CC BY-NC-ND 4.0 · Ind J Car Dis Wom 2018; 03(01): 039-048
DOI: 10.1055/s-0038-1668611
Clinical Rounds
Women in Cardiology and Related Sciences

Cardinal Symptoms of Cardiovascular Diseases: Dyspnea

Jyotsna Maddury
1  Department of Cardiology, NIMS, Punjagutta, Hyderabad, India
› Author Affiliations
Further Information

Publication History

Publication Date:
31 August 2018 (online)

Definition

The American Thoracic Society defines dyspnea as a “subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity. The experience derives from interactions among multiple physiological, psychological, social, and environmental factors and may induce secondary physiological and behavioral responses.”[1]

Dyspnea is “synthetic sensation” such as thirst or hunger and is a result of complex interaction of signals arising from the central nervous system (CNS) (brainstem and motor cortex) and from a variety of receptors, in the respiratory and cardiovascular systems. Various terms have been used to express dissociation of motor command and mechanical response as “Length-tension inappropriateness” or “Neuro-mechanical dissociation” or “Efferent afferent dissociation.”

 
  • References

  • 1 Kasper DL, Harrison TR. Dyspnea. In: Harrison's Principles of Internal Medicine. 19th ed. New York, NY: McGraw-Hill; 2015. chap 47e, p. 243
  • 2 Hurst JW, Fuster V, Walsh RA, Harrington RA. The history, physical examination, and cardiac auscultation. In: Hurst's the Heart. New York, NY: McGraw-Hill; 2011. chap 14, p. 247
  • 3 Hurst JW, Fuster V, Walsh RA, Harrington RA. Pathophysiology of heart failure. In: Hurst's the Heart. New York, NY: McGraw-Hill; 2011. chap 26, p. 733
  • 4 Mann DL, Zipes DP, Libby P, Bonow RO. The history and physical examination: an evidence-based approach. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 12, p. 107
  • 5 Hurst JW, Fuster V, Walsh RA, Harrington RA. The epidemiology and diagnosis of heart failure. In: Hurst's the Heart. New York, NY: McGraw-Hill; 2011. chap 27, p. 740
  • 6 Mann DL, Zipes DP, Libby P, Bonow RO. The history and physical examination: an evidence-based approach. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 12, p. 108
  • 7 Mann DL, Zipes DP, Libby P, Bonow RO. Pulmonary hypertension. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 78, p. 1707
  • 8 Hurst JW, Fuster V, Walsh RA, Harrington RA. Pulmonary hypertension. In: Hurst's the Heart.. New York, NY: McGraw-Hill; 2011. chap 71, pp. 1609-1633
  • 9 Mann DL, Zipes DP, Libby P, Bonow RO. Pericardial diseases. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 75, p 1656
  • 10 Anderson RH, Baker JE, Redington A, Rigby LM, Penny D, Wernovsky G. Management of congenital heart disease in pregnancy. In: Paediatric Cardiology.. 3rd ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010. chap 60, p. 1228
  • 11 Allen HD, Shaddy RE, Penny DJ, Feltes TF, Cetta F. Exercise testing. In: Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult.. 9th ed. Philadelphia, PA: Wolters Kluwer Health; 2016. chap 7, p. 127
  • 12 Allen HD, Shaddy RE, Penny DJ, Feltes TF, Cetta F. Echocardiography: basic principles and imaging. In: Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult.. 9th ed. Philadelphia, PA: Wolters Kluwer Health; 2016. chap 8, p. 164
  • 13 Mann DL, Zipes DP, Libby P, Bonow RO. Unstable angina non-ST elevation myocardial infarction. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 56, p. 1189
  • 14 Anderson RH, Baker JE, Redington A, Rigby LM, Penny D, Wernovsky G. Pharmacological and interventional fetal cardiovascular treatment. In: Paediatric Cardiology.. 3rd ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010. chap 12, p. 201
  • 15 Anderson RH, Baker JE, Redington A, Rigby LM, Penny D, Wernovsky G. Pharmacological and interventional fetal cardiovascular treatment. In: Paediatric Cardiology.. 3rd ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2010. chap 12, p. 206
  • 16 Allen HD, Shaddy RE, Penny DJ, Feltes TF, Cetta F. Exercise testing. In: Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult.. 9th ed. Philadelphia, PA: Wolters Kluwer Health; 2016. chap 7, p. 119
  • 17 Mann DL, Zipes DP, Libby P, Bonow RO. The history and physical examination: an evidence-based approach. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 12, p. 118
  • 18 Mann DL, Zipes DP, Libby P, Bonow RO. Congenital heart disease. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 65, p. 1428
  • 19 Joseph PAM. Congenital aortic stenosis: congenital aortic regurgitation. In: Clinical Recognition of Congenital Heart Disease: Expert Consult.. Philadelphia, PA: Elsevier/Saunders; 2012. chap 7, p. 80
  • 20 Mann DL, Zipes DP, Libby P, Bonow RO. Stable ischemic heart disease. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 57, p. 1210
  • 21 Mann DL, Zipes DP, Libby P, Bonow RO. Stable ischemic heart disease. In: Braun Wald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 57, p. 1243
  • 22 Mann DL, Zipes DP, Libby P, Bonow RO. Echocardiography. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 16, p. 224-230
  • 23 Mann DL, Zipes DP, Libby P, Bonow RO. Echocardiography. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 16, p. 248
  • 24 Mann DL, Zipes DP, Libby P, Bonow RO. Endocrine disorders and cardiovascular diseases. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 86, p. 1836
  • 25 Mann DL, Zipes DP, Libby P, Bonow RO. Management of heart failure patients with reduced ejection fraction. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 28, p. 549
  • 26 Drazner MH, Hellkamp AS, Leier CV. et al. Value of clinician assessment of hemodynamics in advanced heart failure: the ESCAPE trial. Circ Heart Fail 2008; 1 (03) 170-177
  • 27 Mann DL, Zipes DP, Libby P, Bonow RO. Electrocardiography. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 13, p. 166
  • 28 Mueller C, Scholer A, Laule-Kilian K. et al. Use of B-type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med 2004; 350 (07) 647-654
  • 29 Mann DL, Zipes DP, Libby P, Bonow RO. Management of heart failure patients with reduced ejection fraction. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 28, p. 575
  • 30 Allen HD, Shaddy RE, Penny DJ, Feltes TF, Cetta F. Anomalies of the pulmonary veins. In: Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult.. 9th ed. Philadelphia, PA: Wolters Kluwer Health; 2016. chap 35, p. 831
  • 31 Allen HD, Shaddy RE, Penny DJ, Feltes TF, Cetta F. Pericardial diseases. In: Moss & Adams’ Heart Disease in Infants, Children, and Adolescents, Including the Fetus and Young Adult.. 9th ed. Philadelphia, PA: Wolters Kluwer Health; 2016. chap 62, p. 1354
  • 32 Hurst JW, Fuster V, Walsh RA, Harrington RA. Mitral valve regurgitation. In: Hurst's the Heart.. New York, NY: McGraw-Hill; 2011. chap 77, p. 1729
  • 33 Joseph PAM. Atrial septal defect: simple and complex. In: Clinical Recognition of Congenital Heart Disease: Expert Consult.. Philadelphia, PA: Elsevier/Saunders; 2012. chap 15, p. 220
  • 34 Joseph PAM. Ventricular septal defect. In: Clinical Recognition of Congenital Heart Disease: Expert Consult.. Philadelphia, PA: Elsevier/Saunders; 2012. chap 17, p. 292
  • 35 Joseph PAM. Ventricular septal defect with pulmonary stenosis. In: Clinical Recognition of Congenital Heart Disease: Expert Consult.. Philadelphia, PA: Elsevier/Saunders; 2012. chap 18, p. 326
  • 36 Joseph PAM. Clinical Recognition of Congenital Heart Disease: Expert Consult, Chapter 20 Patent Ductus Arteriosus Aortopulmonary Window, p. 373. Philadelphia, PA: Elsevier/Saunders; 2012
  • 37 Joseph PAM. Tricuspid atresia. In: Clinical Recognition of Congenital Heart Disease: Expert Consult.. Philadelphia, PA: Elsevier/Saunders; 2012. chap 25, p. 444
  • 38 Joseph PAM. Congenital pulmonary arteriovenous fistula. In: Clinical Recognition of Congenital Heart Disease: Expert Consult.. Philadelphia, PA: Elsevier/Saunders; 2012. chap 30, p. 515
  • 39 Mann DL, Zipes DP, Libby P, Bonow RO. Congenital heart disease. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 65, p. 1446
  • 40 Mann DL, Zipes DP, Libby P, Bonow RO. Congenital heart disease. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 65, p. 1448
  • 41 Mann DL, Zipes DP, Libby P, Bonow RO. Hypertrophic cardiomyopathy. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 69, p. 1586
  • 42 Mann DL, Zipes DP, Libby P, Bonow RO. Therapy for cardiac arrhythmias. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine.. 9th ed. Philadelphia, PA: Elsevier/Saunders; 2011. chap 30, p. 729
  • 43 Hurst JW, Fuster V, Walsh RA, Harrington RA. Nuclear cardiology. In: Hurst's the Heart.. New York, NY: McGraw-Hill; 2011. chap 21, p. 576