Dyspnoea

From inhalation at pressures above atmospheric, used in tunnelling or diving, or from breathing apparatus or resuscitation equipment, if the pressure is too high or exposure is prolonged. This may cause symptoms from pain to dyspnoea, disorientation and unconsciousness it may be fatal. 

Anxiety is a normal reaction. Pathological anxiety interferes with daily-life activities and may be accompanied by autonomic symptoms (chest pain, dyspnoea and palpitations). Severe forms include phobic anxiety and panic disorder. 

The onset of symptoms may be delayed for several minutes after initial exposure (especially with DM) effective exposure may, therefore, occur before the presence of the smoke is suspected. The paranasal sinuses are irritated and fill with secretions and severe frontal headache results. Prolonged exposure may cause retrosternal pain, dyspnoea, and asthma-like symptoms. Symptoms reach their climax after 5-10 min and disappear 1-2 h after cessation of exposure. 

It is known that sensory stimulations in skin, eye, or nose are induced in workers who handle pyrethroids. Itching and burning sensations, paresthesia, blisters, nasal hypersecretion, sneezing, coughing, dyspnoea, and irritation were reported as... 

When mice, rats, rabbits and guinea-pigs were exposed to a concentration of 0-88 mg./l. (i.e. 1/5000) of ethyl phosphorodifluoridate for 10 min. there was irritation of the eyes and nose with nasal discharge, lacrimation and salivation. Four minutes after exposure the mice and some of the rats developed dyspnoea, but all the animals recovered. When animals were exposed to a corresponding concentration of ethyl phosphorodi-chloridate (1-46 mg. 1. 1/5000), similar symptoms were observed and no deaths resulted. 

Side effects include transient skin reactions (urticaria, wheals), hypotension, tachycardia, bradycardia, nausea/vomiting, dyspnoea, a rise in temperature and/or chills may occasionally occur. In rare cases of severe hypersensitivity reactions leading to shock. 

Adverse effects include local thrombophlebitis, hypersensitivity reactions (skin eruptions, tachycardia, pallor/cyanosis, dyspnoea, nausea or anaphylactic shock) may occur. 

The parenteral administration can cause local pain at the site of injection. The other adverse effects include headache, fever, flushing, palpitation, dyspnoea, chest pain, metallic taste and even disorientation and temporary loss of taste. 

Bascom et al. (1988) reported a spectrum of respiratory illnesses which occurred in a group of workers who were exposed to heated chloroprene-based rubber. These included an acute sensitizing illness with dyspnoea and wheezing in some workers and pulmonary infiltrates with eosinophilia in others. One worker developed chronic obstruc-tion of the airways with recurrent bronchitic illnesses. 

The irritative effects of 1,5-naphthalene diisocyanate were confirmed in a further study of rubber production workers, in which exposure over the range of 0.002-0.007 mg/m was associated with increased frequency of eye irritation, cough and exertion dyspnoea. Also, an increase in the closing volmne, especially among the older workers, was observed, suggesting airway irritation (Alexandersson et al., 1986)... 

Central chest tightness or heaviness, which may be brought on by exertion or relieved by rest. It may radiate to one or both arms, the neck, jaw or teeth. Other associated symptoms include dyspnoea (shortness of breath), nausea, sweatiness and faintness. 

Symptoms Breathlessness/dyspnoea, palpitations, syncope or dizziness, chest discomfort or stroke/transient ischaemic attack. 

Class IV - Severe disability, dyspnoea at rest, no physical activity possible without discomfort. 

Severe cardiac pain, chest tightness, sweating, breathlessness and nausea. Some patients may present with atypical features including indigestion, pleuritic chest pain or dyspnoea. 

On arrival he had shortness of breath on exertion after 2 yards (best 30 yards), cough - chronic, no worse, non-productive, chronic wheeze, no chest pain, no palpitations, ankle swelling no worse then usual, both legs swollen to upper calf, orthopnoea. The patient sleeps upright and gets paroxysmal nocturnal dyspnoea if lying flat. 

Very short of breath at rest MRC dyspnoea scale (graded 1-5), based on the level of exertion to get breathless, this patient scores 5 (too breathless to leave the house)... 

Monitor patients nutrition Check the patients BMI and record the MRC dyspnoea score. 

Docetaxel should be administered the day after trastuzumab for the first cycle because of the potential for infusion-related reactions to trastuzumab, particularly during or after the first administration. Serious adverse reactions to trastuzumab infusion that have been reported infrequently include dyspnoea (shortness of breath), hypotension, wheezing, hypertension, bronchospasm, supraventricular tachyarrhythmia, reduced oxygen saturation, anaphylaxis, respiratory distress and urticaria (itching). The majority of these events occur during or within 2.5 hours of the start of the first infusion. Should an infusion reaction occur, the infusion should be discontinued and the patient monitored until resolution of any observed symptoms - the infusion may be resumed when symptoms abate. If the first cycle is well tolerated then dosing of the drugs in future cycles may occur on the same day. 

On examination Mrs HK is pale and lethargic. She has mild effort dyspnoea and the following blood results ... 

Workers at a Inhalation pulp mill 54 workers were exposed to sulfur dioxide and another 54 2-36 ppm NR A significantly higher frequency of cough> expectoration, and dyspnoea on exertion was found in the exposed group the maximal expiratory flow rate was significantly lower in the exposed group there was no significant difference Skalpe 1964... 

Q10 Explain how the defective mitral valve affects blood flow and pressure within the heart. Can these changes account for Hannah s dyspnoea ... 

Bob recently made a huge effort to give up smoking on the advice of his doctor and has nearly succeeded. He has become increasingly short of breath over the last three years, which makes working difficult. He has developed dyspnoea and tachypnoea and his doctor has indicated that he is not really fit enough to continue working and should now retire. 

Q1 Define the terms dyspnoea, atelectasis, pneumothorax and cyanosis. 

Q6 What is the definition of dyspnoea and how may it have developed in this patient ... 

---