Chronic Dyspnea

Management

Determining the Cause

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Pulmonary congestion occurs when there is an accumulation of fluid in the lungs, often due to left-sided heart failure or other conditions affecting pulmonary circulation. Common symptoms include:

1. Respiratory Symptoms

   • Shortness of breath (dyspnea): Especially during exertion or when lying flat (orthopnea).
   • Paroxysmal nocturnal dyspnea (PND): Sudden shortness of breath that awakens you from sleep.
   • Cough: Often dry but can produce frothy or blood-tinged sputum in severe cases.
   • Wheezing: Often referred to as "cardiac asthma" due to fluid-related narrowing of airways.

2. General Symptoms

   • Fatigue: Due to poor oxygenation and reduced cardiac output.
   • Chest discomfort: Feeling of heaviness or pressure (not necessarily pain).

3. Physical Signs

   • Crackles (rales): Heard on auscultation, particularly at the lung bases.
   • Tachypnea: Increased breathing rate to compensate for reduced oxygen exchange.
   • Cyanosis: Bluish discoloration of lips or extremities in severe cases.
   • Peripheral edema: Suggestive of concurrent right-sided heart failure.

If you or someone else is experiencing these symptoms, particularly shortness of breath or pink, frothy sputum, it’s important to seek medical attention immediately, as this can indicate acute pulmonary edema, a medical emergency.