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!

SGLT2 (sodium-glucose-co-transporter 2) inhibitor is an oral tablet used in conjunction with exercise and diet to improve blood glucose control in Type 2 diabetes mellitus patients.

The medication works by targeting and helping prevent sodium-glucose transport proteins from allowing glucose that has been filtered by the kidneys to be reabsorbed into your bloodstream.

Who is SGLT2 Inhibitor suitable for?

This drug is not suitable for everyone. Selection of the right patients is crucial to understand the mechanism of the medication and see improvement in the condition.

SGLT2 Inhibitor is given to patients with Type 2 diabetes mellitus as a second-line drug in case the first line of treatment, metformin, fails to keep high blood sugar levels in check.

If the patient has hyperglycemia i.e. high, uncontrolled blood sugar, and a Body Mass Index (BMI) equal to or greater than 30 due to the accumulation of fat in the abdominal region (central obesity), then SGLT2 Inhibitor could be a useful medication. The drug not only works to reduce high blood glucose but also helps with weight loss. However, in patients with normal BMI, the medication does not induce weight loss.

SGLT2 Inhibitor may not be suitable for patients with a history of urinary tract infection. Hence, it is advisable for all patients to undergo a urine test before starting with the dosage. If the test results are normal, then only you can discuss the dosage with your doctor/healthcare provider and start taking the prescribed medications immediately.

Benefits of Taking SGLT2 Inhibitor :

The benefits of using SGLT2 Inhibitor are as follows  

Helps reduce excess weight if the patient is obese. If taken in the correct dosage as prescribed, you can lose up to 5 Kgs in about three months.

Helps reduce Systolic blood pressure   if a diabetic is living with hypertension, SGLT2 Inhibitor can bring down systolic blood pressure.

As an anti-diabetic drug, SGLT2 Inhibitor works to control high blood glucose and improves glycemic control. Thus, with the help of the drug, Type 2 diabetes mellitus patients can keep their HbA1c levels at 7% or less.

Side Effects

One major side effect of SGLT2 Inhibitor is urinary tract infection. SGLT2 Inhibitor drug filters excess blood sugar from the body in the form of urine. Frequent urination or filtering of wastes through the urethra may lead to infections. Therefore, it is imperative that patients are informed about the mechanism of the drug and its probable side effects before taking the medication. One way to avoid urinary tract infections is to maintain good hygiene   wash and clean your private areas after urination.

SGLT2 Inhibitor can also cause dehydration in the patient, as a lot of fluid is drained out of the body. Patients are advised to have a glass or two of water more than what they usually drink.

SGLT2 Inhibitor is an effective oral medication for Type 2 Diabetes mellitus. Speak with your doctor and get yourself thoroughly checked before you start taking the drug.

SGLT2 Inhibitor - Know Merits & Demerits Of It!

If you are facing difficulties in breathing, especially in the process of exhaling, you are suffering from emphysema. Emphysema is a condition in which the air sacs of the lungs are damaged and enlarged, causing breathlessness. It occurs as a result of several triggers, smoking being the most common one. Emphysema is a type of chronic obstructive pulmonary disease. People with this condition struggle to exhale, which implies that there is some obstruction in the air flow. This disease has no permanent cure but by quitting smoking, you can stop it from getting worse.

Stages
The progression and severity of emphysema occurs with the staging systems. The staging of the condition can help in developing a prognosis.

The Gold emphysema staging system
Gold is a major emphysema staging system created by a group known as the Global Initiative for Chronic Obstructive Lung Disease. The amount of air a patient can exhale forcefully in one second is determined during this stage. It is also referred to as the forced expiratory volume or FEV1.

The staging is as follows:

Stage 1: Mild emphysema (FEV1 greater than 80% of normal)
Stage 2: Moderate emphysema (FEV less than 80%, but more than 50% normal)
Stage 3: Severe emphysema (FEV lesser than 50%, but more than 30% normal)
Stage 4: Extremely severe emphysema. (FEV lesser than 30% of normal or lesser than 50% normal, with low levels of oxygen in the blood.
The BODE emphysema staging system
The condition affects several abilities. The BODE index, an acronym for BMI (body mass index), obstruction, dyspnea (breathlessness), exercise capacity (health index) is another staging system for emphysema in which the emphysema s impact on several areas of life are measured. They include the following:

Body mass index (B)
Airflow limitation or obstruction (O), which is measured by pulmonary function tests
Breathless or dyspnea (D), which is assessed thoroughly via a questionnaire
Exercise capacity (E), which is measured to check how long a person with emphysema can walk in a span of six minutes
Life expectancy
The prognosis of emphysema is impossible to be determined in any person individually. The staging system helps to identify the severity of the condition, but the future cannot be predicted. Not many studies have been undertaken for the determination of the effects of emphysema on life expectancy. The best research that has been carried out included around 100 people, which is very less. The condition varies largely among people, even if they are in the same stage.

The statistics available on emphysema are not reliable enough for individuals who wish to know their life expectancy. It is considered that if a patient falls in a higher stage, his/her long-term life expectancy is less.

Emphysema - Know The Life Expectancy and Stages!

Our survival is solely reliant on the working of the heart. It is this that makes the prospect of a heart failure so fatal and so terrifying. Notwithstanding what the heart evokes, a heart failure is not indicative of a defunct heart; but only a situation when the heart pumps weaker than what is generally deemed as natural. Consequently, the blood flows at a slower rate to the heart and the body that in turn increases pressure in the heart. The oxygen that is produced by the heart in such a scenario is scanty and insufficient for the body. 

body responds with its own defense mechanism, as the heart, in an attempt to hold more blood, stretches its chambers. Though this strenuous effort may keep the blood moving, it would gradually and inevitably weary the heart with all the effort. Subsequently, the kidney responds by retaining more salt and fluid in the body. These fluids may accumulate in different parts of the body, mainly in the legs, feet, ankles leading to congestion in the body. This very condition in medical terminology is referred to as congestive heart failure. 

Different causes can contribute to the onset of such a fatal condition. Some of them are

Coronary artery disease: In such a condition, the arteries supply insufficient amount of oxygen and blood to the heart. Subsequently, the heart receives scanty amount of nutrients and oxygen.
Heart attack: The sudden, unanticipated blockage of the coronary artery and the ensuing stoppage of the flow of the blood lead to a heart attack. The heart muscles are damaged in such a case and prevent the proper functioning.
Diseases: Though the term may be generic and over expansive, most of the ailments which people suffer from tend to manifest themselves by posing a potential threat to the functioning of the heart. A high blood pressure, kidney disease, even a thyroid disease can cause congestive heart failure.
Every disorder is preceded by certain symptoms, and congestive heart failure is no different. Some of them are

Fatigue: This is one of the most perceptible symptoms of congestive heart failure. One of the earliest premonitions of an impending heart failure is a nagging sense of weariness and lethargy.
Swelling: As the condition is characterized by accumulation and build-up of fluids in various part of the body, swelling is an inevitable symptom of this condition and a clear indication of the ailment.

Congestive Heart Failure - Factors that Make it Fatal

A brain stroke can affect anyone at any point of time when the supply of blood to the brain is interrupted. It can threaten major physical functions and can prove to be fatally dangerous at times. The brain stem which is placed right above the spinal cord controls the breathing, heartbeat and levels of blood pressure. It is also in charge of controlling some elementary functions such as swallowing, hearing, speech and eye movements. 

What are the different types of strokes?
There are three main kinds of stroke: ischemic strokes, hemorrhagic strokes and transient ischemic attacks. The most common type of brain stroke is the ischemic stroke is caused by narrowing or blocking of arteries to the brain, which prevents the proper supply of blood to the brain. Sometimes it so happens that the blood clot that has formed elsewhere in the body have travelled via the blood vessels and has been trapped in the blood vessel which provides blood to the brain. When the supply of blood to a part of the brain is hindered, the tissue in that area dies off owing to lack of oxygen. The other variant of brain stroke is termed as hemorrhagic stroke is caused when the blood vessels in and around the brain burst or leak. Strokes need to be diagnosed and treated as quickly as possible in order to minimize brain damage.  Remembering the F.A.S.T. acronym can help with recognizing the onset of stroke (Face, Arms, Speed, Time - explained below). 

What are the common symptoms of a brain stroke?
The symptoms of the brain stroke are largely dependent on the area of the brain that has been affected. It can interfere with normal functioning, such as breathing and talking and other functions which human beings can perform without thinking such as eye movements or swallowing. Since all the signals from the brain as well as other parts of the body traverse through the brain stem, the interruption of blood flow often leads to numbness or paralysis in different parts of the body.

Who is likely to have a stroke?
Anyone is at a risk of developing brain stroke although ageing is directly proportional to the risk of having a stroke. Not only that an individual with a family history of brain stroke or transient ischemic attack is at a higher risk of developing stroke. People who have aged over 65 accounts for about 33 percent of all brain strokes. It is important to point here that individuals with high blood pressure, high blood sugar, cholesterol, cancer, autoimmune diseases and some blood disorders are at a higher risk of developing brain stroke.

There are a few factors which can increase the risk of developing stroke beyond any control. But there are certain lifestyle choices as well which aids in controlling the chances of being affected by stroke. It is crucial to refrain from long-term hormone replacement therapies as well as birth control pills, smoking, lack of physical activity, excessive use of alcohol and drug addiction. A brain stroke is a life-threatening medical condition, and when an individual has symptoms that resemble that of stroke, it is crucial to seek immediate medical help.

Treatment for stroke

Treatment depends on the type of stroke.
Ischemic strokes can be treated with 'clot-busting' drugs.
Hemorrhagic strokes can be treated with surgery to repair or block blood vessel weaknesses.
The most effective way to prevent strokes is through maintaining a healthy lifestyle.
What is TPA?
TPA is a thrombolytic or a  Clot Buster  drug. This clot buster is used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain. It is given by intravenous (IV). This can be given only within 4.5 hrs of the onset of symptoms

Time is brain

Remember Every second Loss means brain cells die.
Rush to the nearest Stroke Centre whenever you experience such symptoms.
U can save the brain cells dying if you reach within 4.5 hrs by the CLOT BUSTER. 
Endovascular procedures 
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try  removing a large blood clot by sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain

Stroke prevention
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including 

High blood pressure,
Cigarette smoking,
Diabetes
Atrial fibrillation and
Physical inactivity.
More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control. 
Rehabilitation
The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.

Brain Stroke - Things You Must Know!

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!

Don't wait any longer, manage your Cardiologist online with a Lybrate doctor today

Consult for Cardiologist - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES