Shortness of breath and weakness

Dyspnea and weakness is a common complaint that forces patients to consult doctors. Step-by-step diagnosis based on the analysis of complaints and features of clinical symptoms, as well as the use of additional diagnostic methods, allows to determine the cause of this pathological condition and prescribe appropriate treatment.

Dyspnea - a subjective feeling of lack of air, is among the top ten most common complaints of patients coming to see a general practitioner or family doctor.

Pathological weakness - subjective feeling of lack of energy, unmotivated fatigue, unnatural for the body, not associated with the performance of large and complex work or the end of the work day.

Causes of the shortness of breath and weakness

Dyspnea and weakness can be both pathological and physiological symptoms. Physiological symptoms are caused by physical overload or excessive excitement, which can be considered a variant of the norm. Sometimes this also happens in allergic reactions.

Weakness and dyspnea on exercise in the elderly is due to a decrease in physical adaptive tolerance and a weakening of respiratory performance in general. Age-related changes lead to loss of physical strength of respiratory muscles. As a consequence, gas exchange deteriorates, breathing becomes more difficult.

In addition, in old age, as a rule, people have a different number of cardiovascular and pulmonary pathologies, which also contributes to the appearance of the corresponding symptoms. There is often weakness, shortness of breath when walking uphill, on stairs, or during walking at an accelerated pace.

Among the pathologic causes of dyspnea and weakness are these major problems:

• Diseases of the Respiratory System.
• Cardiovascular Pathologies.
• Severe infectious diseases.
• Nervous system disorders.

The first group includes bronchial, pulmonary diseases, respiratory failure, disorders of diaphragmatic function, pleurisy, chest and spinal column curvatures, pulmonary hypertension and pulmonary embolism.

A separate group distinguishes cardiovascular disorders - in particular, hypertension, mitral stenosis, ischemic heart disease, cardiomyopathies, postinfarction cardiosclerosis.

Other reasons include:

• intoxication;
• infectious pathologies;
• Acidosis (acid-base imbalance, which may be associated with diabetes mellitus or kidney failure);
• allergic processes;
• neuroses, hysteria, panic attacks;
• strokes, brain injuries.

Dyspnea and weakness, which appear for no apparent reason and at rest, can be considered an alarming symptom that requires mandatory medical consultation and additional examination.

Risk factors

The main risk factors for dyspnea and weakness are considered to be:

• old and senile age;
• respiratory disorders of acute and chronic course (pneumonia, coronavirus infection, bronchial asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, tumor processes, etc.);
• Cardiovascular pathologies (arrhythmias, coronary heart disease, hypertension, heart failure);
• intoxications (food, chemical, and carbon monoxide poisoning);
• Blood diseases (particularly anemia).

At-risk groups include:

• people whose direct relatives have or have had problems with the respiratory and cardiovascular system (hereditary predisposition);
• heavy smokers;
• patients prone to developing allergies;
• people who, due to their profession, regularly come into contact with dust, acid and alkaline vapors, coal, asbestos, etc., work in smoky, unventilated rooms;
• overweight individuals;
• weakened patients, with low immunity, frequently ill.

Pathogenesis

Dyspnea (dyspnea) is accompanied by a feeling of air shortage, and in severe cases - suffocation. If breathing difficulties occur during physical exertion or strong psycho-emotional tension, then this condition can be called natural, normal for the body, as it is due to increased oxygen demand. In other cases, shortness of breath and weakness are spoken of as a sign of a pathological condition.

The above-mentioned physiological dyspnea is an adaptive mechanism, which is accompanied by changes in the depth, frequency, rhythm of respiratory movements. The condition can manifest itself with intense physical activity, when climbing stairs. In addition, difficulty breathing with weakness can be felt in conditions of thin air (high in the mountains): in such a situation, the mechanism is explained by the body's attempt to eliminate oxygen deficiency.

Physiological shortness of breath and weakness do not pose a danger to health, but the appearance of these symptoms at rest is a clear manifestation of any pathology, which is important to identify in time to avoid further aggravation of the disease process.

It should be understood that difficulty breathing against a background of weakness is not a separate disease, but only symptomatology, indicating certain violations in the body.

The following types of dyspnea are distinguished:

• expiratory (associated with a decrease in the lumen of small bronchi, accompanied by problems with exhalation);
• Inspiratory (caused by a decrease in the lumen of the trachea and bronchi, accompanied by breathing problems);
• mixed (occurs in lung or heart disease, accompanied by difficulty in both exhaling and inhaling).

A person with shortness of breath and weakness can not breathe normally, he feels discomfort, dizziness. In severe cases, choking and loss of consciousness may occur. It is important for doctors to take into account the severity of breathing difficulties and the frequency of attacks. These factors may indicate the development of serious pathologies of both the respiratory system and the cardiovascular apparatus.

Epidemiology

Dyspnea and weakness is one of the most common symptom combinations, occurring in 20-30% of people worldwide. In many patients, these signs are detected during the diagnostic history of other diseases. The physiologic form of dyspnea and weakness occurs at least once in a lifetime in almost every person.

The problem is not characterized by any specificity, although according to statistics, such symptoms are most often registered in winter and summer. In winter, the appearance of shortness of breath with weakness is associated with an increase in the incidence of colds and viral diseases, in which the body is significantly weakened and exhausted. In summer, the problem is caused by increased air dustiness, increased temperature, increased stress on the body, which in general requires increased oxygen content in the blood.

In female representatives of the female sex shortness of breath and weakness is noted more often than in men, which can be explained by a more sensitive nervous system.

Young people are less likely to experience this problem, in contrast to the elderly and the elderly: in those who have crossed the threshold of 65-70 years, dyspnea and weakness are found almost 3 times more often than in patients 35-60 years.

The most common cause of this disorder is cardiovascular pathologies.

Symptoms

Dyspnea is reported when the rhythm, depth and frequency of breathing are disturbed, inhalation or exhalation becomes atypically deep and difficult. At the same time, the resulting weakness indicates that the problem is negatively affecting the condition of the whole body.

In moments of intense physical activity, weakness and breathing difficulties can also occur in healthy people - for example, this often happens when walking up stairs for long periods of time. In many cases, however, functional disorders and diseases are the cause.

Conditions in which dyspnea and weakness occur require special attention:

• at rest, during the night's rest;
• during habitual physical activity that has not previously been accompanied by the appearance of these symptoms;
• with a fever, cough.

Dyspnea and weakness caused by diseases of the respiratory system (bronchitis, pneumonia, respiratory failure, pleurisy, kyphoscoliosis) are accompanied by the following signs:

• a labored and prolonged exhalation;
• tension of the accessory muscles on the inhalation;
• protruding cervical vessels on exhalation with their recession on inhalation and retraction of the intercostal spaces simultaneously;
• dry wheezing;
• The onset of coughing, without subsequent relief.

First signs of vascular pulmonary abnormalities:

• The appearance of dyspnea and weakness depends on the position of the body. In the case of pulmonary embolism, in addition to palpitations and chest pain, sitting does not improve the feeling of well-being.
• Skin and mucous membranes become bluish, which is associated with oxygen deficiency or slow blood circulation. In this case, shortness of breath and weakness are most often intense.
• Disorders of consciousness, unilateral edema of the lower extremity even against the background of slight dyspnea and weakness often indicates pulmonary artery thrombosis. This sign is serious enough and requires urgent medical attention, as there is a real danger of vascular spasm with the development of acute cardiac and respiratory failure with hypoxia. Failure to provide assistance may result in death.

If the patient has "wheezing" dyspnea on the background of weakness, it may be a sign of laryngeal stenosis. This occurs in laryngitis, anaphylaxis, or when a foreign body penetrates into the respiratory tract.

Symptoms by which you can suspect problems from the cardiovascular system:

• orthopnea - dyspnea, worsening in the supine position, especially at night, which is associated with circulatory disturbances in the small circle;
• shortness of breath and weakness during walking or other physical activities previously habitual;
• Swelling associated with impaired cardiac contractility and fluid stasis;
• protrusion of neck veins in sitting position, which is caused by increased pressure in the right atrium.

Cardiac type of shortness of breath and weakness is typical of mitral stenosis, hypertension, cardiomyopathy, cardiosclerosis, ischemic heart disease.

Pulmonary fibrosis is characterized by:

• prolonged labored breathing;
• rapid breathing, a person cannot pronounce a phrase in "one breath";
• appearance of lividity of the skin and mucous membranes even with a little physical activity.

Heart palpitations, fever, dizziness, fatigue, general weakness, sweating, heart pain, chest pain do not occur only in heart and lung disorders. Other possible and quite common causes are severe intoxication, infectious pathologies, acidosis, nervous system disorders, hyperventilation syndrome, and so on. It is important to pay attention to the problem in time and consult a doctor.

Diagnostics of the shortness of breath and weakness

To diagnose the causes of shortness of breath and weakness, the doctor collects information about symptoms, complaints, and patient's life history. Then conducts a physical examination, assesses the general condition, listens to the work of the heart and lungs, measures body temperature, pulse rate and respiration. In the course of diagnostic measures, attention is necessarily paid to the presence of signs of infectious-inflammatory processes, cardiovascular and pulmonary diseases.

To clarify the diagnosis, appropriate laboratory and instrumental diagnostics is prescribed:

• general blood tests and urine for signs of inflammation and infectious processes, anemia;
• a study of oxygen and carbon dioxide levels in the blood;
• Chest X-ray (helps detect lung changes, tumor or inflammatory processes, presence of fluid);
• computed tomography (provides a layer-by-layer detailed image of tissues and organs);
• spirography, spirometry, bicycle ergometry;
• electrocardiography;
• ultrasonography.

Diagnostic measures are prescribed individually, depending on the presumed root cause of unpleasant symptoms. The results are interpreted and a preliminary and final diagnosis is made.

Differential diagnosis

In clinical practice, doctors most often encounter symptoms of chronic dyspnea and weakness, so differential diagnosis should be carried out, first of all, with cardiac, respiratory, cardiac-respiratory and indirect causes of this pathological sign. Analyzing complaints and anamnesis, special attention should be paid to how the patient himself describes dyspnea and weakness, how quickly the symptoms develop, how they change depending on the position of the body, ambient temperature, humidity.

Pathologies and conditions that should be considered as part of the differential diagnosis:

• bronchial obstruction;
• Bronchospasm;
• restrictive pulmonary pathologies;
• pulmonary hypertension;
• pneumonia;
• bronchial asthma;
• obesity;
• pleural effusion;
• neuromuscular pathologies, neuroses, neurosis-like conditions;
• pronounced degree of spinal curvature;
• Cardiovascular pathologies (myocardial dysfunction, valve defects);
• anemia;
• thyrotoxicosis;
• acidosis (in diabetes mellitus, renal failure);
• panic attacks, alveolar hyperventilation, etc.

Treatment of the shortness of breath and weakness

If shortness of breath and weakness appeared suddenly, and the condition gradually worsens, it is necessary to necessarily and urgently contact a doctor. While waiting for help, it is desirable to perform the following manipulations:

• provide fresh air;
• Provide the patient with a comfortable position in which dyspnea is minimized;
• take your blood pressure and pulse;
• Do not take any medication until the doctor arrives.

Dyspnea and weakness can be signs of different pathologic conditions, so approaches to therapy also differ significantly.

Thus, patients with heart failure are often prescribed diuretics, and in ischemic heart disease - statins, nitrates, beta-adrenoblockers. If anemia is diagnosed - vitamin and mineral complexes, iron preparations are used.

For the treatment of bronchial asthma, a multistage individualized approach is used, including inhalation of beta-adrenomimetics, corticosteroid hormones, m-choline blockers. Short- or long-acting bronchodilators are indicated for chronic pulmonary obstruction. Inflammatory diseases, such as pneumonia, require extended antibiotic therapy.

Complications and consequences

Dyspnea and weakness are symptoms that accompany many pathological conditions. If ignored, they can develop serious complications directly related to the causes of the disorder:

• pneumonia;
• bronchial asthma;
• Pulmonary atelectasis;
• heart failure.

If shortness of breath and weakness do not go away for several days, or gradually worsen, or are accompanied by other pathological signs (pain, fever, etc.), it is necessary to seek medical help.

It is also necessary to visit a doctor if shortness of breath and weakness appear against the background of habitual physical activity, although previously this was not observed.

These symptoms require special attention:

• severe chest pain;
• hemoptysis;
• nocturnal choking attacks;
• attacks tachycardia, arrhythmias.

Difficulty in breathing can lead to hypoxia, a condition in which there is insufficient oxygen supply to tissues and organs. Signs of hypoxia are:

• impaired motor coordination, unsteady gait, muscle twitching;
• pallor or lividity of the skin;
• agitation or lethargy;
• nausea, vomiting, dizziness;
• blurring or loss of consciousness.

In the most severe cases of hypoxia, brain edema can develop.

Prevention

A healthy lifestyle is the basis for preventing the development of shortness of breath and weakness. It is important to pay special attention to keeping fit and strengthening the body.

• A healthy diet is a sufficient intake of nutrients and vitamins, especially ascorbic acid, tocopherol, vitamin D, which support the immune system. The diet should contain a sufficient amount of vegetables, herbs, fruits.
• A healthy lifestyle includes adequate sleep, physical activity, avoiding alcohol and smoking.
• Sufficient drinking regime helps to optimize the work of internal organs, helps in the work of immunity.
• By countering stress, you can strengthen your immune system and prevent vulnerability to infections.
• Vaccination is an effective way to fight off the most dangerous infections.
• Hygiene, regular cleaning, ventilation, moisturizing the air, avoiding contact with tobacco smoke, sources of allergies and infections are important parts of prevention.

Strengthening the immune system and improving cardiovascular function is an important step in preventing the development of symptoms such as shortness of breath and weakness. For normal functioning, the body needs sufficient quality nutrition, physical activity, and a minimum of stress and toxic influences. Care for your own health should be constant, and if you have any suspicious symptoms, you should see a doctor without delay.