they are not absorbed in the gastrointestinal tract.

Malabsorption of nutrients most often occurs in the following cases:

• malabsorption syndrome ( nutrient malabsorption syndrome);
• gastrectomy ( removal of part of the stomach);
• resection of the proximal part of the small intestine;
• chronic enteritis ( chronic inflammation of the small intestine).

These periods include:

• teenage years;
• pregnancy;

Anemia as a result of massive blood loss can result from:

• injuries;
• bleeding in the gastrointestinal tract ( gastric and duodenal ulcers, Crohn's disease, diverticulosis, esophageal varices);
• blood loss during menstruation;
• donation;
• hemostasis disorders.

Drugs that can cause anemia include:

• antibiotics;
• antimalarials;
• antiepileptic drugs;
• antipsychotic medications.

Tumors
The mechanism of anemia in malignant tumors is complex. In this case, anemia may appear as a result of massive blood loss ( colorectal cancer), lack of appetite ( which, in turn, leads to insufficient intake of nutrients necessary for hematopoiesis into the body), taking antitumor drugs that can lead to suppression of hematopoiesis.

Intoxication
Poisoning with substances such as benzene and lead can also lead to the development of anemia. The mechanism is increased destruction of red blood cells, impaired synthesis of porphyrins, and damage to the bone marrow.

Genetic factor
In some cases, anemia is established as a result of anomalies that occur at the gene level.

Abnormalities that lead to anemia include:

• defect in the red blood cell membrane;
• disruption of hemoglobin structure;
• enzymopathies ( disruption of enzyme systems).

Diagnosis of anemia

General blood count indicators important for diagnosing anemia

To effectively treat anemia, it is necessary to adhere to several principles:

• Treatment of chronic diseases that cause anemia.
• Dieting. A balanced diet with sufficient nutrients necessary for hematopoiesis.
• Taking iron supplements for iron deficiency anemia. Iron supplements are usually given orally, but in rare cases they may be given intravenously or intramuscularly. However, with this administration of the drug there is a risk of developing an allergic reaction, and the effectiveness is lower. Iron preparations include sorbifer, ferrum lek, ferroplex.
• Taking cyanocobalamin ( subcutaneous injections) before normalization of hematopoiesis and after for prevention.
• Stopping bleeding in anemia caused by blood loss with various medications or through surgery.
• Transfusions ( transfusion) blood and its components are prescribed in case of a patient’s serious condition that threatens his life. Reasoned prescription of blood transfusions is necessary.
• Glucocorticoids are prescribed for anemia caused by autoimmune mechanisms ( that is, antibodies are produced against own cells blood).
• Folic acid preparations in tablets.

• increase in hemoglobin level in the third week of treatment;
• increase in the number of red blood cells;
• reticulocytosis on days 7–10;
• disappearance of symptoms of sideropenia ( iron deficiency in the body).

Why does shortness of breath occur during pregnancy?

During pregnancy, shortness of breath occurs for the following reasons:

• Dyspnea as a compensatory mechanism. Shortness of breath appears as a mechanism of the body’s adaptation to the increased need for oxygen during pregnancy. In this regard, changes occur in the respiratory system - the frequency and depth of breathing increases, the work of the respiratory muscles increases, and vital capacity increases ( vital capacity) and tidal volume.
• Hormonal changes in the body also affects the appearance of shortness of breath. For the normal course of pregnancy, changes in the production of hormones occur in the body. So, progesterone ( a hormone that is produced in large quantities by the placenta during pregnancy), stimulating the respiratory center, helps to increase pulmonary ventilation.
• Fetal weight gain. As the weight of the fetus increases, the uterus becomes enlarged. The enlarged uterus gradually begins to put pressure on nearby organs. When pressure begins on the diaphragm, breathing problems begin, which primarily manifest as shortness of breath. Shortness of breath is usually mixed, that is, both inhalation and exhalation are difficult. In about 2–4 weeks, changes occur in the pregnant woman’s body that affect the breathing process. The uterus drops down by 5–6 centimeters, which leads to easier breathing.

Pathological shortness of breath during pregnancy can result from:

• Anemia is a condition that often appears during pregnancy. Due to hemoglobin related disorders ( disruption of synthesis, insufficient intake of iron into the body), oxygen transport to tissues and organs is disrupted. As a result, hypoxemia occurs, that is, low oxygen content in the blood. Therefore, it is especially important to monitor the level of red blood cells and hemoglobin in a pregnant woman to avoid complications.
• Smoking. There are many reasons for shortness of breath when smoking. Firstly, damage occurs to the mucous membrane of the respiratory tract. Also, atherosclerotic plaques accumulate on the walls of blood vessels, which contributes to poor circulation. In turn, impaired blood circulation affects the breathing process.
• Stress is a factor that contributes to an increase in the respiratory rate and heart rate; it is subjectively felt as a lack of air, a feeling of tightness in the chest.
• Respiratory system diseases (bronchial asthma, bronchitis, pneumonia, COPD).
• Diseases of the cardiovascular system (cardiomyopathy, heart disease, heart failure).

• elevated temperature;
• dizziness and loss of consciousness;
• cough;
• pallor or cyanosis;
• headache;
• fatigue and malaise.

Why does shortness of breath occur with osteochondrosis?

Dyspnea with osteochondrosis develops most often for the following reasons:

• Reducing the space between vertebrae. Because of degenerative changes (violations in the structure) of the vertebrae and the spine as a whole, the intervertebral discs gradually become thinner. Thus, the space between the vertebrae is reduced. And this, in turn, contributes to pain, stiffness and shortness of breath.
• Vertebral displacement. With the progressive course of the disease, dystrophic changes ( characterized by cell damage) in tissues can also lead to displacement of the vertebrae. Displacement of different vertebrae can lead to characteristic consequences. Shortness of breath, as a rule, occurs when the first thoracic vertebra is displaced.
• Compression of blood vessels. When the space between the vertebrae decreases or they are displaced, the vessels are compressed. Thus, the blood supply to the diaphragm, which is the main respiratory muscle, becomes problematic. Also, with cervical osteochondrosis, compression of the neck vessels occurs. At the same time, the blood supply to the brain deteriorates, vital centers in the brain are depressed, including the respiratory center, which leads to the development of shortness of breath.
• Pinched or damaged nerve roots can lead to sharp pain, which is accompanied by difficulty breathing and shortness of breath, especially when inhaling. Pain due to osteochondrosis limits breathing movements.
• Deformation ( violation in the structure) chest. Due to the deformation of individual vertebrae or parts of the spinal column, deformation of the chest occurs. In such conditions, breathing becomes difficult. The elasticity of the chest also decreases, which also limits the ability to breathe fully.

To prevent the appearance of shortness of breath during osteochondrosis, you must adhere to the following rules:

• timely diagnosis of osteochondrosis;
• adequate drug treatment;
• physiotherapeutic procedures and massage;
• physiotherapy;
• avoiding prolonged stay in one position;
• matching bed and pillow for quality rest during sleep;
• breathing exercises;
• avoidance sedentary image life;
• avoiding excessive physical activity.

What to do if a child has shortness of breath?

Normally, the frequency of respiratory movements in a child is higher than in adults. There are normal breathing rates for each age group, so don't panic if your child's breathing rate seems elevated. Perhaps this is just the norm for his age. Respiration rate is measured in a calm state, without physical activity or stress preceding the measurement. It is best to measure the respiratory rate while the child is sleeping.

Respiratory rate norms for children of different age groups

If a child experiences shortness of breath, you can contact family doctor, pediatrician, cardiologist, pulmonologist. In order to get rid of shortness of breath in a child, you should find its cause and fight the cause.

Shortness of breath in a child may occur as a result of the following factors:

• rhinitis ( inflammation of the nasal mucosa) can also lead to shortness of breath by making it difficult for air to pass through the airways;
• bronchial asthma, which is manifested by periodic attacks of severe shortness of breath, and the diagnosis of which in childhood is sometimes quite difficult to establish;
• viral diseases (influenza virus, parainfluenza virus, adenovirus);
• heart disease ( heart defects), which in addition to shortness of breath are also manifested by cyanosis and developmental delays in the child;
• lung diseases ( pneumonia, emphysema);
• entry of a foreign body into the respiratory tract is a condition that requires immediate intervention, as this can very quickly lead to fatal outcome;
• hyperventilation syndrome, which manifests itself during stress, panic disorder, hysteria; in this case, the level of carbon dioxide in the blood decreases, which, in turn, contributes to hypoxia;
• cystic fibrosis is a genetic disease characterized by serious disorders of respiration and exocrine glands;
• physical exercise;
• diseases of the immune system;
• hormonal imbalance.

Is it possible to treat shortness of breath using traditional methods?

Traditional medicine has many means and methods for treating shortness of breath, which have different mechanisms of action. Such remedies can be taken in the form of solutions, tinctures, and teas.

The following traditional medicine methods can be used to treat shortness of breath:

• Cranberry infusion. Pour 5 tablespoons of cranberries into 500 ml of boiling water, let it brew for several hours, then add 1 teaspoon of honey. The prepared infusion should be drunk within 24 hours.
• Infusion of wormwood. To prepare the infusion, you need to pour boiling water over 1–2 teaspoons of wormwood and let it brew for half an hour. After the infusion is ready, take 1 teaspoon half an hour before meals 3 times a day.
• Astragalus root infusion prepared on a water basis. To do this, take 1 tablespoon of dried and crushed astragalus root and pour boiling water over it. Then you need to let the mixture brew for several hours. The finished tincture is taken 3 times a day, 3 tablespoons.
• A mixture of honey, lemon and garlic. To prepare the mixture, you need to add 10 peeled and chopped heads of garlic to 1 liter of honey, and also squeeze the juice from 10 lemons. Then you need to tightly close the container in which the mixture is prepared and put it in a dark place for 1 - 2 weeks. After this, the medicine is ready for use. It is recommended to drink 1 teaspoon of this medicine 3 – 4 times a day.
• Infusion of potato sprouts. First you need to dry it well, then chop and grind the raw materials. Dried sprouts are poured with alcohol and infused for 10 days. It is recommended to take the infusion 1 – 3 potassium 3 times a day.
• Motherwort infusion. Pour 1 tablespoon of motherwort into a glass of boiling water, let it brew for an hour, and then drink half a glass 2 times a day.
• Melissa infusion. 2 tablespoons of dried lemon balm leaves are poured with a glass of boiling water and infused for 30 minutes. Take the product 3-4 times a day, 3-4 tablespoons.
• Infusion of hawthorn flowers. To prepare the infusion, pour 1 teaspoon of hawthorn flowers into 1 glass of boiling water and leave for 1 – 2 hours. Once ready, the infusion is taken 3 times a day, 1/3 cup.