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Sitting upright breathing

Orthopnea means that the patient dyspnea Forced to take end Seating or Semi recumbent position Status of. Sitting and breathing is a kind of Forced position , also called forced seating. Cardiac insufficiency Twenty five percent of patients sit upright and breathe, which can increase the blood storage of lower limbs, reduce the amount of blood returning to the heart, reduce the burden of the heart, and alleviate the symptoms of cardiac insufficiency. This is Heart failure More serious performance, with upright breathing prompt heart failure Already obvious Pulmonary congestion 。 For primary disease treatment, remove Predisposing factors 。

TCM disease name

Foreign name

Orthopnea

Visiting department

Respiratory Medicine

Common diseases

lungs

Common causes

Chronic obstructive pulmonary disease, left heart failure, mediastinal tumor, etc

common symptom

Difficulty in breathing, forced to take end sitting or semi lying position

Science popularization in China

Committed to authoritative science communication

The certification expert of this term is

Wei Gengshu | Chief physician

Department of Orthopaedics, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine to examine

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essential information

TCM disease name: Sitting upright breathing
Foreign name: Orthopnea
Visiting department: Respiratory Medicine

Common location: lungs
Common causes: Chronic obstructive pulmonary disease, left heart failure, mediastinal tumor, etc
common symptom: Difficulty in breathing, forced to take end sitting or semi lying position

Etiology and common diseases

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one Chronic obstructive pulmonary disease

Such diseases can cause orthopnea and other dyspnea Chief complaint , concomitant Auxiliary respiratory muscle Application of. Shortness of breath 、 Tachycardia and Odd pulse 。 Auscultation can find Breath sound Weakening, drying Moist rale And wheezing. Patients can also appear cough (No cough or accompanied by a large amount of sputum).

2. Left heart failure

This disease can occur in the late sitting breathing. In acute right heart failure, sitting breathing may suddenly occur; The chronic can persist. The earliest symptom of the disease is gradually worsening dyspnea. Other common early symptoms include CheyneStoks breathing Paroxysmal nocturnal dyspnea , fatigue, weakness and cough accompanied by clear sputum or blood sputum. Can appear palpitation , shortness of breath and moist rales. Other late manifestations include Cyanosis 、 Pestle finger , Ventricle Galloping horse law and hemoptysis 。 Left heart failure Shock signs can also occur, such as hypotension Weak pulse and wet and cold skin.

three Mediastinal tumor Sitting upright breathing

It is the early manifestation of this disease. When the patient lies down, because tumour Compress the trachea a bronchial tube Or lung. However, many patients still have no symptoms until the tumor is very large. It can cause sternum Post Chest pain 、 Dry cough 、 hoarseness 、 Dysphagia Snoring breathing, palpitations, cyanosis.

4. Common upright breathing in children

Reasons include Heart failure 、 Growl Syndrome Cystic fibrosis Sickness and asthma 。

5. Other common diseases

（1） Aortic valve insufficiency Unstable angina pectoris , sitting upright and breathing Femoral artery Gunshot sound , dyspnea Jugular vein distension 、 Exertional dyspnea , fatigue dizzy , palpitations syncope Etc.

（2） Aortic valve stenosis Sudden death, upright breathing, dyspnea Systolic murmur 、 angina pectoris 、 Arrhythmia , loss of consciousness, paroxysmal nocturnal dyspnea, etc.

（3） Idiopathic pulmonary fibrosis Sitting and breathing, joint pain respiratory failure , labored dyspnea Purulent sputum 、 Collapse of one side of thorax Etc.

（4） Senile idiopathic pulmonary fibrosis Sitting breathing, dry cough, joint pain, dyspnea, respiratory failure, labored dyspnea, purulent sputum, emaciation Circulatory failure Etc.

（5） pulmonary edema Sit up and breathe Increased lung water content 、 Increased hilar shadows 、 pulmonary ventilation 1. Blood flow imbalance Pink foam sputum , dyspnea Mixed acid-base disturbance 、 Cough with dyspnea Wet rales, edema with dyspnea, cyanosis, etc.

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Physical examination: there are other signs of dyspnea, such as the application of auxiliary respiratory muscles, shallow, slow and rapid breathing. At the same time, pay attention to Barrel chest 。 Observe whether the skin is pale or cyanotic, clubbed fingers, edema, and jugular vein distension. Auscultate breath sounds and heart sounds 。 Monitor patient's Blood oxygen saturation 。 Close monitoring electrolyte Level and inflow and outflow. Further checks include electrocardiogram ， Chest radiograph 、 Pulmonary function and Arterial blood gas 。 center Venous catheter And lungs Ductus arteriosus The placement of helps Central venous pressure , wedge pressure and Cardiac output Determination of.

differential diagnosis

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one Pulmonary dyspnea

yes Respiratory diseases Induced ventilation Ventilatory dysfunction , resulting in hypoxia and/or Carbon dioxide retention 。

two Cardiogenic dyspnea

Mainly composed of left heart and (or) Right heart failure The mechanism of the two is different, Left heart failure It causes severe dyspnea.

three Toxic dyspnea

stay uremia 、 Diabetic ketoacidosis and Renal tubular acidosis When, the blood is acidic Metabolites Increase, strong stimulation Respiratory center , deep and regular breathing may be accompanied by snore , called Acidosis breathing (Kussmaul breathing). Acute infection and Acute infectious disease When the temperature rises and the effects of toxic metabolites stimulate the respiratory center Respiratory rate Increase. Certain drugs and chemistry material Poisoning such as morphine Class Barbiturates Drugs Organophosphorus poisoning When the respiratory center is inhibited, the respiration becomes slow, which can show Respiratory rhythm Abnormalities such as Cheyne Stokess breathing or Biots breathing.

4. Bloodborne dyspnea

severe anemia 、 Methemoglobinemia or Hemoglobinemia Sulfide Etc, due to red blood cell The oxygen carrying capacity is reduced, Blood oxygen content Decrease, resulting in faster breathing and faster heart rate. In case of massive hemorrhage or shock ischemia With the decrease of blood pressure, it can stimulate the respiratory center and accelerate the respiration.

5. Neuropsychiatric dyspnea

Severe brain diseases such as Craniocerebral trauma 、 cerebral hemorrhage 、 encephalitis 、 meningitis 、 brain abscess and brain tumor The respiratory center is increased due to intracranial pressure And reduced blood supply to stimulate breathing Slower It is deep and often accompanied by abnormal respiratory rhythm, such as respiratory arrest Double inspiratory Etc. Hysteria Patients with mental or psychological factor The effect of can have dyspnea attacks, characterized by shallow breathing with a frequency of up to 60~100 times per minute, often due to hyperventilation Respiratory alkalosis , perioral Numbness of limbs and Tetany 。

Therapeutic principles

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For the primary disease treatment, remove the inducing factors. Symptomatic treatment, treatment of acid-base imbalance Arrhythmia 、 heart failure Etc., prevent complication happen.

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