What is Dyspnea?

Shortness of breath is termed as dyspnea and it is a temporary condition that passes away after a while. This is not an illness if it lasts only for a few minutes and is not a serious condition which requires treatment. It can be described as tightening of the chest or feeling suffocated but this can vary from person to person and the cause. For example a person who has asthma will experience dyspnea through coughing or wheezing and a person suffering from heart issues will experience dyspnea by finding it difficult to breath.  An adult who is about 70 kgs should breathe on an average around 14 breaths in a minute.

Physical exercise, over exertion of the body, obesity, high temperature and high altitude can cause dyspnea. If the shortness of breath occurs due to these reasons it will last for couple of minutes and does not indicate any illness. But if a person is suffering from shortness of breath due to certain factors other than the causes mentioned above, it could signify a serious problem of the lungs or heart which requires medical attention and treatment.

Shortness of breath can cause the following symptoms – pain in the chest or neck, anxiety, fainting, light headedness, wheezing, coughing and chest injury.

The doctor will examine the patient and try to classify dyspnea on basis of its occurrence, whether it occurs when the person is doing some physical activity or while the person is at rest. And the doctor will also study if dyspnes occurs slowly or suddenly. Basis these symptoms the doctor will be in a position to understand the cause of dyspnea and prescribe medications.

Causes of dyspnea:

In most of the cases dyspnea is caused due to some heart or lung illnesses which are – lung cancer, pulmonary edema ( extra fluid in the lungs), pulmonary high blood pressure (high blood pressure in the blood vessels inside the lungs), tuberculosis, heart failure, pericarditis (inflammation of the membrane which is around the heart) , cardiomyopathy (issues with the heart muscles) etc. The heart and lungs are responsible to supply oxygen and remove carbon dioxide from the body. If any of these activities are not performed properly it can cause difficulty in breathing.

The most common factors causing shortness of breath are:
• Asthma
• Chronic Obstructive pulmonary disease (COPD)
• Pneumonia
• Physical deconditioning
• Myocardial ischemia
• Obesity
• Allergies
• Inhalation of a foreign object
• Panic attacks
• Stress

Acute (sudden) shortness of breath could be due to the various factors;

• Pulmonary embolism  which is blood clotting in an artery in the lungs
• Pneumonia
• Low blood pressure
• Heart failure
• Carbon monoxide poisoning
• Asthma
• Rapid blood loss
• Blockage of the upper airway

Chronic shortness of breath i.e breathing difficulty which lasts for few weeks or more could be due to the following factors.

• Asthma
• Dysfunction of the heart
• Interstitial lung problem 
• Obesity
• Chronic obstructive pulmonary disorder

Developing shortness of breath due to physical activity/ over exertion or not being in good physical condition does not require any treatment since this can managed with regular exercise and being healthy .

Signs of Dyspnea:

Some of the signs of dyspnea are;

• Audible heavy breathing

• Flaring of nostrils

• Wheezing

• Anxious and troubled facial expression

• Protruding of the chest or abdomen

• Coughing

• Dizziness

• Chest pain

Medical care for dyspnea:

A person will need immediate medical care if he/she is undergoing the following issues;

• Sudden shortness of breath and unable to function properly

• Shortness of breath along with chest pain, dizziness and nausea

These symptoms can indicate heart attack or pulmonary embolism. 

A person should meet the doctor for treatment if he/she has shortness of breath along with;

• Swelling on feet and ankles

• High temperature, shivering and cough

• Wheezing

• Difficulty in breathing while lying flat

• Or worsening of the breathing problem

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Lifestyle changes to control dyspnea:

Certain lifestyle changes that can control the shortness of breath are;

• Quite smoking as this can reduce the risk of developing heart and lung disorders
• Avoid breathing polluted air as much as possible 
• If the patient is overweight, reduce excessive weight slowly in a systematic manner
• If the patient is suffering from any illness take the necessary medication and treatment and remain healthy
• Consult the doctor and work on a proper treatment plan to be followed if the symptoms get worse
• Avoid high altitudes which is more than 5000 feet, especially if the person has had a past experience of breathing issues in a higher altitude

• If a person makes use of supplemental oxygen equipment, make a regular check to see if the equipment is functioning properly and there is sufficient supply of oxygen.

·        Treatment for dyspnea:

Since the causes and the medical condition of the patient differ, the treatment process will also be different.  For instance if a person is having shortness of breath due to asthma then the doctor will prescribe various inhalers to relive the patient from the breathing issues.

The other treatment options are more for curing the cause rather than dyspnea. For instance if a person has pulmonary embolism disorder, then treatment options available are blood thinners and surgery.

The doctor will suggest the following measures to relieve the patient from dyspnea symptoms;

• Take in extra oxygen
• Sit near a fan
• Reduce the room temperature and breath cooler air
• Breath clear and clean air by opening the window or using a humidifier
• Getting the feel of being in a more open environment by opening the window and letting the fresh air flow in, seeing the outside view or being in a vacant room
• Keep the head elevated while lying on the back by making use of pillows so that the person is almost in a sitting position 
• Practicing techniques to keep the mind away from all the stress like yoga, meditation and relaxation techniques
• Taking pain killers to get relief from pain
• Taking anti anxiety medicines to manage anxiety and stress 

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Can Addison’s disease be fatal?

Adrenal glands are two small glands which are located on top of the kidney. These glands produce many hormones which are required for the normal functioning of the body. Two important hormones which are produced by these glands are cortisol and aldosterone. When the adrenal glands get damaged and do not product sufficient of these two hormones it causes Addison’s diseases. The cortisol hormone controls the body’s reaction to stressful situations and aldosterone hormone is necessary for regulating sodium and potassium in the body.

The Addison’s disease is a rare disorder that affects 1 in 100,000 people. This disease can affect people of any age group and gender. People who have this disease can lead a normal life as long as they take the medication throughout their life without missing any dose. These people must be aware of the risks related to sudden worsening of the symptoms. This situation is called as addisonian crisis and this happens when the cortisol hormone in the body reduces considerably. The addisonian crisis is a medical emergency and can be fatal if not treated promptly.

Symptoms of Addison’s disease:

The signs and symptoms of Addison’s disease are;

·         Muscle pain

·         Fatigue

·         Fainting

·         Skin darkening

·         Loss of appetite or weight loss

·         Reduction in  heart rate

·         Low blood pressure

·         Low blood sugar

·         Salt craving

·         Nausea

·         Vomiting

·         Sores in mouth

·         Irritability

·         Depression

·         Loss of body hair

Some of the symptoms of addisonian crisis are;

·         Confusion

·         Restlessness

·         High fever

·         Sudden pain in lower back, abdomen or legs

If Addisonian crisis if not treated on time with proper medication it can lead to shock and eventually death.

Causes of Addison’s disease:

The Addison’s disease is classified into two types which are - primary adrenal insufficiency and secondary adrenal insufficiency. The doctor will need to first know which type of Addison’s disease the patient is suffering from to provide the right treatment.

Primary Adrenal Insufficiency

Primary adrenal Insufficiency is caused when the adrenal glands get so badly damaged that iit does not produce hormones in the required quantity. This occurs when the immune system attacks the adrenal glands and this is also known as an autoimmune disease. In such a scenario, the immune system of the body attacks a particular organ or part as it mistakes it for a virus, bacteria or some foreign invader.

The other causes of primary adrenal insufficiency are;

·         Infection in the adrenal gland

·         Cancer that spreads to the adrenal glands

·         Tuberculosis

·         Bleeding into the adrenal glands

·         Prolonged administration of glucocorticoids

Secondary Adrenal Insufficiency

Secondary adrenal insufficiency is caused when the pituitary gland which is located in the brain is unable to produce adrenocorticotropic hormone (ACTH). The ACTH stimulates the adrenal cortex to produce its hormones.

This secondary adrenal insufficiency can also occur if a person takes corticosteroid medications prescribed by the doctor. This medication is usually taken to control chronic illnesses like asthma.

People who are at risk of developing Addison’s disease:

A person is more at risk of getting the Addison’s disease in the following cases;

·         Suffering from cancer

·         Taking blood thinners

·         Suffering from chronic illnesses like tuberculosis

·         Has undergone a surgery to remove a part of the adrenal gland

·         Suffering from an autoimmune illness like type 1 diabetes

 

Diagnosing Addison’s disease:

The doctor will make a note of the medical history and the signs or symptoms the patient is suffering from. The doctor will also conduct a physical examination and advice to do certain lab tests to check the potassium and sodium levels in the body. The doctor may also suggest imaging tests and measure the hormone levels.

 Treatment of Addison’s disease:

The treatment of this disease will be basis the cause of the problem. The doctor can suggest some medicines to regulate the adrenal gland. It is very important for the patient to follow the treatment plan by taking the medicines as prescribed by the doctor in the right quantity and right time. If this disease is left untreated it can worsen the symptoms and cause Addisonian crisis which is very fatal.  The doctor will have to then prescribe medication to treat the symptoms of this crisis first so as to avoid any further complications.

The patient may have to take glucocorticoids medicines which are useful to stop the inflammation and improve the health. These medicines have to be continued lifelong without missing any dose.

Hormone replacement may also be suggested to replace the hormones which are not being produced by the adrenal glands.

Apart from medication it is important for patients to manage their stress levels. Certain life events like loss of a loved one or an injury or accident can increase the stress levels and this has an impact on the way the body responds to the medicines take for this disease. The patient must discuss with the doctor on alternate therapies to manage stress levels lie yoga, meditation etc.

Certain other factors that will be beneficial for a patient suffering from Addison’s disease during a medical emergency are;

·    Always keep a medical alert card or bracelet - In cases where the patient is incapacitated, this will help the medical practitioner to know what kind of treatment is required to be given

·        Stock extra medication – In this disease the patient cannot miss even a single dose of medication every day. So it will be a good idea to stock some extra medicines at the work place, vacation homes and in carry bags. And the patient can also ask the doctor to prescribe an injectable form of corticosteroids to be used during an emergency.

·    Remain in constant touch with the doctor – The patient must be in touch with the doctor to ensure that he/she has sufficient doses of replacement hormones but it should not be excessive. Also if the patient is having continuous problems due to the medication the doctor will have to make certain adjustments in the doses and the timings of taking the medicines.

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Complications associated with high blood pressure

High blood pressure is also termed as hypertension and it is high pressure caused in the arteries which supply blood from the heart to the other parts of the body. The blood readings while measuring blood pressure is always given in two numbers – the systolic and diastolic blood pressure. The former is the pressure in the arteries when the heart contracts and the later is the pressure when the heart relaxes. Normal blood pressure should be below 120/80, and blood pressure reading of 140/90 is considered high and when the systolic blood pressure ranges between 90 to 100 it is considered as low blood pressure.

Some of the complications and risk associated with high blood pressure are heart and kidney disorders, the arteries becoming hard or stiff which is termed as atherosclerosis or arteriosclerosis, damage to the brain or eyes.

High blood pressure is a big health issue and it affects one out of three individuals in America which amounts to around 76.4 million people.

Causes of high blood pressure:

There are various factors combined that causes high blood pressure, some of which are mentioned below;

·         People who have a high intake of salt or salt sensitivity are more prone to  hypertension and this is mostly seen in elderly people who are obese or  have some kidney problems.

·     People whose both or any one parent has high blood pressure are more  likely to get this disorder.

·        Any abnormality with the arteries which increases the resistance to supply  blood to the other parts of the body. This is more common among older  adults, people who do not exercise regularly, obese people or have a high  intake of salt.

Method of measuring high blood pressure:

Blood pressure is measured with the help of a devise called as sphygmomanometer i.e. a blood pressure cuff. This blood pressure cuff has an air pump, pressure gauge and rubber cuff and this equipment measures the pressure in millimeters of mercury.

This cuff is placed around the upper arm of the patient and is inflated with the help of the air pump up to the extent that it prevents the passing of the blood through the arm to the main artery. The patient is asked to place the arm on the side of the body at the heart level and the pressure of the cuff is slowly released. As the pressure reduces the doctor or nurse places a stethoscope over the artery at the front of the elbow or will make use of an electronic machine that senses the pulsation. The pressure at which the first pulsation from the artery is heard is the systolic pressure and the pressure at which the pulsation stops is the diastolic pressure.

Symptoms of high blood pressure:

High blood pressure is also known as the silent killer since it does not necessarily show any signs and symptoms.  But if high blood pressure is not treated and a person is suffering from this disorder for a very long time then he/she can have a lot of complications which can be heart attack, kidney problems or stroke.

Some individual experience certain symptoms because of high blood pressure which are;

·         Headache

·         Lightheadedness

·         Difficulty in breathing

·         Blurred vision

·         Nausea

·         Feeling the pulsation in the head or neck

Diagnosis of high blood pressure:

For getting an accurate and official diagnosis of high blood pressure one will have to meet the doctor. In most of the cases the blood pressure is checked in two different times of the day and two visits with the doctor. At times the doctor may suggest the patient to maintain a blood pressure chart for a limited period to track the blood pressure pattern. If the patient is continuously having blood pressure which is over 140/90 then the doctor will work on a treatment plan and medication basis the condition of the patient.

Treatment of high blood pressure:

High blood pressure is caused due to various factors therefore there are various methods to treat this disorder. The main objective of treating high blood pressure is to reduce the blood pressure below 140/90 and maintain it in a steady level.

Some of the treatment options include:

·         Lifestyle changes:

o   Stop smoking cigarettes

o   Lose extra weight

o   Exercise regularly to keep the body fit and healthy and reduce fat

o   Stop drinking

o   Reduce salt intake and eat low sodium and low fat food

• Medications: 

There are various types of medications available in different categories. The doctor will prescribe the appropriate medication post discussion and checking the condition of the patient.

• Treatment is also given for the other disorders that cause high blood pressure, which are:

o      Renal artery stenosis

o      Congestive heart failure

o      Diabetes

o      Obesity 

Risks and complications of high blood pressure:

Complication associated with high blood pressure, is the damage to the organ which occurs if high blood pressure lasts for a long period of time or left untreated.

Some of the risks that are associated with high blood pressure are;

·         Heart diseases due to the increased pressure on the heart to function against the high blood pressure which can lead to heart failure, coronary artery disease or enlargement of the heart muscle

·         High blood pressure can have an impact on the filtering system of the kidneys because of which the proteins spill out into the urine and eventually cause kidney failure

·         The arteries get hardened because of tremendous pressure which harms the inner walls of the blood vessels

·         Stretching of the blood vessels due to the high pressure which leads to aneurysms

·         The sensitive tissues within the eye get affected due to high blood pressure

·         The hardening of the arteries and stretching of the blood vessels can cause a stroke

Alternatives for controlling high blood pressure:

·         Managing personal and professional stress

·         Making use of relaxation techniques like deep breathing, yoga, imagery relaxation and medication

·         Maintaining a blood pressure chart on a daily basis

·         Taking adequate rest and sleep

·         Following some home remedies like eating garlic, fish oil, calcium, magnesium and flax seed as they are known to be beneficial in lowering the blood pressure