Orthopnea

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Orthopnea or orthopnoea is shortness of breath (dyspnea) that occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure. It is also seen in cases of abdominal obesity or pulmonary disease. Orthopnea is the opposite of platypnea, shortness of breath that worsens when sitting or standing up.

Video Orthopnea

Mechanism

Orthopnea is due to increased distribution of blood to the pulmonary circulation while a person was lying down. In a normal person, this redistribution of blood has little effect on lungs because the left ventricle is strong enough to pump out extra blood. In a person with heart failure, the ventricle is not strong enough to pump out the extra blood back into systemic circulation. The increase of intravascular pressure in the lungs causes exudation of fluid into the alveoli, reducing the lungs capacity of breathing. This results in shortness of breath while the person was lying down but is relieved when assume in a more upright position. This is because gravity pulls extra fluids away from the lungs, thus reducing lungs congestion.

Maps Orthopnea

Causes

Orthopnea is often a symptom of left ventricular heart failure and/or pulmonary edema. It can also occur in those with asthma and chronic bronchitis, as well as those with sleep apnea or panic disorder. It is also associated with polycystic liver disease. From a neuromuscular perspective, orthopnea is a sign of severe diaphragmatic weakness. Under such circumstances, patients may describe shortness of breath when they bend over (e.g. when tying shoelaces).

Diagnosis is based mostly on the clinical features.

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Treatment

Treating the underlying cause will serve the purpose.

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Etymology

The word orthopnea uses combining forms of ortho- + -pnea, from Greek ortho, straight, regular, + pnoia, breath. See pronunciation information at dyspnea.

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See also

• Paroxysmal nocturnal dyspnoea
• Trepopnea

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References

Source of article : Wikipedia