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When a person is recumbent, or is lying down, blood is redistributed from the lower extremities and abdominal cavity (splanchnic circulation) to the lungs. [5] Failure to accommodate this redistribution results in decreased vital capacity and pulmonary compliance , further causing the shortness of breath experienced in PND.
Orthopnea or orthopnoea [1] is shortness of breath (dyspnea) that occurs when lying flat, [2] causing the person to have to sleep propped up in bed or sitting in a chair. It is commonly seen as a late manifestation of heart failure, resulting from fluid redistribution into the central circulation, causing an increase in pulmonary capillary pressure and causing difficulty in breathing.
An exacerbation (attack) of asthma is experienced as a worsening of asthma symptoms with breathlessness and cough (often worse at night). In acute severe asthma, breathlessness may be so severe that it is impossible to speak more than a few words (inability to complete sentences). [5] [6]
Shortness of breath can manifest as orthopnea (inability to breathe sufficiently when lying down flat) and/or paroxysmal nocturnal dyspnea (episodes of severe sudden breathlessness at night). These are common presenting symptoms of chronic and cardiogenic pulmonary edema due to left ventricular failure.
Platypnea or platypnoea is shortness of breath (dyspnea) that is relieved when lying down, and worsens when sitting or standing upright. It is the opposite of orthopnea. [1] The condition was first described in 1949 and named in 1969.
While a different cause, this has very similar symptoms, namely the immunological reaction involving release of inflammatory mediators. Inhalation of allergens in sensitized subjects develops into bronchoconstriction within 10 minutes, reaches a maximum within 30 minutes, and usually resolves itself within one to three hours.
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