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In assessing
the sensations of dyspnea, it is important to consider the ways
in which the sensations may vary with time. The first, and most
common type of variation, is intensity of the sensation. Intensity
may vary with activity or position, for example. But the quality
of dyspnea also may change over time.
Consider
the following example: A 55 year old woman with a history of COPD
has had a longstanding complaint of dyspnea with exertion, particularly
when walking up stairs or quickly on flat ground. She generally
describes her breathing discomfort as a sensation of "an
inability to get a deep breath" or "an increased sense
of effort or work of breathing." Today she spilled a strong
cleaning agent in her home and after inhaling the fumes she developed
a sense of "chest tightness."
Question
7.1
Does this new sensation
represent:
 | Worsening
of her COPD |
 | A
new physiological derangement |
Breathing is characterized
by its cyclical nature; there is an inspiratory phase and an expiratory
phase to each breath. We need to consider the phase of breathing
when assessing dyspnea.
Question
7.2
Do patients with asthma
predominantly describe their breathing discomfort in association
with:
| | Inspiration |
| | Expiration |
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