Clinical Case Database / Category: Patient Management
Functional and psychological aspects of breathlessness
Publication details
N Pargeter, L Stonehewer, AH Mansur
Foundation Years Journal, volume 5, issue 9, p.34 (123Doc Education, London, October 2011)
Abstract
Acute dyspnoea or breathlessness is one of the commonest presenting complaints to emergency or acute medical departments. The causes vary widely from respiratory to cardiac or haematological diseases. However, functional disorders often associated with anxiety or depression or other psychological diseases can present with breathlessness. This is not uncommon, but often not appropriately diagnosed and mistreated with harmful side-effects, due to general lack of recognition of this aspect of breathlessness. Some of the common presentations are the clinical entities of vocal cord dysfunction (VCD), hyperventilation syndrome (HVS) and dysfunctional breathing (DB). Any of these may present alone or as an epiphenomena to another disease such as refractory asthma. Awareness of foundation doctors of these conditions and what would be required to make diagnosis and arrange treatment plans is crucial to the initiation of proper management and the avoidance of harmful inappropriate interventions. In this article we present some illustrative cases and provide general tips to foundation doctor trainees on this subject.
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Authors
N Pargeter
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L Stonehewer
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AH Mansur
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References
1. Staudenmayer H, et al. Mass Psychogenic Illness: Psychological Predisposition and Iatrogenic Pseudo-vocal Cord Dysfunction and Pseudo-reactive Airways Disease Syndrome. Med Toxicol 2011 Feb 8 ahead of print.
2. Benninger C, et al. Vocal cord dysfunction and asthma. Curr Opin Pulm Med, 2011, 7: 45-9.
3. Ken K, et al. What do we know about vocal cord dysfunction. Eur Resp J. 2011, 37: 194-200.
4. vanSteeke et al. Diagnostic tests of hyperventilation syndrome. Eur Resp J. 1991, 4: 393-9.
5. Castro PF, et al. Chronic hyperventilation syndrome associated with syncope and coronary vasospasm. Am J Med. 2000,109: 78-80.
6. Courtney R, et al. Medically unexplained dyspnea: partly moderated by dysfunctional (thoracic dominant) breathing pattern. J Asthma. 2011, 48: 259-65.
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About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.