Paroxysmal nocturnal dyspnea: Difference between revisions
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The experience of PND is often described as awakening suddenly to a feeling that one is suffocating, with wheezing respirations and coughing. It can be quite frightening. | The experience of PND is often described as awakening suddenly to a feeling that one is suffocating, with wheezing respirations and coughing. It can be quite frightening. | ||
==Treatment== | |||
Treatment depends upon the underlying cause. The treatment of [[congestive heart failure]] can be found [[congestive heart failure treatment|here]]. | |||
==See also== | ==See also== | ||
Revision as of 15:58, 4 May 2014
| Paroxysmal nocturnal dyspnea | |
| MeSH | D004418 |
|---|---|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Cardiac asthma; PND
Overview
Paroxysmal nocturnal dyspnea is defined as sudden, severe shortness of breath at night that awakens a person from sleep, often with coughing and wheezing. It is most closely associated with congestive heart failure. PND commonly occurs several hours after a person with heart failure has fallen asleep. PND is often relieved by sitting upright, but not as quickly as simple orthopnea. Also unlike orthopnea, it does not develop immediately upon lying down.
Historical Perspective
It was first described by Charles Lepois in the 1500s.
Pathophysiology
PND is caused by increasing amounts of fluid entering the lung during sleep and filling the small, air-filled sacs (alveoli) in the lung responsible for absorbing oxygen from the atmosphere. This fluid typically rests in the legs (peripheral edema) during the day when the individual is upright. At night, when recumbent for an extended period, this fluid is reabsorbed, increasing total blood volume and blood pressure, leading to pulmonary hypertension in people with underlying heart failure. The consequent pulmonary hypertension leads to the accumulation of fluid in the lungs, or pulmonary edema.
Causes
PND is a symptom of heart failure and other associated conditions such as mitral stenosis, aortic insufficiency, and systemic hypertension.
- Anxiety
- Aortic regurgitation
- Aortic stenosis
- Cardiomyopathies
- Chronic heart failure
- Congenital heart disease
- Mitral stenosis
- Obesity
- Obstructive sleep apnea
- Severe COPD and emphysema
- Tropical pulmonary eosinophilia
Diagnosis
Symptoms
The experience of PND is often described as awakening suddenly to a feeling that one is suffocating, with wheezing respirations and coughing. It can be quite frightening.
Treatment
Treatment depends upon the underlying cause. The treatment of congestive heart failure can be found here.
See also
References
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