Hyperventilation syndrome

Hyperventilation syndrome (Da Costa syndrome, effort syndrome, nervous respiratory syndrome, psychophysiological respiratory reactions, irritable heart syndrome, etc.) has attracted the attention of many researchers in recent years due to its frequency and the important role it plays in the formation of numerous clinical manifestations.

Hyperventilation syndrome can be defined as a pathological condition manifested by polysystemic mental, vegetative (including vascular-visceral), algic and muscular-tonic disorders, disturbances of consciousness associated with primary dysfunction of the nervous system of psychogenic or organic nature, leading to disorders of normal and the formation of a stable pathological breathing pattern, which is manifested by an increase in pulmonary ventilation inadequate to the level of gas exchange in the body.

Most often, hyperventilation syndrome has a psychogenic nature.

Hyperventilation syndrome or prolonged persistent hyperventilation can be caused by numerous reasons. It is advisable to distinguish three classes of such reasons (factors):

1. organic diseases of the nervous system;
2. psychogenic diseases;
3. somatic factors and diseases, endocrine-metabolic disorders, exogenous and endogenous intoxications.

In the vast majority of cases, the main causes that determine the occurrence of hyperventilation syndrome are psychogenic. Therefore, in most publications, the term hyperventilation syndrome implies a psychogenic basis. However, not all researchers agree with this assessment.

Causes and pathogenesis of hyperventilation syndrome

Among the numerous symptoms of hyperventilation syndrome, five leading ones can be identified:

1. vegetative disorders;
2. changes and disturbances of consciousness;
3. muscular-tonic and motor disorders;
4. pain and other sensory disturbances;
5. mental disorders.

The complexity of the symptoms of hyperventilation syndrome is related to the fact that the complaints presented by patients are non-specific. The classic ("specific") triad of symptoms - increased breathing, paresthesia and tetany - only minimally reflect the richness of the clinical picture of hyperventilation syndrome. Although a bright hyperventilation crisis (hyperventilation attack) sometimes causes serious diagnostic difficulties, it is nevertheless accepted that acute hyperventilation paroxysm is easy to recognize. Clinical manifestations of hyperventilation crisis or paroxysm are presented below.

Hyperventilation Syndrome - Symptoms

Treatment of hyperventilation syndrome should be comprehensive. Correction of mental disorders is carried out using psychotherapeutic influence. Of great importance is the "reconstruction" of the internal picture of the disease, demonstration (this is easily done using hyperventilation provocations) to the patient of the connection between clinical manifestations and respiratory dysfunction. The impact on the neurophysiological and neurochemical bases of the mechanisms of hyperventilation syndrome is realized by prescribing psychotropic, vegetotropic drugs and drugs that reduce neuromuscular excitability.

As means of reducing neuromuscular excitability, drugs regulating calcium metabolism and magnesium metabolism are prescribed. The most commonly used are ergocalficerol (vitamin D2) at a dose of 20,000-40,000 IU per day enterally for 1-2 months, calcium gluconate, calcium chloride. Other calcium preparations (tachystin, AT-10) and preparations containing magnesium (magnesium lactate, potassium and magnesium aspartate, etc.) can also be used.

Hyperventilation Syndrome - Treatment

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