Dyspnea, defined as uncomfortable or labored breathing, is a common and often devastating cause of distress for patients and their caregivers with advanced cancer and other life-threatening illnesses. The mechanism by which dyspnea develops is not fully understood, but it involves integration of the central respiratory complex with the sensory (perceptual) cortex. The gold standard of diagnosis is patient self-report. Careful assessment should be undertaken to identify reversible existing causes. Systemic opioids are the first-line therapy for symptomatic management, along with other general comfort measures (positioning, cool air, calming environment). Medical or surgical management can be directed toward underlying causes. Advanced care planning should include discussions concerning the burdens and benefits of medical/surgical management of underlying causes of dyspnea to more effectively direct goals of care. This article reviews current literature on dyspnea, with a focus on items published since 2000.
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http://dx.doi.org/10.1097/00130404-200609000-00006 | DOI Listing |
J Vet Diagn Invest
January 2025
Brookfield Zoo Chicago, Brookfield, IL, USA.
Bacteria in the complex and nontuberculous mycobacteria may affect a variety of animal species under human care and pose public health risks as zoonotic pathogens. A case of sudden onset of lethargy and increased respiratory effort in a 5-y-old, intact female reindeer () under managed care had progressed to severe dyspnea despite aggressive treatment. The animal was euthanized due to poor prognosis.
View Article and Find Full Text PDFOpen Heart
January 2025
Cardiology, Hospital Alvaro Cunqueiro, Vigo, Spain.
Introduction: ST-elevation myocardial infarction (STEMI) is one of the most prevalent presentations in young patients. It is essential to emphasise that each minute of delay in providing medical care is negatively correlated to the patient's prognosis. The present study was carried out to evaluate the ischaemia-reperfusion times in patients ≤40 years of age versus individuals >40 years of age and their association with mortality and major adverse cardiac event (MACE) over the long term.
View Article and Find Full Text PDFEur Clin Respir J
January 2025
Department of Clinical Medicine, Aarhus University & Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.
Diagnosis of subglottic stenosis remains greatly a challenge for physicians due to case rarity and presentation of symptoms imitating several other more prevalent medical disorders. Idiopathic subglottic stenosis most often occurs in previously healthy perimenopausal Caucasian women. Several cases have reported symptom progression and increased stenosis, during or in between pregnancies in younger women.
View Article and Find Full Text PDFPulmonary embolism (PE) is a life-threatening condition with varied presentations, occasionally mimicking ST-segment elevation myocardial infarction (STEMI). This case highlights a 52-year-old male patient with a history of venous thromboembolism (VTE) who presented with progressive shortness of breath over a month, culminating in dyspnea at rest, and anterior ST-segment elevation on electrocardiography (ECG). The initial evaluation suggested STEMI.
View Article and Find Full Text PDFCureus
December 2024
Emergency Department, Bayhealth Hospital, Dover, USA.
Subglottic stenosis (SGS) presents a rare, yet challenging condition characterized by airway obstruction below the glottis, with diverse etiologies ranging from congenital to acquired factors like intubation or autoimmune diseases. Diagnosis and management of SGS during pregnancy are particularly complex due to limited literature and diagnostic consensus. This article presents a case of a 26-year-old pregnant woman presenting with escalating dyspnea and stridor attributed to SGS, most likely secondary to idiopathic etiology.
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