Breathlessness

Question 1

What can cause breathlessness ?

Answer 1

HF
Asthma and lung diseases
PE
Angina etc
Hyperventilation syndrome
Anaemia

Question 2

What is V02 max and how is it calculated ?

Answer 2

VO2 max is reached when oxygen consumption remains at steady state despite an increase in workload

Fick equation:
VO2 = CO x (CaO2 – CvO2)

Question 3

What is a V02 max of severe heart failure ?

Answer 3

<10ml/kg/min

Question 4

Did you know that BREATHLESSNESS ≠ HYPOXIA

Answer 4

yeah…now you do

Question 5

What are examples of mechancical restriction/weaknesses which can cause shortness of breath ?

Answer 5

MND
Obesity
Pleural effusion
Guillain-Barre
Hyperventilation
ILD

Question 6

Give examples of different conditions which cause different onsets of breathlessness

Answer 6

Instant
-Pneumothorax
-Pulmonary Embolus

Acute (mins-hours)
-Asthma
-Pneumonia
-Acute MI
-Cardiac Tamponade

Subacute (days)
-Pleural Effusion
-Pulmonary Vasculitis
-SVCO

Chronic (months-years)
-COPD
-ILD
-Pulmonary Hypertension
-Anaemia

Question 7

What is dysfunctional breathing ?

Answer 7

Normally a diagnosis of exclusion
-Very difficult for patients to understand they have symptoms but no ‘physical’ cause for them
-Can be seen on complex physiology testing during exercise - CPET
-Breathing retraining techniques from physiotherapist can be helpful

Question 8

How does dysfunctional breathing present ?

Answer 8

SOB with relatively little activity for many years
Symptoms are there some days but not others
Sometimes gets tingling in hands when breathless
Tests are normal but can be seen on complex physiology testing during exercise - CPET