Severe obesity can cause orthopnea, not by a redistribution of fluid, but rather by a shifting of the abdominal mass when recumbent, which can impinge on lung capacity. Orthopnea has also been seen in people with large goiters enlargement of the thyroid gland , which can obstruct airflow in the upper airways when lying down. In most cases, making the diagnosis of orthopnea is pretty straightforward. Healthcare providers ask patients about nocturnal dyspnea, and whether they are able to sleep while lying flat, as part of a routine medical evaluation.
Many people who have orthopnea will deal with the symptom subconsciously by adding a pillow or two. This is why practitioners will often ask about how many pillows you routinely use. If a person describes orthopnea to a practitioner, the healthcare provider will ask follow-up questions to begin to pin down the cause. For instance, symptoms consistent with heart failure, sleep apnea, asthma, or bronchitis should be elicited.
A thorough physical examination, to uncover physical signs of these kinds of medical problems, will also help to determine the cause. Additional testing is often needed to diagnose the cause of orthopnea. An echocardiogram , pulmonary function tests , or sleep studies are commonly obtained.
In the large majority of cases, after performing a complete medical history and physical examination, and doing a non-invasive test or two, the cause of the orthopnea will become apparent. Because worsening orthopnea is often an early sign of worsening heart failure, anyone with heart failure and their significant others should pay attention to this symptom, and even to the number of pillows they are using.
Early intervention when symptoms are relatively mild can avoid a heart failure crisis, and prevent the need for hospitalization. Treating orthopnea requires identifying and treating the underlying cause.
In most cases, orthopnea is due to heart failure, and as noted an important goal in treating heart failure should be to eliminate orthopnea entirely. Orthopnea is usually a manifestation the of pulmonary congestion that can occur in people with heart failure.
The onset of orthopnea, or changes in the severity of orthopnea, can indicate important changes in the severity of heart failure. Because orthopnea can also be caused by other significant medical conditions, this is a symptom that should always be reported to your healthcare provider. Did you know the most common forms of heart disease are largely preventable?
Our guide will show you what puts you at risk, and how to take control of your heart health. Value of orthopnea, paroxysmal nocturnal dyspnea, and medications in prospective population studies of incident heart failure. Am J Cardiol. Mukerji V. Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea.
Boston: Butterworths; Chapter Circulation: Heart Failure. Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page. A doctor or dietician can advise on an exercise or diet plan for losing weight. Orthopnea is often a symptom of an underlying heart condition. The treatment of this condition may involve ongoing care and lifestyle changes. Depending on the severity of the heart condition, a person may sometimes require surgery.
Orthopnea is a shortness of breath that occurs when lying down but usually resolves on sitting or standing up.
Orthopnea is often a symptom of heart failure, but it can develop due to other conditions that affect the normal functioning of the lungs, such as COPD. Anyone who experiences orthopnea should see a doctor for an evaluation.
The treatment of orthopnea will depend on its underlying cause. However, a person may find temporary relief by raising their head and chest with some pillows when lying in bed.
What causes shortness of breath, and is this issue treatable at home? In this article, learn about some home remedies that may help manage shortness…. Pulmonary edema occurs when fluid collects in air sacs of the lungs, making it difficult to breathe. It can develop suddenly or gradually, and it is…. Heart disease is a major cause of death. In this article, learn about the different types, how to recognize the symptoms, and what treatment to expect. What is orthopnea?
Medically reviewed by Gerhard Whitworth, R. Symptoms Causes Diagnosis Treatment Takeaway Orthopnea is a shortness of breath that affects a person when they are lying down but subsides in other positions, such as standing or sitting up. If you have heart failure, your heart may not be able to keep up with the increased amount of blood returning to the heart, so fluid builds up inside the lungs and causes shortness of breath.
Shortness of breath while sleeping. Some people with heart failure wake up in the middle of the night with severe shortness of breath. The medical term for this symptom is paroxysmal nocturnal dyspnea PND.
In general, people who experience PND don't feel increased shortness of breath when they first lie down. But after several hours of lying down, they awake with shortness of breath, which often occurs suddenly.
People who experience PND often have to sit up on the side of the bed, and they may feel a need to open a window to get more air. The shortness of breath generally goes away after a few minutes of sitting up. You might also have low exercise capacity. This can be harder to describe. It is a symptom that people with heart failure often don't even notice because they have gradually reduced the level at which they exert themselves.
For example, they may stop walking up the stairs, or they may drive to the store instead of walking. Some people at first deny that they have been experiencing this symptom. It is only after doctors ask them about changes in their activities that they realize they have been avoiding physical exertion. This decrease in your ability to exert yourself physically is what doctors call low exercise capacity.
People with heart failure often experience swelling in their ankles or feet. You might notice that:. The degree of swelling you experience depends on how well your body is compensating for heart failure and how much sodium and water your body retains. In some cases the swelling is mild and merely bothersome, while in other cases it can be severe and painful if the skin becomes taut and sensitive.
The medical term for this swelling in the legs is pedal edema—"pedal" refers to the feet and "edema" refers to the buildup of excess fluid. Heart failure often causes what doctors call "pitting edema," meaning that applying pressure to the swollen skin leaves an indentation in the skin. Doctors often test for edema by pressing their thumb to the skin and seeing whether it leaves an impression.
You may see this yourself if you take off your shoes and socks and find that your socks have left an impression in the skin of your ankles and feet. You may notice more severe swelling if you have been eating too much salt, which causes your body to retain fluid.
Elevating your feet or wearing supportive stockings can help relieve the swelling. Weight gain may be the first noticeable sign that you have developed heart failure or that your heart failure is getting worse.
0コメント