SYMPTOMS

What is Dyspnea?

Dyspnea is a subjective sensation of insufficient air, labored breathing, or suffocation, or the patient's subjective feeling of needing to increase respiratory effort.

Objectively, it manifests as changes in respiratory rate, depth, and rhythm, such as rapid breathing, forceful inhalation, or periodic breathing.

The severity of dyspnea can be classified into five levels:

• Grade 0: No dyspnea during routine non-strenuous activities;
• Grade 1, Mild: Dyspnea occurs when walking briskly on level ground or climbing a slight slope;
• Grade 2, Moderate: Walking on level ground is slower than peers due to breathlessness;
• Grade 3, Severe: Must stop to rest after walking 100 meters or a few minutes on level ground;
• Grade 4, Very Severe: Unable to leave home; dyspnea occurs while dressing or undressing.

TREATMENT

How to relieve difficulty breathing?

• If a patient with a history of asthma or COPD experiences worsening difficulty breathing, they can first try inhaling salbutamol aerosol or using inhaled corticosteroids;

• If difficulty breathing occurs when lying flat at night and is relieved by sitting up, they can adopt a sitting position with both legs hanging off the edge of the bed;

• If difficulty breathing is accompanied by sudden chest pain, they can try sublingual nitroglycerin tablets;

• If difficulty breathing is accompanied by chest pain on one side when inhaling, they can take shallow breaths and gently press the painful area with their hand;

• If difficulty breathing is caused by emotional agitation, accompanied by numbness around the mouth and hands, or finger spasms, they can relieve it by taking deep breaths, wearing a mask, or breathing into a paper bag;

• If difficulty breathing occurs after chest trauma, they should bandage and immobilize the area, stay calm, reduce activity, and seek medical attention as soon as possible;

• If difficulty breathing is accompanied by fever or hoarseness, they can try inhaling corticosteroid medications such as Symbicort or Seretide.

It is important to note that if these measures do not relieve the difficulty breathing, or if the condition worsens, they should seek medical attention promptly to determine the underlying cause.

DIAGNOSIS

When should you seek medical attention for difficulty breathing?

Seek immediate medical attention if difficulty breathing is accompanied by one or more of the following conditions:

• Severe difficulty breathing
• Progressively worsening difficulty breathing
• Accompanied by hives
• Accompanied by fever
• Accompanied by sore throat, foreign body sensation in the throat with hoarseness or even loss of voice
• Difficulty breathing after choking while eating
• Accompanied by coughing up blood
• Accompanied by persistent chest pain
• Difficulty breathing after exposure to toxic gases or food
• Difficulty breathing after trauma
• Difficulty breathing after acupuncture
• Asthma or COPD patients not relieved by their usual medications
• Coughing up pink frothy sputum that worsens when lying flat
• Difficulty breathing after fractures, especially lower limb fractures

POTENTIAL DISEASES

What are the possible causes of difficulty breathing?

• Respiratory diseases:
  Retropharyngeal abscess, foreign bodies in the larynx and trachea, laryngeal edema, laryngeal diphtheria, laryngeal cancer, acute bronchiolitis, pneumonia, tuberculosis, bronchial asthma, allergic bronchopulmonary aspergillosis, pneumoconiosis, hypersensitivity pneumonitis, interstitial pneumonia, nodular lesions, allergic granulomatous angiitis, pulmonary alveolar proteinosis, COPD, obstructive atelectasis, acute lung injury, acute respiratory distress syndrome, hepatopulmonary syndrome, pneumothorax, massive pleural effusion, acute mediastinitis, chronic fibrous mediastinitis, mediastinal tumors, mediastinal emphysema, respiratory muscle and diaphragmatic paralysis, pulmonary embolism, etc.;
• Cardiovascular diseases: Acute pulmonary edema, heart failure, arrhythmia, pericardial effusion, etc.;
• Hematological diseases: Severe anemia, massive hemorrhage or shock, etc.;
• Neurological, psychiatric, and myopathic diseases: Severe brain diseases, hysteria, hyperventilation syndrome, myasthenia gravis, etc.;
• Poisoning: Carbon monoxide poisoning, cyanide poisoning, nitrite poisoning, aniline poisoning, organophosphate poisoning, morphine poisoning, barbiturate poisoning, etc.