Continuing Medical Education

Dyspnoea: Pathophysiology and a clinical approach

Cecilia B I Coccia, Gregori H Palkowski, Beverley Schweitzer, Tshepo Motsohi, Ntobeko Ntusi

Abstract


Dyspnoea, also known as shortness of breath or breathlessness, is a subjective awareness of the sensation of uncomfortable breathing. It
may be of physiological, pathological or social origin. The pathophysiology of dyspnoea is complex, and involves the activation of several
pathways that lead to increased work of breathing, stimulation of the receptors of the upper or lower airway, lung parenchyma, or chest
wall, and excessive stimulation of the respiratory centre by central and peripheral chemoreceptors. Activation of these pathways is relayed
to the central nervous system via respiratory muscle and vagal afferents, which are consequently interpreted by the individual in the context
of the affective state, attention, and prior experience, resulting in the awareness of breathing. The clinical evaluation and approach to the
management of dyspnoea are directed by the clinical presentation and underlying cause. The causes of dyspnoea are manifold, and include
a spectrum of disorders, from benign to serious and life-threatening entities. The pathophysiology, aetiology, clinical presentation and
management of dyspnoea are reviewed.


Authors' affiliations

Cecilia B I Coccia, Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

Gregori H Palkowski, Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

Beverley Schweitzer, Division of Family Medicine, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Tshepo Motsohi, Division of Family Medicine, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Ntobeko Ntusi, Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa

Full Text

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Keywords

Dyspnoea; Breathlessness; Shortness of breath; Heart failure; Africa

Cite this article

South African Medical Journal 2016;106(1):32-36. DOI:10.7196/SAMJ.2016.v106i1.10324

Article History

Date submitted: 2015-11-10
Date published: 2015-11-26

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