Never as in this (long) period has it occurred to us to think, even without having made any particular efforts: Damn, I’m out of breath. Do you want masks, do you want the feeling of discomfort that now takes us when we do not feel protected by the enclosure of the home, do you want the lack of physical exercise that quickly makes you feel tired, the impression of shortness of breath is often felt even between who senior not. It would be nice to be able to immediately understand if it is just a feeling due to a generic state of anxiety or a physical problem, but the distinction is not always easy. Difficulty in breathing, in medical terms dyspnea, can in fact be the indicator of numerous diseases, starting from asthma to anemia.
Psychological component
It is a symptom that can create anxiety, starting a vicious circle, in which a psychological component can be added to any organic disease – he explains Sergio Harari, director of the medical clinic at the San Giuseppe MultiMedica hospital in Milan and professor of internal medicine at the State University of Milan -. This is why it is also necessary to frame the psychological profile of the person, even more so if there is a disparity between the clinical situation and the severity of the shortness of breath. We remind you that dyspnea is a subjective sympton, perceived by the patient who can also ignore any objective respiratory difficulty.
What are the possible causes?
Any acute or chronic cardiopulmonary disease can present with respiratory distress. The most frequent pulmonary causes are bronchial obstruction linked to an asthma attack, pneumothorax, pneumonia and the most severe pulmonary embolism. In most cases, chronic dyspnea is a consequence of chronic respiratory diseases such as chronic obstructive pulmonary disease (Bpco), pulmonary emphysema, asthma, fibrosis or other interstitial diseases, diseases of the pleura and also pulmonary hypertension, a disease of the pulmonary vessels. Numerous cardiovascular diseases can also be accompanied by dyspnea. Although less frequently, shortness of breath can ultimately indicate diseases such as anemia, neuromyopathies (for example myasthenia and ALS), hyperthyroidism, obesity (see also the articles on the following pages, ed).
How to make a first distinction?
Attention must be paid to how the patient describes the situation. Expressions such as “I am short of breath”, “or I feel suffocating”, “I cannot breathe deeply” or “my breathing has become heavy” can help guide the diagnosis. Heavy breathing, for example, invokes a sense of chest tightness that can make you think of asthma. It is also important to understand if and to what extent any anxious component influences shortness of breath. The presence of other symptoms, such as chest pain, palpitations, fever, fatigue, respiratory infections, can also provide valuable information. Once the patient has been visited, more targeted tests are carried out such as: blood tests (to understand if anemia or hyperthyroidism is present); spirometry (allows to diagnose asthma, BPCO and other respiratory diseases and to follow their evolution); chest x-ray (can document pneumonia or other lung tissue diseases); electrocardiogram and echocardiogram if cardiovascular problems are suspected.
How can you intervene?
The treatment to be adopted obviously depends on the causes that cause dyspnea. In many situations, effective and decisive drug therapy, just think of pneumonia. Often the patient’s attention to follow the treatments regularly, as in the case of asthma, is essential to obtain concrete and long-term results.
Covid-19 must now be added to all the possible causes of shortness of breath …
In several cases it has been seen that those attacked by the Coronavirus manifest a phenomenon called “happy hipoxia”, which means that patients do not adequately perceive the severity of their symptoms and the respiratory failure situation they experience. A simple oximeter, also for home use, very useful for objectively monitoring the clinical situation. Below 92% of saturation, in an otherwise healthy subject, it is good to go to a hospital. However, it is always essential to be followed, even during the home phases, by your family doctor. remember that in most cases it is sufficient to take paracetamol to control fever and osteo-muscular pain, as in cases of flu. The use of cortisone and heparins reserved for some particular situations while antibiotics are completely useless. There is a precise ministerial protocol easily available on the web, to which reference can be made.
May 9, 2021 (change May 9, 2021 | 20:28)
© REPRODUCTION RESERVED