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What Is Paroxysmal Nocturnal Dyspnea?

In the beginning, yes, this is a tongue-twister. I had to go through several attempts before I was able to pronounce it correctly and not forgetting that the sound is like that of a frightening zombie! What does it mean? To put it in a simple way: Paroxymal means an attack or sudden outburst in which night is the main theme and dyspnea means the shortness in breath. All together, Paroxysmal Nocturnal Dyspnea (PND) is the feeling of a lack of oxygen during sleep The lack of oxygen causes one to cough and wheeze that can cause diastolic blood pressure to rise.

This doesn’t mean it’s an epidemic however, many would say it’s scary. PND is a frequent sign of heart failure that is congestive. Anyone suffering from PND is likely to require immediate medical attention. Calling an ambulance as the initial priority, but other methods to treat the symptoms could include diuretics and nitroglycerin.

PND is characterized by similar symptoms to those of obstructive sleep apnea disorder (OSA) but is not a distinct disorder. PND is distinct and is a serious clinical condition that is directly linked to acute heart failure.

People who suffer from obstructive sleeping apnea syndrome suffer from a dramatic reduction in the muscle tension of the respiratory tracts while they sleep, leading to obstruction of the airways. The result is apnea episodes when breathing stops completely.

When these pauses occur in between, the oxygen level of blood decreases, and signals are sent to the respiratory system that tissues are experiencing hypoxia. Within 10 to 20 seconds, the oxygen content in the blood falls to a minimum which causes the body to respond to the condition. Microstimulation of the brain enhances the tension in the respiratory tract, which assists in breathing. In the following few seconds the sleeping person’s breathing remains deep and frequent. At this point the individual also feels shortness of breath. However, they might not be able to wake up.

Paroxysmal Nocturnal Dyspnea Causes?

A disorder called paroxysmal nocturnal dyspnea can be found for people over the age of 65 with heart issues, but it is still a possibility for any person suffering from:

  • left ventricular dysfunction during the course of an exacerbation
  • acute myocardial infarction
  • acute myocarditis
  • aneurysms that occur in the heart;
  • postpartum cardiomyopathy;
  • cardiosclerosis;
  • mitral stenosis;
  • Aortic insufficiency
  • the presence of a significant intracardiac tumor or thrombus.

The factors that may be the cause of an PND episode in a patient who suffers from the medical conditions listed above are:

  • pneumonia;
  • kidney damage;
  • conditions of the cerebral circulation
  • emotional overwork;
  • large dinner to enjoy the evening;
  • hypervolemia;
  • Rapidly shifting from vertical position into horizontal position of the body.

What are the Symptoms of Paroxysmal Nocturnal Dyspnea?

The most frequent manifestations of PND are as follows:

  • intermittent sleep;
  • dyspnea by physical exercise
  • dyspnea during the night when lying position, however, it is relieved when sitting;
  • A cough that is wheezing or snoring;
  • the production of sputum, and sometimes with blood;
  • The lungs are whirling;
  • an unending sense of a lack of air.
  • chest pain;
  • arrhythmia;
  • feet are swelling;
  • tiredness and drowsiness.

The typical episode is like this: a person awakes from a nightmare, experiencing chest tightness and a desire to lie down. Their breathing is strong and deep. A narrowing of the bronchioles causes breathing problems that makes it difficult to speak. When sitting, a person tends to lean forward a bit. The skin turns pale as a result of the spasms of their vessels on the surface, and occasionally they begin to sweat. PND can begin abruptly and stop quickly in just half an hour. It is possible that a patient will be experiencing dyspnea during the morning, when they awake.

What is the reason why Paroxysmal Nocturnal Dyspnea cause these symptoms?

In the course of sleep for a patient who has heart problems the body fluid starts to flow out of tissues to blood, which is then during the day can be found in abdomen or legs. The process doesn’t happen fast, and after a person has fallen asleep, there will be no immediate signs. The symptoms of dyspnea can develop slowly over an extended period of time following having fallen asleep.

For people suffering from heart failing the left side the heart doesn’t function fully, which means that the blood circulation can’t handle the extra amount of fluid. The extra volume is stored in extra vessels in the lungs. This extra volume moves from the vessels to the tissue of lung, leading to the development of interstitial lung Edema.

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