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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.
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.
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.
Bendopnea should be distinguished from orthopnea (shortness of breath while lying down), trepopnea (shortness of breath while lying on one side), and platypnea (shortness of breath relieved by lying down and worsened when upright) with or without orthodeoxia (oxygen desaturation).
Shortness of breath (SOB), known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity", and recommends evaluating dyspnea by assessing the intensity of its distinct ...
The doctor injects a local anesthetic into the area of the chest wall outside where the fluid is. A plastic tube is then inserted into the chest between two ribs. The tube is connected to a box that suctions the fluid out. A chest x-ray is taken to check the tube's position. A chest tube is also used to drain blood and air from the pleural space.
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Auscultation shows crackles or wheezing. Oxygen saturation usually shows hypoxemia. In most cases chest radiological examination shows signs of pulmonary edema, but a significant minority have a normal initial chest X-Ray. [3] Rapid resolution of initial signs and symptoms within 48 hours is typical.