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What Is Paroxysmal Nocturnal Dyspnea?
First, yes, this is a tongue-twister, I have to have a few go before I say it correctly, not to mention it sounds like a horrible zombie virus! So, what does it really mean? To destroy it is very easy – Paroxymal means sudden burst or attack; nocturnal means night and dyspnea is shortness of breath. Together, Paroxysmal Nocturnal Dyspnea (PND) is the perception of oxygen deficiency during sleep, oxygen deprivation causes a person to cough and wheeze, which increases diastolic pressure.
So it’s not a zombie virus, but most would say it’s scary. PND is a symptom of congestive heart failure. A person suffering from PND will need immediate medical attention – calling an ambulance is the first step immediately, however other medical treatments to satisfy the can also include taking nitroglycerin and diuretics.
PND has similar symptoms to obstructive sleep apnea syndrome (OSA), however is not a separate disease. PND is very different, it is a very serious condition that is directly related to heart failure.
People who suffer from obstructive sleep apnea syndrome have a decrease in the muscles of their breathing during sleep, which leads to obstruction of the airway. This leads to periods of apnea where breathing is complete.
At rest, the oxygen content of the blood drops, and signals are received in the respiratory area that the tissues are in a state of hypoxia. After 10-20 seconds, the oxygen in the blood drops to a minimum, and this eventually causes the body to forget the situation. The microstimulation of the brain increases the muscles of the respiratory tract that helps to breathe. For a few minutes after that, the breathing of the sleeping person is still active and deep. At this time, the person also has shortness of breath, although they will not wake up.
Paroxysmal Nocturnal Dyspnea Causes?
Paroxysmal nocturnal dyspnea is common in adults with heart problems, however it can also occur in anyone who suffers from:
left ventricular failure during exacerbation;
acute myocardial infarction;
aneurysms of the heart;
the presence of a large intracardiac thrombus or tumor.
Exacerbation events that can lead to PND recurrence in a person with the medical conditions listed above are:
problems of cerebral circulation;
Rapid change from vertical to horizontal body position.
What are the symptoms of Paroxysmal Nocturnal Dyspnea?
The most common symptoms of PND are the following:
dyspnea with physical exertion;
dyspnea at night in the lying position, but relieving in a sitting position;
cough with asthma;
production of mucus, sometimes with blood;
whistling in the lungs;
constant feeling of no wind;
tired and sleepy.
Often an event occurs as follows: a person wakes up from a bad dream, feels good in the chest and wants to sit down, they do Breathe deeply and hard. Narrowing of the bronchioles creates shortness of breath, which makes it difficult for the person to speak. When sitting, the person usually leans forward a little. Their skin becomes pale because of the spasm of the blood vessels, and sometimes they break out into sweat. PND can start immediately and can stop as quickly as half an hour. The person will still suffer in the morning in the morning.
Why does Paroxysmal Nocturnal Dyspnea cause these symptoms?
When sleeping in a person with heart problems, the fluid in the body begins to be recycled from the tissues into the blood, which during the day is collected in the legs or in the abdominal cavity. This process does not happen quickly so after sleeping there will be no immediate symptoms. Paroxysmal dyspnea occurs gradually after a long period of time after sleep.
In people with heart failure, the left side of the heart does not work at full capacity, so the small circle of blood can not cope with the extra fluid. This volume remains in the blood vessels beyond the lungs. This extra volume moves from the blood vessels into the lung tissue, which leads to the development of interstitial pulmonary edema.
The most severe form of paroxysmal dyspnea is pulmonary edema, which is caused by increased pressure in the pulmonary capillaries and causes alveolar edema. Symptoms of pulmonary edema are shortness of breath, wheezing, and bloody mucus. Acute pulmonary edema can cause sudden death.
How to treat Paroxysmal Nocturnal Dyspnea?
Before treatment, it is very important to do a thorough examination to determine the cause of paroxysmal nocturnal dyspnea. Appropriate examination, medical history, chest X-ray, ECG, ultrasound of the heart and Doppler of the heart are important for an accurate diagnosis.
During paroxysmal nocturnal dyspnea episodes, it is important to call an ambulance because of the risk of pulmonary edema. First aid for the person includes keeping them still, putting them in a semi-sitting position, and putting their feet in a hot bath. Place the nitroglycerin solution under the tongue and repeat the solution every 5-10 minutes. If the attack is accompanied by pain and dyspnea, analgesics can also be used. Further treatment can be done according to the cause of the disease.
Recommendations for preventing paroxysmal nocturnal dyspnea are stopping smoking, reducing the weight of obese people and normalizing blood pressure. A strict diet in fresh fruits and vegetables and avoiding a heavy salt diet is also recommended. Oxygen therapy is an effective method of disease control, used not only in the hospital but also at home.
Disease prevention includes timely treatment of coronary artery disease and heart failure, arterial hypertension, compliance with water-salt management, prevention of diseases spread.
A proper medical evaluation is required to make sure the condition is diagnosed, so if you think you have sleep apnea symptoms, it could be PND, so get checked. by a doctor properly.
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