Paroxysmal nocturnal dyspnea: Difference between revisions
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| '''Nutritional/Metabolic''' | | '''Nutritional/Metabolic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Hurler syndrome]], [[metabolic acidosis]], [[obesity]] | ||
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| '''Obstetric/Gynecologic''' | | '''Obstetric/Gynecologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Pregnancy]] | ||
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| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Adrenal carcinoma]], [[paraneoplastic syndromes]] | ||
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| '''Psychiatric''' | | '''Psychiatric''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Anxiety]], [[Hurler syndrome]], [[panic disorder]] | ||
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| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Cor pulmonale]], [[emphysema]], [[interstitial lung disease]], [[pulmonary edema]], [[pulmonary embolism]], [[chronic obstructive pulmonary disease|severe chronic obstructive pulmonary disease]], [[pulmonary eosinophilia|tropical pulmonary eosinophilia]] | ||
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| '''Renal/Electrolyte''' | | '''Renal/Electrolyte''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Renal failure]] | ||
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| '''Rheumatology/Immunology/Allergy''' | | '''Rheumatology/Immunology/Allergy''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Myasthenia gravis]], [[paraneoplastic syndromes]] | ||
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|bgcolor="Beige"| No underlying causes | |bgcolor="Beige"| No underlying causes | ||
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===Causes in Alphabetical Order=== | ===Causes in Alphabetical Order=== |
Revision as of 14:14, 14 May 2014
Paroxysmal nocturnal dyspnea |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]
Synonyms and keywords: Cardiac asthma; PND
Overview
Paroxysmal nocturnal dyspnea (PND) 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
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.