Expiratory dyspnea occurs when bronchospasm occurs. In this case, the patency of the small bronchi is impaired. The bronchioles narrow, a secret builds up in them, and the mucous membrane swells.
Types of Dyspnea
Difficulty breathing doctors often call dyspnea. This is
a respiratory function
disorder that occurs in a number of diseases. Dyspnea may be inspiratory. It is characterized by difficulty breathing. This type of dyspnea can occur with heart failure or with damage to the upper respiratory tract. It may appear due to spasm of the bronchi, accumulation of pathological secretions, tumors that compress the airways, and swelling of the mucosa.
A slowed out exhalation, at which a small whistle can be heard, is a sign that expiratory dyspnea has begun. It occurs with swelling of the mucous membrane, accumulation of secretion in the bronchioles or the appearance of obstacles that worsen the patency of the small bronchi.
There is also mixed dyspnea. It is characteristic of acute respiratory failure.
It should be understood that shortness of breath - inspiratory and expiratory - is caused by various reasons. Therefore, approaches to the treatment of these conditions differ.
Causes of expiratory dyspnea
People suffering from bronchial asthma or frequent obstructive bronchitis know what symptoms accompany these diseases. One of their main symptoms is the appearance of shortness of breath. It is characterized by slow expiration, which is accompanied by a whistle. The chest is practically not involved in breathing. She is constantly in the position characteristic of inspiration.
Espiratory dyspnea is characteristic of diseases such as:
- bronchial asthma;
- bronchiolitis or obstructive bronchitis;
- chronic lung epizema, characterized by loss of tissue elasticity;
- bronchial tumors;
- COPD;
- pneumosclerosis of the lungs.
It can also appear when a foreign body enters the respiratory tract. But when an obstacle appears in the trachea and larynx, inspiratory dyspnea appears. But with narrowing of the large bronchus and trachea, both inhalation and exhalation are difficult.
Characteristic signs
With impaired
lung function, expiratory dyspnea may appear. In this case, inhalation is performed normally, and exhalation is difficult. To release air from the lungs, the patient is forced to exert effort. The respiratory muscles begin to work more actively.
Many complain of pain in the chest area. Lip cyanosis can also develop, the skin noticeably turns pale. People with this type of dyspnea often have excessive sweating. When the situation worsens, the skin may acquire a gray tint, weakness is noticeably increasing.
Despite the fact that expiratory dyspnea is difficult to exhale, the patient may start an asthma attack. But dyspnea can be unexpressed. The intensity of the manifestations of shortness of breath will depend on the reasons for which it appeared, on the stage of the disease, the presence of sputum.
With the development of this type of dyspnea, air can enter the lungs, but due to edema and spasm of the walls of the bronchi, it does not completely exit. Often the situation is complicated by the accumulation of viscous mucus.
Clinical signs
It is not always possible to understand that the patient began to have breathing problems. In order to pay attention in time and notice the onset of an attack before complications occur, you need to know the signs of expiratory dyspnea.
One of the main points that you should pay attention to is the output length. It is noticeably increasing. In some cases, its duration may exceed the length of the inspiration by 2 times. Exhalation is accompanied by significant muscle tension. Symptoms of changes in intrathoracic pressure also appear. This is evidenced by the bulging and subsidence of the intercostal spaces. At the same time, as you exhale, the veins of the neck become visible.
Expiratory dyspnea is characteristic of bronchial asthma. With a long course of this disease, you can notice a characteristic box-shaped sound that occurs due to excessive accumulation of air. Indeed, at the same time, the movement of the diaphragm is limited. When tapping certain sections of the chest, you can notice that the borders of the lungs are lowered.
But there are other signs of expiratory dyspnea, which can be noticed by people without a medical education. When exhaling, you can hear a slight whistle or a characteristic crunchy sound (crepitus). In some cases, it is even audible from a distance.
Disease symptoms
Given that expiratory dyspnea is a sign of the development of some of the diseases of the respiratory tract, one must understand how the disease should be determined.
For example, if a patient has obstructive bronchitis, then his characteristic sign is not only the development of respiratory failure, but an increase in temperature. In addition, the patient has increased weakness, pallor of the skin, acrocyanosis. The bluish color of the skin manifests itself in areas of the body remote from the heart: fingers and toes, auricles, lips, tip of the nose.
But often this symptom is a sign that asthma has begun. Expiratory dyspnea occurs with an exacerbation of this disease. In most cases, it begins by contact with an allergen. The disease is seasonal. But deterioration can occur when inhaling tobacco smoke or other pungent substances. Sometimes exacerbation of asthma is associated with increased physical activity. Often attacks begin in the morning or evening hours.
Diagnostics of problems
In some cases, it is necessary to conduct special examinations to understand the nature of the shortness of breath that appears. Especially dangerous is its occurrence in childhood. In babies, expiratory dyspnea is often noted with obstructive bronchitis. In this case, you need to seek help at the hospital. A medical institution can not only accurately determine the diagnosis, but also provide the necessary qualified assistance.
To determine the nature of dyspnea, you can use radiography, ECG, echocardiography. A study of the gas composition of the blood is also shown. The degree of bronchial obstruction can be detected by measuring the vital volume of the lungs or by performing pneumotachometry.
First aid
If you or a person in your environment suffers from asthma attacks, then you need to know what can be done before the doctors arrive. First of all, such a patient must be seated and try to calm him down. Stress leads to increased heart rate and an increase in oxygen consumption and a number of nutrients. Because of this, expiratory dyspnea may begin to develop more strongly.
The room in which the patient with an attack of dyspnea is located should be well ventilated. In addition, attention should be paid to air humidity. If it is excessively dry, it is advisable to put a pot or kettle of water on the fire and open the lid. You can also hang wet towels or sheets.
Necessary treatment
If the cause of shortness of breath is a spasm, then bronchodilators can help. People with asthma should always have inhalers on hand. Such patients during seizures should use antagonists of leukotirene receptors,
monoclonal antibodies, and cromons. If the patient is not prescribed the appropriate therapy, then over time, his sensitivity to bronchial dilators (substances that relax smooth muscles and increase their clearance) may decrease. Because of this, the patient may have uncontrolled attacks of shortness of breath.
Such drugs as Salbutamol, Berotek, Ventolin, Metaprel, Fenoterol, Berodual, Terbutaline can be used to relieve spasm. But each of these medicines has side effects and contraindications. Therefore, the selection of the right drug must be carried out together with the doctor.
In obstructive bronchitis, inhalations are also prescribed, because this disease is characterized by the fact that there is expiratory dyspnea. The plan of nursing interventions in this case is to ensure bed rest for the patient, limiting physical activity and organizing the treatment process. The nurse must monitor compliance with all doctor's prescriptions.
Preventative measures
In some cases with respiratory diseases, the development of an attack can be prevented. To do this, follow the recommendations of doctors. They come down to the fact that it is necessary:
- give up smoking and other bad habits, avoid visiting places where there may be tobacco smoke;
- minimize contact with possible allergens, including household chemicals;
- conduct hardening, vitamin therapy;
- to reconsider a way of life, to devote sufficient time to nutritious nutrition and rest;
- with the development of bronchitis, use expectorants;
- when attaching a bacterial infection, use antibiotics.
Compliance with the recommended preventive measures and the rapid start of treatment in the event of an attack contribute to the fact that the patient will be able to control dyspnea. It is also important to remember that expiratory dyspnea occurs with respiratory diseases due to narrowing of the small bronchi. Symptomatic therapy should be aimed at relaxing smooth muscle.