Hype: What is it? Characteristics, Causes and Associated Disorders of G.Bertelli

Generality

Breathlessness is a feeling of difficulty in breathing, completely subjective, which manifests and is described by the patient in a different way depending on the cause.

The main reason why it arises is attributable to the discrepancy between the body's oxygen demand and the ability to respond to this input . Therefore, wheezing can depend, first of all, on dysfunctions of the lungs and / or the heart, organs that supply the body with oxygen respectively through gas exchange and blood circulation .

In most cases, wheezing is a symptom that results from diseases of the respiratory system (lung diseases) or from heart disease. However, there are other conditions associated with this manifestation, such as neurological, musculoskeletal, endocrine, hematologic and psychiatric. Breathing also occurs in healthy subjects during intense physical activity, due to the hyperventilation evoked by the same effort.

Generally, treatment is aimed at the underlying disease. For this reason, the diagnostic procedure for framing the causes of breathlessness must be as complete as possible.

What's this

What is meant by Affanno?

Wheezing is the unpleasant sensation of air hunger or difficult breathing . This symptom can occur suddenly or, as happens in chronic diseases of various origins, gradually.

When it occurs after a period of intense sporting activity, wheezing is generally a mild and transient problem. The wheezing becomes "abnormal" in unexpected situations or in the course of respiratory diseases, cardio-vascular or other origin.

Terminology and synonyms of Affanno

Breathing is defined, in medical terms, as dyspnea . This consists in a difficulty breathing, forced and accompanied by a subjective suffering.

The breathlessness is felt differently by those who suffer from it; most commonly, the feeling is described as:

• Difficult breathing;
• Shortness of breath;
• Air hunger;
• Struggle to breathe;
• Sense of weight on the chest;
• Inability to take a deep breath.

Causes and Risk Factors

Premise

Breathing allows the body's cells to supply the oxygen necessary for their functioning and to eliminate carbon dioxide, a waste product of metabolic activity. Moreover, this activity allows the regulation of the acid-alkaline balance. For this reason, it is not surprising that many disorders affect breathing, especially those that involve the heart, lungs and brain (the organ that supervises).

Wheezing is a manifestation that arises:

• Following an increase in respiratory work

or

• When they are stimulated :
  • The respiratory centers located in the brain stem : the breath is regulated by groups of neurons that function independently of the control of the subject's will; these are located in a structure of the central nervous system, below the hemispheres of the brain (trunk of the brain). When the function of these neurons is compromised, breathing can be affected. The appearance of breathlessness can therefore be the consequence of: inflammation, infections, traumas (especially due to road accidents), toxic substances (drugs or drugs based on opium and barbiturates), hypoxia, hypercapnia (accumulation of carbon dioxide in the blood ) and tumors;
  • Receptors located at the level of the upper airways, alveolar and interstitial space, respiratory muscles and chest wall.

Furthermore, breathlessness can be functional in nature ; in this case, it is a compensatory phenomenon implemented for:

• Overcoming an obstacle to regular lung ventilation;
• Meet a body's increased oxygen demand .

The feeling of breathlessness can result from multiple causes . Some are purely physiological, such as, for example, in the last trimester of pregnancy, where the breathing difficulty is a consequence of the increase in the volume of the uterus that presses on the vena cava and on the diaphragm. In other cases, the breathlessness has a pathological origin .

Wheezing: what is it caused by?

Breathing is the key symptom of respiratory tract diseases (especially pulmonary) and of the cardiovascular system.

The most frequent causes include:

• Asthma ;
• Pneumonia ;
• Chronic obstructive pulmonary disease (COPD) ;
• Myocardial ischemia .

However, wheezing can depend on many other conditions, pathological or not. The symptom may present itself as acute or chronic.

Rapid onset wheezing

The breathlessness can manifest itself rapidly, that is, in an acute way and without a precise regularity, as happens in asthma crises or in myocardial infarction. These sudden attacks can lead to suffocation or suffocation.

PULMONARY CAUSES

Wheezing can be caused by obstructive respiratory diseases (ie by an obstructed passage of air in the airways; eg, asthma and suffocation) or restrictive (secondary to an impairment of the entire lung tissue; eg fibrosis and pneumothorax) .

A sudden wheezing can be the consequence of a bronchospasm or an airway hyperreactivity, aroused by the stimulation of the "irritative" receptors of the bronchi, after exposure to specific stimuli, represented, for example, by:

• Allergens;
• Upper respiratory tract infections (colds, flu, parainfluenza syndromes);
• Cold;
• Physical exercise;
• Cigarette smoke;
• Air pollution;
• Prolonged exposure to irritants, chemical or physical.

Sudden wheezing can also result from exposure to toxic substances (eg inhalation of chlorine or hydrogen sulfide) and from inhalation of a foreign body (suffocation).

A respiratory difficulty may appear within a few hours or days (subacute onset), instead, in the presence of pneumonia, pulmonary edema (presence of fluid that hinders the diffusion of oxygen from the lung to the blood) and exacerbation of chronic obstructive pulmonary disease (COPD) .

Even acute asthma crises typically occur with breathlessness, wheezing, coughing and a feeling of constriction. During early childhood, wheezing may result from viral infections responsible for bronchiolitis or croup (laringo-tracheitis).

The breathlessness can arise abruptly even in the event of:

• Bronchitis ;
• Pulmonary embolism ;
• Pneumothorax (air in the pleura);
• Pleural effusion (liquid in the pleura);
• Hemothorax (blood in the pleura);
• Thoracic traumas and rib fractures (note: severe pain and injuries secondary to these pathological events can limit respiratory movements).

The possible causes of wheezing include diaphragm paralysis, which typically causes an acute respiratory crisis.

HEART CAUSES

As for the heart and circulatory system, the most common causes of acute respiratory distress are:

• Ischemia or myocardial infarction ;
• Heart failure .

A sudden onset breathlessness may also depend on:

• Angina ;
• Coronary artery disease ;
• Pericardial effusion or tamponade ;
• Dysfunction or rupture of a papillary muscle .

Wheezing is also found under stress, in patients who lead a sedentary lifestyle, due to muscle and heart weakness due to inactivity; this condition is known as physical deconditioning .

Chronic wheezing

Chronic wheezing occurs in days, weeks or months, so it persists continuously and continuously, as happens, for example, in the case of heart failure or severe respiratory failure .

CARDIO-PULMONARY CAUSES

Wheezing is one of the most common symptoms of chronic respiratory diseases, such as:

• Bronchitis;
• COPD;
• Pulmonary emphysema;
• Asthma;
• Cystic fibrosis;
• Interstitial pneumopathies;
• Primary or metastatic lung tumors.

Heart failure is one of the main causes of chronic shortness of breath. As for the heart, the anxiety is also found in the presence of:

• arrhythmias;
• Valvular disease.

Other causes of breathlessness

A respiratory difficulty of varying degrees can also be caused by diseases affecting other districts.

The breathlessness can derive, for example, from the impairment of the nerve pathways that carry information from the neurons of the brainstem (respiratory centers) to the effector muscles of respiration, such as:

• Multiple sclerosis ;
• Amyotrophic lateral sclerosis .

Other neuromyopathies that can manifest themselves with breathlessness are:

• Spinal cord injury ;
• Myasthenia gravis ;
• Guillain-Barré syndrome ;
• Muscular dystrophy .

Wheezing can also be caused by diseases that cause chest stiffness and / or deformity of the thoracic cage (fibrosis, kyphoscoliosis, pectus excavatum, ankylosing spondyloarthritis, etc.).

Other causes of breathlessness include:

• Metabolic disorders ;
• Obesity ;
• Hyperthyroidism ;
• Anemia ;
• Pregnancy .

When it arises during a more or less intense physical activity and is resolved with rest, the anxiety is called " exertion ". This condition occurs, for example, in some heart diseases, in anemia and in the last trimester of gestation (the fetus in the womb compresses the diaphragm, which is located above the uterus and represents the main breathing muscle) .

Finally, anxiety can be triggered by psychological problems . An accelerated and short breath is one of the most common symptoms reported by people suffering from anxiety, especially when they are going through a period of particular physical or emotional stress. Wheezing can be accompanied by dizziness, excessive sweating, chest pains and palpitations. In less severe cases, this symptom disappears when the reason that causes anxiety is overcome. At other times, the management of breathlessness makes it necessary to use psychotherapy and drugs.

Symptoms and Complications

Breathing manifests as a breathing difficulty of varying degrees, which can be reported by the patient differently depending on the cause.

Wheezing: how does it manifest itself?

Usually, the fastest breath is associated with the feeling of lack of air ; the sufferer is aware of the need to make a greater effort to expand the chest during the inspiratory phase or to expel the air during the expiratory phase.

In addition, the person may perceive the urgent need to inhale before completing the expiratory phase and report a sense of chest tightness .

Wheezing breath: when does it manifest itself?

Wheezing occurs mainly during particular physical activities, since the body produces more carbon dioxide and consumes more oxygen; if the underlying condition worsens, however, this symptom may also occur after a little effort or in resting conditions .

Breathlessness: possible associated disorders

In addition to signs of an increase in respiratory effort, wheezing can occur in association with other symptoms, which vary depending on the cause, such as:

• Dry or productive cough;
• Chest pain;
• Temperature;
• Cyanosis;
• Fatigue;
• Drowsiness.

In patients with breathing difficulties, the following manifestations represent alarm bells, to be promptly brought to the attention of a doctor:

• Shortness of breath at rest ;
• Reduced level of consciousness, agitation or confusion ;
• Chest pain with rapid heart beat (palpitations) ;
• Weight loss ;
• Night sweats .

Diagnosis

Wheezing is a symptom that should not be underestimated, especially if it occurs after a physical effort and when it was not previously detected. In these cases, it is good to consult a doctor to investigate the situation.

Warning! Patients who have wheezing at rest, low level of consciousness or confusion must go to the emergency room immediately, for an emergency assessment.

First of all, the doctor asks the patient to determine:

• Personal and family history (predisposing conditions of breathlessness, possible previous pulmonary or cardiac diseases, familiarity for arterial hypertension, etc.);
• Mode of onset (sudden or gradual);
• Intensity and frequency of breathlessness (situation in which one finds; for how long the patient feels the sensation etc.);
• Symptomatology associated with difficulty breathing (fever, general malaise, edema of the lower limbs, chest pain, etc.);
• Triggering or aggravating factors (such as physical effort necessary to produce breathlessness, colds, exposure to allergens, etc.).

Subsequently, the patient is subjected to an objective examination, centered on the heart and lungs, to direct the execution of instrumental investigations aimed at ascertaining the extent of the breath and to deepen the clinical picture.

The diagnostic path can make use, in particular, of:

• Thoracic radiography;
• Blood tests;
• Electrocardiogram (ECG), to evaluate the possible inadequate blood flow to the heart.
• Fibroscopy of the upper respiratory tract;
• Spirometry;
• Angiography with computed tomography;
• MRI scan.

Treatment

Wheezing: how can you handle it?

Treatment generally depends on the illness that causes breathlessness and can use medications or supportive therapies, such as oxygen supply, respiratory muscle training and body posture education.

In any case, the most appropriate approach must always take into account the individual indications established by the doctor, formulated in relation to the extent of the disorder, the symptoms and the personal needs of the patient.