Psychogenic breathlessness or pseudo-dyspnea is a condition where the patient suffers from shortness of breath time to time. This disease is often confused with a similar breathing disorder called Chronic Dyspnea. While there are a lot of factors involved in chronic dyspnea, like allergens and pulmonary diseases, psychogenic breathlessness has more to do with the current state of mind.

One of the most challenging factors is the diagnosis and differentiation between both conditions. Sometimes, the psychogenic breathlessness is so concentrated that there is no way to differentiate between the two.

Procedure of Diagnosis of Psychogenic Breathlessness:

Here are the steps that doctors typically follow to diagnose Psychogenic Breathlessness

To differentiate between the two diseases (Chronic Dyspnea and Psychogenic Breathlessness), the doctor will ask the patient to try breathing harder. A patient with chronic dyspnea will find it even harder to take a breath when he or she tries to. However, a person with psychogenic dyspnea will show improved conditions when they try to breathe harder

A thorough examination of the chest will be done

Blood tests and lung function test (spirometry) will also be conducted to rule out pulmonary diseases

Causes of Chronic dyspnea:

Allergens causing allergic bronchitis (also known as asthma) is the main reason behind Chronic Dyspnea. Other common causes of the true or chronic dyspnea are heart diseases, COPD which occurs because of smoking. Then there are rare disorders like ILD (sarcoidosis), neuromuscular diseases, infections, anemia, obesity/deconditioning.



Causes of Psychogenic dyspnea or psychogenic breathlessness:

Acid reflux: Acid reflux can cause certain sensation on the inner lining of the esophagus (esophagitis). The esophagus has several nerve endings on the inner linings, when the acidic reflux touches these nerve endings, a temporary breathlessness occurs.

Anxiety: People with anxiety can also develop breathlessness. Though exercises help for a short period of time, a patient needs to see a psychiatrist for this condition.

Panic Attacks: These are also a cause for breathlessness. The temporary feeling of choking is common in people who experience panic attacks.

Treatment:

Medication: Medicine for acidity is prescribed to patients having Pseudo-Dyspnea, due to acid reflux.

Anxiety pills and Talking therapy: People suffering from anxiety are recommended to see a psychiatrist for better evaluation of their problem. Medications (anxiety pills) prescribed by the psychaitrist may help in controlling the breathing pattern in a person. Psychological therapies (Talking therapy) have been effective for people suffering from breathlessness due to anxiety.

Placebo: If the problem remains unsolved and unknown, sometimes doctor prescribes placebo medication, for example sweetened aerosol. Doctors believe that if the patient thinks he/she is taking a real medication, his/her condition can be controlled by eluding the mind.

It is important to remember that Psychogenic Breathlessness is as real as chronic breathlessness and patient doesn t pretend to have this condition. When the first symptoms of it start appearing, a specialist doctor (pulmonologist) should be consulted who after confirming the diagnosis of psychogenic breathlessness, may refer you to a psychiatrist or psychologist for further treatment.

Psychogenic Breathlessness - Causes, Symptoms and Treatment of It!

What is Palpitation?
Palpitation is a feeling of awareness of your own heart beat. It is usually described as heart rate being either too fast (racing), too slow or a sensation of missing a beat.

Types of palpitations?
Normal (Benign)
- These palpitations occur as a response to physical or mental stress like exercise, fever, pain, fear, anxiety etc. 
- They are harmless and settle on their own once the precipitating factors disappear. They do not require any medical treatment.

Abnormal
- These palpitations occur due to some underlying abnormality in either the structure of heart or the beating of heart. 
- These can be dangerous and at times life threatening. They may or may not settle on their own and require some medical treatment.

Warning signs that suggest palpitations are abnormal?
Palpitations are abnormal, if they are associated with chest heaviness, chest pain, uneasiness, sweating, weakness, giddiness, feeling of black out, fainting, nausea, vomiting, seizures. Palpitations are more likely to be abnormal in people who have some existing heart disease and these patients should report to their doctor at the earliest.

What to do during palpitations?
1. Stay calm. 
2. Call for help. If u are alone avoid driving, use a taxi or auto, go to your nearest hospital/doctor and try to get an ECG during the palpitations. If you are helping someone having palpitations, if they faint, call for help, start CPR if they remain unresponsive and take them to the nearest hospital. 

Which doctor can treat palpitations?
Doctors who specialise in the treatment of palpitations are called Electrophysiologists. They specialise in heart rhythm and are capable of performing a variety of complex tests to identify and treat different types of palpitations.

Which investigations are used to diagnose palpitations?
ECG: Taken during palpitations and when the patient is normal is a very helpful tool. 
Holter: Externally applied recorder, which continuously records heart rhythm for 24 hrs. 
ELR: Extended loop recorder, is like holter, but it records rhythm for longer durations. 
ILR:  Internal loop recorder is attached within the body for recording rhythm for long duration. 
EPS: Electrophysiology study, is the most sure shot test to diagnose, identify and treat 
Palpitations.

What is EPS?
EPS stands for Electrophysiology study. By this test a trained Electrophysiologist studies the conduction and formation system of heart beat, to understand the source, cause and type of palpitation. It is a simple and safe procedure of 2 to 3 hours and can be done as a day care procedure (by admitting the patient for a few hours in hospital, with discharge on same day).

It requires fasting for 4 hrs, some standard blood investigations and is done with local anaesthesia and if required it can be combined with treatment like ablation in the same sitting.In the procedure Electrophysiologist take catheters into your heart to study and stimulate the palpitations and understand them. Once found they can use various techniques to stop the palpitations, the techniques are called Ablation.

What are the treatment options available for palpitations?
There are many options depending upon the nature of palpitations and condition of the patient: 
- Drug therapy 
- Cardioversion where either a drug or electric shock is given to stop palpitations immediately. 

Ablations using many sophisticated computer softwares 
Device Therapy like ICD (Internal cardiac defibrillator) 
Combination of all the above therapies.

Your Electrophysiologist and you as a team can make a choice about the options that will be best for you.

Palpitations - Everything You Need to Know

Are you looking for effective and natural ways to prevent heart blockage and blood pressure management? You should consider taking Ayurvedic measures, which have been proven to be quite effective in dealing with various issues of the heart. Usually, heart blockages are difficult to deal with and a surgery has to be carried out for recovery. With Ayurvedic remedies, you can solve such issues without the concern of harmful side effects on your body.

Ayurvedic management of heart blockage
For effective prevention and management of heart blockages, you need to create a certain Ayurvedic medicine using basic ingredients.

Mix lemon, ginger, apple vinegar and garlic together and boil on a light flame.
After the quantity gets reduced, leave the mixture to cool.
After this, add some honey in the solution, and store it in a bottle for use. You have to take this medicine every morning after waking up.
Note all the ingredients are chosen for their unique and beneficial features.
Lemon contains more than 19 qualities, and garlic and ginger are good for dealing with gastric issues. Apple cider vinegar is given great importance in Ayurveda, and honey is good for your blood. Hence, this medicine is ideal for treating heart blockages effectively.
Ayurvedic management of blood pressure
High blood pressure or Rakta Gata Vata refers to an elevation in the pressure of blood in your arteries. The increase in pressure is based upon your age, activities, diet, and medical history.

The Ayurvedic remedies for the prevention and control of blood pressure include the following:

Avoid consuming eggs, meat, tea, coffee, pickles and table salt.
Abstain from smoking.
Increase your intake of food items such as lemon, garlic, parsley, grapefruit, cottage cheese, Indian gooseberry, and watermelon.
Engage in regular exercise as it is important for lowering and preventing your chances of high blood pressure.
Laugh a lot and keep away from anxiety and stress factors.
Make a juice of garlic cloves, wheat grass and basil leaves. Have this regularly for reduced chances of high blood pressure.
Mix onion juice with honey and have the mixture every day.
Make a paste using garlic and buttermilk, and drink it regularly.
Grind roasted watermelon seeds, add water to the powder, strain the liquid, and have it twice every day.
It is important for you to visit an Ayurvedic practitioner before starting to take Ayurvedic measures for heart blockage or high blood pressure on your own. This will ensure that you are prescribed the best measures by a qualified and experienced doctor.

Heart Blockage & Blood Pressure - How Ayurveda Can Help You Prevent It?

Shortness of breath, medically known as dyspnea, is the sensation of tightening of chest accompanied by a feeling of suffocation. Most of us would have experienced this while doing intensive exercise, while in extreme temperature or high altitude to a certain extent. But when the breathlessness is severe, it is due to a lung or heart ailment. The lungs and the heart play the most important role in transporting oxygen to our tissues and removes carbon dioxide. And so, any kind of problem in either of the organs can affect our breathing.

Causes:
Numerous underlying conditions can lead to a shortness of breath. An insight into the most common causes are enumerated below.

Asthma: One of the common reason for shortness of breath is asthma. It is a serious condition in which the passage of air becomes narrow and swells up and produces extra mucus. This can result in shortness of breath, triggers wheezing, coughing and also makes breathing difficult. It cannot be cured but the symptoms can be controlled, and it is also necessary to consult with the doctor to track the symptoms and adjust the treatment.
Carbon monoxide poisoning: Another leading cause of shortness of breath is carbon monoxide poisoning. It is caused when carbon monoxide builds up in our blood stream. When there is excessive carbon monoxide in the surrounding air, our body replaces the oxygen in our red blood cells or RBCs with the carbon monoxide in the air. Appliances that are improperly ventilated and engines, especially in a sealed or tightly enclosed space might allow carbon monoxide to accumulate in our blood stream to a dangerous level.
A hiatal hernia: This is caused when part of our stomach pushes upward through your diaphragm. Our diaphragm usually has a small opening through which our esophagus or food pipe passes and connects the stomach. The stomach pushes up through this opening in case of a hiatal hernia and results in shortness of breath. In most of the cases it can be cured by medications, but in some situations, surgery is required.
Pulmonary embolism: It is a blockage in one of the pulmonary arteries in the lungs. In 95% of the cases of pulmonary embolism, it is caused due to blood clots that travel to the lungs from the legs or some other parts of the body. As the clot blocks the flow of blood to the lungs, it can also be life threatening besides causing a shortage of breath.
Apart from these conditions, others such as bronchitis, pneumonia, lung cancer, COPD, arrhythmia, hypertension, and many other lung and heart ailments can result in shortness of breath and can lead to dire consequences in certain cases. Thus, it becomes paramount to consult a pulmonologist when you frequently experience such breathing difficulty.

Shortness Of Breath - 4 Most Common Reasons Of It!

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

LDL or Low Density Lipoprotein aka bad cholesterol: Cholesterol is a wax like chemical, which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by Lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. LDL levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. peripheral artery disease among many others

HDL or High Density Lipoprotein aka good cholesterol: This is a form of cholesterol which is usually desired in higher quantities as it removes LDL from the system by dislodging it from the arteries and then carrying it through the blood stream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of HDL cholesterol is always desirable. 

Some of the ideal numbers for HDL cholesterol within the body are:

Women - Ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
Men - Ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just LDL or HDL cholesterol. Triglycerides are another type of fat which are used to store energy within the body but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are:
a. Lack of physical activity
b. Obesity or being overweight
c. Excesses in alcohol consumption
d. Smoking
e. Bad diet and others

Thus the good cholesterol versus bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol and Factor involved in It

Hemothorax is a serious and possibly a life-threatening condition in which blood collects between the lungs and the chest wall due to a traumatic injury or some other factor. It can be caused due to an extrapleural or an intrapleural injury. An extrapleural injury damages the chest wall on the outside while an intrapleural injury damages the chest wall on the inside.
Sometimes, Hemothorax is accompanied by excess air in the pleural cavity, known as pneumothorax. If they both occur at the same time, the condition is said to be hemopneumothorax. When blood accumulation is as large as nearly one liter, it has the potential to lead to shock and is referred to as Massive Hemothorax, which can be fatal.

Causes-
Hemothorax can be caused by a number of factors discussed as follows:
  Traumatic injury in an accident or sports causes the pleural lining of the lungs or chest to rupture. It causes blood to spill over into the pleural cavity, and it finds no way to drain itself out. Chest and lungs are so sensitive that even the smallest of injuries (or seemingly small) have the potential to cause Hemothorax.
  Tuberculosis and other lung infections can cause Hemothorax.
  Pulmonary embolism refers to a blood clot in the lungs that can cause Hemothorax.
  Lung or pleural cancer also have the potential to cause grave disease.
  Defective blood clotting as in hemophilia in which blood lacks clotting factors can cause Hemothorax.
  Tissue necrosis in the lungs or pulmonary infarction is a lung tissue dysfunction which can cause Hemothorax.
  Tearing of pulmonary blood vessels due to an invasive surgical procedure also has the potential of causing Hemothorax.
  Patients who have undergone major surgeries like lung transplant and open- heart surgery are very likely to get Hemothorax.


Symptoms-
There are many symptoms associated with Hemothorax like low blood pressure, rapid rate of heart, cold and pale skin color, chest pain while breathing, tense and shallow
breathing, difficulty in breathing, anxiety, and restlessness.


Diagnosis-
  Physical examination includes listening to the sounds of abnormal breathing and to the sounds of liquid in the chest.
  An X-Ray image reveals the presence of liquid in the pleural cavity.
  A full Computed Tomography Scan can reveal the occurrence as well as the cause of Hemothorax.
  An ultrasound provides good insight into the situation of the lungs and the pleural cavity.
  Sometimes, a sample of the pleural fluid is extracted for test and diagnosis.


Treatment-
The procedure is performed under anesthesia. A catheter or a needle is inserted into the chest through ribs for removing air and blood from the pleural cavity. If the lung collapses, it is expanded using the chest tube, which is left attached to a closed system. This ensures the escape of air and fluid from the pleural cavity and prevents additional air from entering the pleural space. This section is hence left in a water seal or hooked up to suction.
If the injury is small, chest drainage might be sufficient depending upon the case. However, if there is a major injury, it might require stopping bleeding at its source through a surgery.


Take Away-
Hemothorax can cause a collapsed lung that might progress to lead to respiratory failure. If left untreated, Hemothorax can cause infection in pleura, lung or pleural fluid in the chest cavity. Hemothorax can cause scarring of the lung tissue and pleural membranes. Retained Hemothorax occurs when blood stays in the pleural cavity for too long. It might clot and get difficult to remove through the catheter. It might also cause the buildup of pus in the surrounding region leading to an infection. Retained Hemothorax is treated by draining the fluid differently or through a video-assisted surgical procedure. Before opting for any treatment or surgery, one should always consult a doctor.

Chest Injuries And Hemothorax - Know How Serious It Can Be!

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